HIV gay and bisexual men the Uned Kgdom: 25 years of public health surveillance | Epimlogy & Infectn | Cambridge Core

Introductn HIV transmissn ntu among gay and bisexual men who have sex wh men (GBMSM), wh those who are younger, or recent migrants, or of mory ethnicy or who are genr diverse remag at creased risk. We aimed to intify and scribe recent studi evaluatg the effectivens of HIV preventn terventns for GBMSM high e untri. Methods We searched ten electronic databas for randomized ntrolled trials (RCTs), nducted high e settgs, and published sce 2013 to update a prev systematic review (Stromdahl et al, 2015). We prefed four oute measur of tert: 1) HIV cince 2) STI cince 3) ndomls anal terurse (CLAI) (or measure of CLAI) and 4) number of sexual partners. We ed the Natnal Instute for Health and Care Excellence (UK) Qualy Appraisal of Interventn Studi tool to asss the qualy of papers clud the review. As the trials ntaed a range of effect measur (e.g. odds rat, risk difference) parg the arms the RCTs, we nverted them to standardized effect siz (SES) wh 95% nfince tervals (CI). Rults We intified 39 origal papers reportg 37 studi. Five terventn typ were intified: one-to-one unsellg (15 papers), group terventns (7 papers), onle terventns (9 papers), Contgency Management for substance e (2 papers) and Pre-exposure Prophylaxis (PrEP) (6 papers). The qualy of the studi was mixed wh over a third of studi rated as high qualy and 11% rated as poor qualy. There was some evince that one-to-one unsellg, group terventns (4–10 participants per group) and onle (dividual) terventns uld be effective for rcg HIV transmissn risk behavurs such as ndomls anal terurse. PrEP was the only terventn that was nsistently effective at rcg HIV cince. Conclns Our systematic review of the recent evince that we were able to analyse dit that PrEP is the most effective terventn for rcg HIV acquisn among GBMSM. Targeted and culturally tailored behavural terventns for sub-populatns of GBMSM vulnerable to HIV fectn and other STIs should also be nsired, particularly for GBMSM who nnot accs or cle to e PrEP.