Cluster-randomized controlled trial of an HIV/sexually transmitted infection risk-reduction intervention for South African men

J.B. Jemmott, L.S. Jemmott, A. O'Leary, Z. Ngwane, L.D. Icard, G.A. Heeren, X. Mtose and C. Carty

American Journal of Public Health, 2014, vol. 104, issue 3, 467-473

Abstract: Objectives. We tested the efficacy of a sexual risk-reduction intervention for men in South Africa, where heterosexual exposure is the main mode of HIV transmission. Methods. Matched-pairs of neighborhoods in Eastern Cape Province, South Africa, were randomly selected and within pairs randomized to 1 of 2 interventions based on social cognitive theory and qualitative research: HIV/sexually transmitted infection (STI) risk-reduction, targeting condom use, or attentionmatched control, targeting health issues unrelated to sexual risks. Sexually active men aged 18 to 45 years were eligible. The primary outcome was consistent condom use in the past 3 months. Results. Of 1181 participants, 1106 (93.6%) completed the 12-month follow-up. HIV and STI risk-reduction participants had higher odds of reporting consistent condom use (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.03, 1.71) and condom use at last vaginal intercourse (OR = 1.40; 95% CI = 1.08, 1.82) than did attention-control participants, adjusting for baseline prevalence. No differences were observed on unprotected intercourse or multiple partnerships. Findings did not differ for sex with steady as opposed to casual partners. Conclusions. Behavioral interventions specifically targeting men can contribute to efforts to reduce sexual risk behaviors in South Africa.

Keywords: adolescent; adult; article; cluster analysis; confidence interval; controlled clinical trial; controlled study; follow up; health promotion; human; Human immunodeficiency virus infection; male; middle aged; Negro; randomized controlled trial; risk; risk reduction; safe sex; sexually transmitted disease; South Africa; young adult, Adolescent; Adult; African Continental Ancestry Group; Cluster Analysis; Confidence Intervals; Follow-Up Studies; Health Promotion; HIV Infections; Humans; Male; Middle Aged; Odds Ratio; Risk Reduction Behavior; Safe Sex; Sexually Transmitted Diseases; South Africa; Young Adult (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301578_8

DOI: 10.2105/AJPH.2013.301578

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