Medical University of South Carolina, Charleston, USA. Department of HIV and AIDS, World Health Organization, Geneva, Switzerland. Today, safe sex hiv positive planners recognize that continued reliance on general HIV prevention messages may limit the effectiveness and sophistication of prevention strategies. Three previous reviews have examined behavioural interventions targeting people living with HIV.
16 However, almost all the included studies had been conducted in the United States of America. There have been no similar reviews of positive prevention interventions in developing country settings. Our review therefore had two objectives. The first was to assess the evidence for a differential effect of interventions by serostatus.
Second, we searched electronic databases specifically for positive prevention articles. Third, we hand-searched the tables of contents of four journals: AIDS, AIDS and Behaviour, AIDS Care and AIDS Education and Prevention. We also examined the reference lists of included articles to identify articles we might have missed. This process was iterated until no new articles were found. Remaining citations were then screened by two senior study staff on the basis of the inclusion criteria above.
The results were merged for comparison, and discrepancies were discussed to establish consensus. Data were entered into a systematic coding form that included detailed questions on intervention, study design, methods and outcomes. The two completed coding forms were compared and discrepancies were resolved by a third reviewer. We used standard meta-analytic methods to derive standardized effect size estimates24 and used Comprehensive Meta-Analysis V.
Meta-analysis was conducted for outcomes reported in at least three studies. For both study objectives, the only outcome that met this criterion was male condom use. 42 These 18 articles reported on 19 studies, as one article described both an individual and a couples-based intervention. 32 Seven were conducted with heterosexual adults, 1 with pregnant women and 1 with female commercial sex workers. Eight evaluated HIV counselling and testing interventions and 1 evaluated a family planning education programme.