Lessons learned from 17 years of HIV-prevention research.(SEX RESEARCH UPDATE)

The emergence of HIV/AIDS as a major public health concern in the 1980s led to unprecedented growth and development in the field of sexual risk reduction intervention. Albarracin, Gillette, Earl et al., (2005) conducted a comprehensive review and meta-analysis of the peer reviewed HIV prevention intervention evaluation literature from 1985 to 2003 in order to examine the extent to which different theoretical models can effectively inform effective risk reduction interventions. The results of the review provide a number of valuable insights concerning the theoretical frameworks and specific components of effective HIV risk reduction interventions among different populations and groups. The Albarracin et al. review included data from 354 HIV-prevention interventions as well as 99 control groups. All studies included in the review described the outcomes of interventions to promote the use of condoms, included a pretest, and calculated the behavioural effect of the interventions over time.

Most evaluated HIV-prevention interventions are explicitly informed by or closely reflect one or more theoretical models of health behaviour change or sexual risk reduction behaviour change. Thus, the authors were able to assess the impact of different theory-based strategies and the relative success of interventions informed by different theoretical models.

With respect to specific theories, the authors did not find empirical support for the Health Belief Model whereas they did find support for the information-motivation-behavioural skills (IMB) model, the theory of reasoned action, the theory of planned behaviour, and social cognitive theory. Sexual risk reduction interventions informed by the Health Belief Model have focused on emphasizing the threat posed by HIV and other STI and the results of the Albarracin et al. review reinforce the growing awareness that threat-based messages are often ineffective in the area of sexual health education. The review's conclusion that IMB-based sexual health education interventions can be effective in changing behaviour provides further empirical support for the Canadian Guidelines for Sexual Health Education (Health Canada, 2003), which provide a guide to utilizing the IMB model to create effective sexual health education programs.

With respect ...