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Utility and delivery of behavioural interventions to prevent sexually transmitted infections
- Source :
- Sexually Transmitted Infections
- Publication Year :
- 2011
- Publisher :
- BMJ, 2011.
-
Abstract
- Over the past three decades, research focus on the development and evaluation of behavioural interventions aimed at reducing the spread of sexually transmitted infections (STIs) including HIV has expanded considerably. Individual, couple and group level interventions aimed at improving condom use, HIV testing, linkage to care and retention, medication adherence, partner counselling and referral services, and decreasing number of partners have been developed and evaluated for many subpopulations.1–5 The interventions have been evaluated among African–Americans, Asian and Pacific Islanders, drug users, heterosexual adults, high-risk youth, Hispanic populations, men who have sex with men, people living with HIV, STI clinic patients, and transgender populations. However, despite their availability, behavioural interventions are inadequately utilised, and evidence of their population level impact is lacking. In this paper we discuss issues related to the utility of behavioural interventions, including questions around feasibility of implementation, scale-up and maintenance, and suggest new directions for planning, implementation, evaluation and continuous improvement of social and behavioural interventions in the context of STI and HIV prevention programmes. Most evidence on the efficacy of behavioural interventions is based on self-reported behaviour, and change in self-reported behaviour, as outcome. Assessment and reporting of sexual behaviour is subject to ascertainment and reporting bias.6 Such bias is particularly important in the context of behavioural intervention trials, because the intervention directly manipulates the desirability of certain reported behaviours, and subjects cannot be effectively blinded to the intervention. For behavioural intervention trials, STI and HIV incidence are the outcome measures of greatest interest. Unfortunately, trials that use STI and HIV incidence as outcome measure have not shown high levels of efficacy. Of the seven randomised controlled trials of behavioural interventions that measured HIV incidence as outcome, none were found to be efficacious.7 Of …
- Subjects :
- Program evaluation
social/policy perspectives
Psychological intervention
coverage
partner notification
chlamydia
law.invention
Men who have sex with men
Condoms
intervention mix
Behavior Therapy
law
behaviour systems
health services research
Sexual Partners
Infectious Diseases
Pacific islanders
epidemiology
behavioural interventions
Public Health
scale-up
medicine.medical_specialty
Referral
Sexual Behavior
sexual health
Sexually Transmitted Diseases
Context (language use)
Dermatology
Condom
Intervention (counseling)
medicine
Humans
gonorrhoea
Psychiatry
sociology
Unsafe Sex
business.industry
PID
HIV
social
heterosexual beh
genitourinary medicine services
STI
business
Delivery of Health Care
intervention systems
target populations
Supplement
Program Evaluation
Subjects
Details
- ISSN :
- 13684973
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- Sexually Transmitted Infections
- Accession number :
- edsair.doi.dedup.....80920773c86333f061fc082c57b98826