HIV prevention programs with heterosexuals

Objective: Efficacious HIV prevention programs designed for heterosexual ad ults were identified. Methods: Thirty-two programs designed with a comparison group and aimed at preventing heterosexual transmission for HIV were identified utilizing comp uterized data bases and key informants. Results: Three types of efficacious interventions were identified: (1) thos e based on social cognitive theories that aimed to improve HIV-related know ledge, attitudes, norms, and behavioral practices (n = 27); (2) treatment o f sexually transmitted diseases (STDs) (n = 3); and (3) pre- and post-test HIV testing and counseling programs (n = 2). The high incidence of HIV and STD in international settings has resulted in these trials demonstrating th e greatest reductions in risk for HIV, reflected in biological markers of i nfection. Only Five of 12 studies with injecting drug users were successful in reducing sexual risk behaviors. The optimal STD treatment strategy (syn dromic case management, mass treatment) varies across communities. HIV test ing and counseling appears an efficacious strategy, particularly for seropo sitive adults, yet current models have not considered the impact of new tec hnologies on HIV testing paradigms. Conclusion: Each successful prevention strategy faces significant challenge s before broad dissemination of the intervention approach can be achieved. (C) 2000 Lippincott Williams & Wilkins.