key data, self-report bias, and analyses neglecting attrition and clustered randomization. Rees R et al, Sero-discordant Principal recommendations Twenty-six studies met the D. The from this review for policy and inclusion criteria for in-depth is not evidence is 2004. or unknown practice are: Reducing review: 14 studies focused on currently inconsistent status HIV health / unknown UAI: the views of specified groups taking place and it is not unprotected anal promotion - Policy makers should consider of vulnerable men with data possible to intercourse implementing counselling collected in or after 1996; 12 draw a MSM based upon outcome evaluations of conclusion EPPI. techniques, or interventions delivered in or but there is workshops using these after 1996 were found that some Multi-level techniques, in place of used a comparison group evidence of Adults standard counselling for MSM design, six of which were effect at high risk of engaging in UAI conducted in the UK. Eight with partners of unknown or outcome evaluations and 10 sero-discordant HIV status, views studies were judged to because it is likely to decrease be of sufficient the proportion of MSM methodological quality to go reporting this activity. Any forward into the reviews implementation of these syntheses. Only four outcome interventions should be evaluations provided data in a accompanied by consideration suitable form for statistical of addressing STIs in the meta-analysis. One intervention and sound of two studies, one evaluation of impact on sdUAI conducted in the UK, the and STI incidence. Community other in the USA, found that peer delivered interventions : counselling or workshops There is no evidence to support based on discontinuing community peer techniques for delivered interventions. MSM who are at high risk
key data, self-report bias, and analyses neglecting attrition and clustered randomization. Rees R et al, 2004. HIV health promotion - MSM EPPI. Multi-level Adults Sero-discordant or unknown status unprotected anal intercourse Principal recommendations from this review for policy and practice are: Reducing / unknown UAI: Policy makers should consider implementing counselling based upon techniques, or workshops using these techniques, in place of standard counselling for MSM at high risk of engaging in UAI with partners of unknown or sero-discordant HIV status, because it is likely to decrease the proportion of MSM reporting this activity. Any implementation of these interventions should be accompanied by consideration of addressing STIs in the intervention and sound evaluation of impact on sdUAI and STI incidence. Community peer delivered interventions : There is no evidence to support discontinuing community peer delivered interventions. Twenty-six studies met the inclusion criteria for in-depth review: 14 studies focused on the views of specified groups of vulnerable men with data collected in or after 1996; 12 outcome evaluations of interventions delivered in or after 1996 were found that used a comparison group design, six of which were conducted in the UK. Eight outcome evaluations and 10 views studies were judged to be of sufficient methodological quality to go forward into the reviews syntheses. Only four outcome evaluations provided data in a suitable form for statistical meta-analysis. One of two studies, one conducted in the UK, the other in the USA, found that counselling or workshops based on techniques for MSM who are at high risk is not currently taking place D. The evidence is inconsistent and it is not possible to draw a conclusion but there is some evidence of effect
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