Review: sexual abstinence only programmes do not affect STIs or HIV risk behaviours in high-income countries

摘要

QUESTIONDo sexual abstinence (SA) only programmes prevent HIV infection in high-income countries?METHODSData sources: Medline, CINAHL, EMBASE/Excerpta Medica, CENTRAL, Catalogue of US Government Publications, and 25 other databases (1980 to February 2007); libraries of agencies involved with HIV prevention (eg, WHO); relevant conference proceedings (after 2000); experts; and cross-referencing articles on pregnancy prevention and HIV prevention.Study selection and assessment: randomised controlled trials (RCTs) or quasi-RCTs in any language that evaluated any intervention or programme for SA as the only means of HIV prevention in high-income countries (ie, gross national income/capita 5> =dollar 10 726, Pound5450, or Euro8035). Trials of pregnancy and HIV prevention, or HIV prevention alone were included. Trials of people who were HIV positive, programmes explicitly promoting condom use or safe sex, SA only programmes not evaluating HIV prevention, and RCTs that did not report biological or behavioural outcomes were excluded. Quality assessment of individual studies was based on Cochrane criteria (eg, allocation concealment, blinding, and follow-up). 13 RCTs (n = 15 940, mean age range 10-19 y) met the selection criteria; control groups included usual care, no treatment, non-enhanced SA programmes, time-matched safe sex programmes, and time-matched programmes that promoted both safe sex and abstinence.