Thirty-two studies (48 separate interventions) were included in the review (n=67,538 participants): condom use (20 studies, 34 interventions), number of sexual partners (15 studies, 28 interventions), incidence of STD (22 studies, 40 interventions), incidence of HIV (five studies, six interventions). Methodological quality scores ranged from 7 to 15 (mean 10.5).
Small to medium improvements with risk reduction interventions were shown in condom use, reduced number of sexual partners and incidence of STDs (HIV included).
Short-term assessment (four to 13 weeks) showed significant benefit in favour of behavioural interventions was found for condom use (0.10, 95% CI 0.07 to 0.14, I2=59%; 31 interventions) and number of sexual partners (0.09, 95% CI 0.06 to 0.13, I2=0%; 24 interventions) compared to control groups. No between-group differences were found for incidence of STDs.
Intermediate assessment (22 to 39 weeks) showed significantly improved condom use (0.05, 95% CI 0.02 to 0.09, I2=0%; 26 interventions), reduced number of sexual partners (0.06, 95% CI 0.03 to 0.09, I2=0%; 22 interventions) and incidence of STDs (0.13, 95% CI 0.08 to 0.18, I2=75%; 21 interventions) reported with the behavioural intervention.
Long term assessment (≥52 weeks) showed a significantly reduced number of sexual partners (0.06, 95 CI 0.01 to 0.11, I2=69%; 11 interventions) and incidence of STDs (0.10, 95 CI 0.08 to 0.12, I2= 70%; 23 interventions), which included HIV (0.56, 95% CI 0.54 to 0.58, I2=99%; five interventions) was found with the behavioural intervention compared with controls. No significant between-group differences were found for condom use.
Eggers test indicated significant publication bias for number of sexual partners at short-term assessment (p=0.4). The fail-safe N indicated that 84 interventions assessing number of sexual partners within three months post intervention with non-significant results would be necessary to reverse the significant findings. Results of moderator analyses were reported.