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    Abstinence-only programs for HIV infection prevention in high-income countries

    Evidence Summaries

    Level of Evidence = C

     Abstinence-only programs may be ineffective for reducing HIV risk in high-income countries.

    A Cochrane review 1 included 13 studies with a total of 15,940 subjects. Six trials were cluster randomised. All included studies enrolled ethnically diverse youth in the US. Seven programs were school-based, two were community-based, and one was delivered in family homes. The trials compared abstinence-only programs to various control groups (e.g., "usual care," no intervention). Median final follow-up occurred 17 months after baseline. Results showed no indications that abstinence-only programs can reduce HIV risk as indicated by self-reported biological and behavioral outcomes. Compared to various controls, the evaluated programs consistently did not affect incidence of unprotected vaginal sex, frequency of vaginal sex, number of partners, sexual initiation, or condom use.

    Comment: The quality of evidence is downgraded by indirectness (the homogeneity of the trial populations) and the probable self-reporting bias.

    References

    1. Underhill K, Operario D, Montgomery P. Abstinence-only programs for HIV infection prevention in high-income countries. Cochrane Database Syst Rev 2007 Oct 17;(4):CD005421.  [PMID:17943855]


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    Citation

    "Abstinence-only Programs for HIV Infection Prevention in High-income Countries." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/451087/all/Abstinence_only_programs_for_HIV_infection_prevention_in_high_income_countries.
    Abstinence-only programs for HIV infection prevention in high-income countries. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/451087/all/Abstinence_only_programs_for_HIV_infection_prevention_in_high_income_countries. Accessed March 24, 2019.
    Abstinence-only programs for HIV infection prevention in high-income countries. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/451087/all/Abstinence_only_programs_for_HIV_infection_prevention_in_high_income_countries
    Abstinence-only Programs for HIV Infection Prevention in High-income Countries [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 March 24]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/451087/all/Abstinence_only_programs_for_HIV_infection_prevention_in_high_income_countries.
    * Article titles in AMA citation format should be in sentence-case
    TY - ELEC T1 - Abstinence-only programs for HIV infection prevention in high-income countries ID - 451087 BT - Evidence-Based Medicine Guidelines UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/451087/all/Abstinence_only_programs_for_HIV_infection_prevention_in_high_income_countries PB - Duodecim Medical Publications Limited DB - Evidence Central DP - Unbound Medicine ER -