***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objective : To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexually transmitted infections among gay men . Design : R and omised controlled trial with 12 months ' follow up . Setting : Sexual health clinic in London . Participants : 343 gay men with an acute sexually transmitted infection or who reported having had unprotected anal intercourse in the past year . Main outcome measures : Number of new sexually transmitted infections diagnosed during follow up and self reported incidence of unprotected anal intercourse . Results : 72 % ( 361/499 ) of men invited to enter the study did so . 90 % ( 308/343 ) of participants returned at least one follow up question naire or re-attended the clinic and requested a check up for sexually transmitted infections during follow up . At baseline , 37 % ( 63/172 ) of the intervention group and 30 % ( 50/166 ) of the control group reported having had unprotected anal intercourse in the past month . At 12 months , the proportions were 27 % ( 31/114 ) and 32 % ( 39/124 ) respectively ( P=0.56 ) . However , 31 % ( 38/123 ) of the intervention group and 21 % ( 35/168 ) of controls had had at least one new infection diagnosed at the clinic ( adjusted odds ratio 1.66 , 95 % confidence interval 1.00 to 2.74 ) . Considering only men who requested a check up for sexually transmitted infections , the proportion diagnosed with a new infection was 58 % ( 53/91 ) for men in the intervention group and 43 % ( 35/81 ) for men in the control group ( adjusted odds ratio 1.84 , 0.99 to 3.40 ) . Using a regional data base that includes information from 23 sexual health clinics in London , we determined that few participants had attended other sexual health clinics . Conclusions : This behavioural intervention was acceptable and feasible to deliver , but it did not reduce the risk of acquiring a new sexually transmitted infection among these gay men at high risk . Even carefully design ed interventions should not be assumed to bring benefit . It is important to evaluate their effects in r and omised trials with objective clinical end points . What is already known on this topic The need for effective HIV prevention strategies based on reducing sexual risk behaviour remains important Few interventions to reduce sexual risk behaviour have been rigorously evaluated using r and omised controlled trials What this study adds This is the first r and omised controlled trial of an intervention addressing sexual behaviour in homosexual men that uses sexually transmitted infections and self reported behaviour as end points The intervention was brief and feasible to use in a busy clinic , but it did not reduce the risk of participants acquiring new infections The potential for behavioural interventions to do more harm than good needs to be taken This study tested the efficacy of behavioral treatments for alcohol use disorders ( AUD ) among men who have sex with men ( MSM ) and who are at risk for HIV transmission . HIV-negative MSM with current AUD ( N = 198 ) were recruited , offered treatment focused on reducing drinking and HIV risk , and followed during treatment and 12 months posttreatment . Participants ( n = 89 ) accepted treatment and were r and omized to either 4 sessions of motivational interviewing ( MI ) or 12 sessions of combined MI and coping skills training ( MI + CBT ) .  Other participants ( n = 109 ) declined treatment but were followed , forming a non-help-seeking group ( NHS ) . MI yielded significantly better drinking outcomes during the 12-week treatment period than MI + CBT , but posttreatment outcomes were equivalent . NHS participants significantly reduced their drinking as well . Service delivery and treatment research implication s are discussed CONTEXT No approved pharmacologic treatments for methamphetamine dependence exist . Methamphetamine use is associated with high morbidity and is a major cofactor in the human immunodeficiency virus epidemic among men who have sex with men ( MSM ) . OBJECTIVE To determine whether mirtazapine would reduce methamphetamine use among MSM who are actively using methamphetamine . DESIGN Double-blind , r and omized , controlled , 12-week trial of mirtazapine vs placebo conducted from September 5 , 2007 , to March 4 , 2010 . SETTING San Francisco Department of Public Health . PARTICIPANTS Participants were actively using , methamphetamine-dependent , sexually active MSM seen weekly for urine sample collection and substance use counseling . INTERVENTIONS R and om assignment to daily oral mirtazapine ( 30 mg ) or placebo ; both arms included 30-minute weekly substance use counseling . MAIN OUTCOME MEASURES The primary study outcome was reduction in methamphetamine-positive urine test results . Secondary outcomes were study medication adherence ( by self-report and medication event monitoring systems ) and sexual risk behavior . RESULTS Sixty MSM were r and omized , 85 % of follow-up visits were completed , and 56 participants ( 93 % ) completed the final visit . In the primary intent-to-treat analysis , participants assigned to the mirtazapine group had fewer methamphetamine-positive urine test results compared with participants assigned to the placebo group ( relative risk , 0.57 ; 95 % CI , 0.35 - 0.93 , P = .02 ) . Urine positivity decreased from 67 % ( 20 of 30 participants ) to 63 % ( 17 of 27 ) in the placebo arm and from 73 % ( 22 of 30 ) to 44 % ( 12 of 27 ) in the mirtazapine arm . The number needed to treat to achieve a negative weekly urine test result was 3.1 . Adherence was 48.5 % by medication event monitoring systems and 74.7 % by self-report ; adherence measures were not significantly different between arms ( medication event monitoring systems , P = .82 ; self-report , P = .92 ) . Most sexual risk behaviors decreased significantly more among participants taking mirtazapine compared with those taking placebo ( number of male partners with whom methamphetamine was used , P = .009 ; number of male partners , P = .04 ; episodes of anal sex with serodiscordant partners , P = .003 ; episodes of unprotected anal sex with serodiscordant partners , P = .003 ; episodes of insertive anal sex with serodiscordant partners , P = .001 ) . There were no serious adverse events related to study drug or significant differences in adverse events by arm ( P ≥ .99 ) . CONCLUSION The addition of mirtazapine to substance use counseling decreased methamphetamine use among active users and was associated with decreases in sexual risk despite low to moderate medication adherence . Trial Registration clinical Trials.gov Identifier NCT00497081 BACKGROUND Effective interventions are needed to prevent acquisition of HIV infection in men who have sex with men . To date , no behavioural interventions specifically for this risk group have been tested with HIV infection as the primary outcome . METHODS This multisite two-group r and omised controlled phase IIb trial tested the efficacy of a behavioural intervention in preventing HIV infection among 4295 men who have sex with men . The experimental intervention consisted of ten one-on-one counselling sessions followed by maintenance sessions every 3 months . The st and ard condition was twice-yearly Project RESPECT individual counselling . Twice-yearly follow-up visits included testing for HIV antibody and assessment of behavioural outcomes . FINDINGS The rate of acquisition of HIV infection was 18.2 % ( 95 % CI -4.7 to 36.0 ) lower in the intervention group than the st and ard group . Adjustment for baseline covariates attenuated the intervention effect to 15.7 % ( -8.4 to 34.4 ) . The effect was more favourable in the first 12 - 18 months of follow-up . The occurrence of unprotected receptive anal intercourse with HIV-positive and unknown-status partners was 20.5 % ( 10.9 to 29.0 ) lower in the intervention than in the st and ard group . INTERPRETATION The results from the primary analyses allow us to rule out that the experimental intervention is associated with a 35 % lower rate of HIV acquisition than in the st and ard group . The overall estimate of a difference of 18.2 % , more favourable estimates of effect in the first 12 - 18 months , and similar effects on risk behaviours suggest that prevention of HIV infection among men who have sex with men by a behavioural intervention is feasible . Further work should be done to develop more effective interventions Background : Brief and low-burden HIV risk reduction counseling interventions are needed for population s at greatest risk for HIV infection . Purpose : This r and omized controlled trial tested a brief theory-based counseling intervention delivered entirely over the telephone for men who engage in unprotected intercourse with men . Methods : Participants received either risk reduction counseling that included information , motivational enhancement and behavior skills building , or brief HIV education counseling . A total of 319 participants completed follow-up assessment s over a 10-month period . Descriptive and r and om effects mixed models are used to evaluate findings . Results : Results demonstrate that a brief telephone intervention can reach and engage high-risk men in risk reduction counseling . Nearly one third of participants identified as men of color ; the median age was 33 years . Participants in both counseling conditions increased their motivation and behavioral skills to practice safer sex and reduced their number of sex partners and frequencies of engaging in unprotected anal sex over the study observation period . However , there were few differences between intervention conditions . Conclusions : The effects of repeated measurement reactivity and brief interpersonal consciousness raising may account for the lack of differences between counseling conditions and the decrease in risk for all participants over time Background Black and Hispanic men who have sex with men ( MSM ) are disproportionately affected by HIV in the United States . The Internet is a promising vehicle for delivery of HIV prevention interventions to these men , but retention of MSM of color in longitudinal Internet-based studies has been problematic . Text message follow-up may enhance retention in these studies . Objective To compare retention in a 12-month prospect i ve Internet-based study of HIV-negative MSM r and omized to receive bimonthly follow-up surveys either through an Internet browser online or through text messages . Methods  Internet-using MSM  were recruited through banner advertisements on social networking and Internet-dating sites . White , black , and Hispanic men who were ≥18 , completed an online baseline survey , and returned an at-home HIV test kit , which tested HIV negative , were eligible . Men were r and omized to receive follow-up surveys every 2 months on the Internet or by text message for 12 months ( unblinded ) . We used time-to-event methods to compare the rate of loss-to-follow-up ( defined as non-response to a follow-up survey after multiple systematic ally-delivered contact attempts ) in the 2 follow-up groups , overall and by race/ethnicity . Results are reported as hazard ratios ( HR ) and 95 % confidence intervals ( CI ) of the rate of loss-to-follow-up for men r and omized to text message follow-up compared to online follow-up . Results Of 1489 eligible and consenting men who started the online baseline survey , 895 ( 60 % ) completed the survey and were sent an at-home HIV test kit . Of these , 710 of the 895 ( 79 % ) returned the at-home HIV test kit , tested HIV-negative , and were followed prospect ively . The study cohort comprised 66 % white men ( 470/710 ) , 15 % ( 106/710 ) black men , and 19 % ( 134/710 ) Hispanic men . At 12 months , 77 % ( 282/366 ) of men r and omized to online follow-up were retained in the study , compared to 70 % ( 241/344 ) men r and omized to text message follow-up ( HR=1.30 , 95 % CI 0.97 - 1.73 ) . The rate of loss-to-follow-up was non-significantly higher in the text message arm compared to the online arm for both white ( HR=1.43 , 95 % CI 0.97 - 1.73 ) and Hispanic men ( HR=1.71 , 95 % CI 0.91 - 3.23 ) ; however , loss-to-follow-up among black men was non-significantly lower among those who received text message follow-up compared to online follow-up ( HR=0.78 , 95 % CI 0.41 - 1.50 ) . In the online arm , black men were significantly more likely to be lost to follow-up compared to white men ( HR=2.25 , 95 % CI 1.36 - 3.71 ) , but this was not the case in the text message arm ( HR=1.23 , 95 % CI 0.70 - 2.16 ) . Conclusions We retained > 70 % of MSM enrolled in an online study for 12 months ; thus , engaging men in online studies for a sufficient time to assess sustained outcomes is possible . Text message follow-up of an online cohort of MSM is feasible , and may result in higher retention among black MSM An exigent need exists for HIV prevention intervention research targeting young men who have sex with men 
    Output:
    
RESULTS Overall , trials included in this review ( n = 10 ) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours .
Experts highlighted overall acceptability of the intervention and outlined key ways that the c and i date intervention could be optimised to enhance UK implementation .
The lack of detailed intervention manuals limited the assessment of intervention content , delivery and fidelity .
CONCLUSIONS Evidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission .
Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing .
However , UK experts found the intervention acceptable and provided ways of optimising the c and i date intervention .