Men who have sex with men comprise the largest proportion of newly diagnosed HIV cases among persons living in Norway. Unprotected anal intercourse is the biggest risk factor for HIV infection among men who have sex with men. At the same time, use of alcohol and other drugs exacerbate risk through the increased likelihood of engaging in unprotected sex. Motivational interviewing is a type of counseling used to motivate people to change undesirable behaviors such as unsafe sex and substance use.
The main objective of this systematic review was to assess the effectiveness of motivational interviewing on HIV-related behaviors among men who have sex with men.
We conducted a systematic review according to the Norwegian Knowledge Centre's methods manual. Nine randomized controlled trials, with a total of 5863 participants, were included. We performed meta-analyses for tre outcomes: use of condoms, unprotected sex with non-primary partners, and unprotected sex with a primary partner.
We found that:
One study reported HIV infection: odds ratio for HIV infection was 0.82 (95% CI= 0.64-1.05), that is, 15.7% lower in the intervention group compared to the control group at 18 months follow-up. The outcome is very relevant and clinically important, although the difference was not statistically significant.
None of the three meta-analyses for unsafe sex (at 2-4 months follow up) showed a significant difference between the intervention group and the control group.
Motivational interviewing is not likely to lead to changes regarding unsafe sexual behaviors compared to other active or minimal interventions.
Keywords: Motivational Interviewing; Homosexuality, Male; Unsafe Sex; HIV Infections; Alcohol Drinking; Drug use.
Copyright ©2011 by The Norwegian Institute of Public Health (NIPH).