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Evidence summaries

Population-Based Interventions for Reducing Sexually Transmitted Infections Including HIV

Population-based interventions may have a limited effect on the prevalence of sexually transmitted infections (STI), but little effect on HIV incidence. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 4 trials. Any intervention vs control demonstrated no statistically significant effect on HIV incidence (0.97, 95% CI 0.78 - 1.2; 4 trials, n=23 981). Combining the mass treatment trial and one of the STI management trials, a significant reduction in the prevalence of syphilis for those receiving a biomedical STI intervention (RR 0.88, 95% CI 0.80 - 0.96), and for gonorrhoea (RR 0.49, 95% CI 0.31 - 0.77) was shown. Finally, for chlamydia, we found no significant difference between any biomedical intervention and control (RR 1.03, 95% CI 0.77 - 1.4).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by indirectness (differences in studied settings and reported outcomes).

    References

    • Sangani P, Rutherford G, Wilkinson D. Population-based interventions for reducing sexually transmitted infections, including HIV infection. Cochrane Database Syst Rev 2004;(2):CD001220 [Review content assessed as up-to-date: 14 February 2011]. [PubMed]

Primary/Secondary Keywords