HIV sexual risk reduction interventions with heterosexual men: The forgotten group

This paper reviews published evaluations (through fall 1998) of HIV sexual risk reduction programs conducted in the United States that have targeted adult heterosexual men. The review was limited to studies that provided a male-specific analysis of intervention effects on sexual risk behavior. Fifteen of 20 peer-reviewed studies meeting inclusion criteria demonstrated that HIV sexual risk reduction programs can be effective in reducing men's heterosexual risk behavior, although effect sizes were usually modest. Outcomes varied and included biological markers and self-reported behavior. No clear pattern distinguished effective from ineffective interventions. All intervention types (information-only; condom skills/distribution; behavioral skills-focused; HIV counseling and testing; individual risk counseling; street outreach) showed some efficacy, and there were no discernable differences by targeted population. Both group and individual delivery formats were effective. The review includes a methodologic critique, identifies research gaps, and provides recommendations for future research efforts with heterosexually active men.