Behavioral Interventions to Promote Condom Use among Women Living with HIV: A Systematic Review Update
This study updated a previous systematic review and meta-analysis (1980–2010) on behavioral interventions promoting condom use among women living with HIV. The authors broadened the previous review, including newly published studies (2010–2014). They identified recent randomized controlled trials (RCTs) or controlled studies investigating behavioral interventions that: included women living with HIV; focused on condom use promotion; presented/analyzed outcomes by gender; used a three-month follow-up or more; and considered at least one HIV-related behavioral or biological outcome. Eight studies comprising a total of 1,355 women living with HIV were included in the meta-analyses, and 13 studies were qualitatively described. The authors noted that data on how behavioral interventions affect HIV-positive women's condom use remain limited. The meta-analysis showed that behavioral interventions did not have a greater impact on consistent condom use or unprotected sex when compared to standard care or minimal support interventions. However, the qualitative syntheses showed improvements in consistent condom use and fewer unprotected sexual acts in all but one intervention. The authors suggested interpreting the findings with caution (they were based on a few small trials). They said that behavioral change interventions appear to be difficult to evaluate through RCTs and called for additional research to assess potential gains from interventions that promote safe sexual behavior.