Preventing HIV Among Heterosexual African-Americans

June 30, 2008
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Behavioral HIV prevention interventions targeting heterosexual African Americans that are proven to work require several key characteristics, according to UCSF researchers.

Study lead author Lynae Darbes, Ph.D., assistant professor of medicine at UCSF's Center for AIDS Prevention Studies and Global Health Sciences, said "Peer education, skills training and cultural tailoring were critical factors we found in interventions that reduced HIV risk behaviors and led to lower rates of sexually transmitted infections."

The results, published in the June 19 issue of the journal AIDS, were based on a meta-analysis of 38 randomized controlled trials involving over 14,000 participants.

"It is important to recognize the diversity that exists within the African American community, and we are not recommending 'one size fits all' types of interventions. Successful interventions honed in on specific aspects of the target populations,' Darbes said.

For instance, the social norms targeted may include influencing one's perception of being at risk for HIV in one population, delaying sexual initiation in another or reducing the number of partners in another or some combination of all of these, she said. In addition, actual members from the target population should conduct peer education.

"Cultural tailoring was crucial and in effective interventions was derived from activities such as formative research within the target community using a 'ground up' approach as opposed to a top down or 'parachute' approach. Understanding the community was important in developing efficacious interventions," Darbes said.

The study's meta-analysis focused on randomized controlled trials that measured outcomes such as changes in rates of unprotected sex, consistency of condom use or sexually transmitted infections and reported at least one outcome post intervention.

"This study shows how the technique of meta-analysis can be used to understand an entire literature and to find subtle but important associations that single studies simply can't find," said study co-author Dr. George W. Rutherford, director of UCSF Global Health Sciences Prevention and Public Health Group.

Co-authors also include Nicole Crepaz and Cynthia Lyles from the Centers for Disease Control and Prevention and Gail Kennedy from UCSF Global Health Sciences.

The research was funded by the Office of AIDS, California Department of Health Services; the Office of Minority Health, U.S. Department of Health and Human Services; National Institutes of Health; and Centers for Disease Control and Prevention.

Established in 1986 in the early days of the HIV/AIDS epidemic, UCSF's Center for AIDS Prevention Studies (CAPS) conducts domestic and international research to prevent the acquisition of HIV and to optimize health outcomes among HIV-infected individuals.

UCSF Global Health Sciences Prevention and Public Health Group is dedicated to improving health and reducing the burden of disease in the world's most vulnerable populations through applied public health research, education, and program improvement.

UCSF Global Health Sciences and CAPS are affiliated with the AIDS Research Institute (ARI) at UCSF. UCSF ARI houses hundreds of scientists and dozens of programs throughout UCSF and affiliated labs and institutions, making ARI one of the largest AIDS research entities in the world.

UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care.

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