HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice–Involved Black Men Who Have Sex With Men: A Systematic Review

Summary

Published Date: November 01, 2018

​Because Black men who have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Study authors describe the range and impact of published HIV, sexually-transmitted infection (STI), and related substance use interventions for US-based criminal justice-involved (CJI) populations and to understand their relevance for Black men who have sex with men (BMSM) by using systematic searches in the following databases: PubMed, MEDLINE, Cochrane, CINAHL, and PsycINFO, covering the period preceding December 1, 2016.

Fifty-eight articles met inclusion criteria, including 8 (13.8 percent) modeling or cost-effectiveness studies and 13 (22.4 percent) randomized controlled trials. Just 3 studies (5.2 percent) focused on sexual or gender minorities, with only 1 focused on BMSM. In most studies (n= 36; 62.1 percent), however, more than 50 percent of participants were Black. The most common intervention addressed screening, including 20 empirical studies and 7 modeling studies. Screening programs consistently indicated cost-effectiveness, including with BMSM. Care continuum interventions for people living with HIV showed mixed results; just 3 involved randomized controlled trials, and these interventions did not show significant differences compared with control conditions. A minority of programs targeted non–custody-based CJI populations, despite their constituting a majority of the CJI population at any given time. Screening CJI populations for HIV and other STIs is effective and cost-efficient and holds promise for reducing HIV in BMSM. Education-based and care provision interventions also hold promise for addressing HIV, STIs, mental health, and substance use in CJI populations.