scholarly journals Peer education for HIV prevention among high-risk groups: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Na He ◽  
Yuantao Hao

Abstract Background Peer education has become a strategy for health promotion among HIV groups at high-risk worldwide. However, the quantitative effect and its duration of peer education on preventing HIV is still unknown.Method A systematic review and meta-analysis was adopted to assess the effects and its duration of peer education, following the PRISMA guidelines. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on HIV high-risk groups were reviewed. Pooled effects were calculated and the heterogeneity source were explored using meta-regression and subgroup analysis.Results A total of 60 articles with 96484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among high risk groups overall (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR=3.19; 95%CI:2.13,4.79) better than condom use (OR=2.66, 95% CI: 2.11-3.36) and can reduce equipment sharing (OR=0.50; 95%CI:0.33,0.75) better than unprotected sex (OR=0.82; 95%CI: 0.72-0.94). Time trend analysis showed a persistent effect of peer education and the different follow-up time was a source of heterogeneity.Conclusion Peer education is persistently effective for changing behaviors among high-risk groups worldwide, especially for the behaviors of HIV testing and equipment sharing. Low and middle income countries are encouraged to conduct peer education at a large scale.

2020 ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao ◽  
Na He ◽  
...  

Abstract Background: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally. Method: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis. Results: A total of 60 articles with 96484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR=3.19; 95%CI:2.13,4.79) and condom use (OR=2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR=0.50; 95%CI:0.33,0.75) and unprotected sex (OR=0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity. Conclusion: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.


2020 ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao New ◽  
Na He ◽  
...  

Abstract Background: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally. Method: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis. Results: A total of 60 articles with 96484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR=3.19; 95%CI:2.13,4.79) and condom use (OR=2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR=0.50; 95%CI:0.33,0.75) and unprotected sex (OR=0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity. Conclusion: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao ◽  
Na He ◽  
...  

2020 ◽  
Vol 5 (10) ◽  
pp. e003438
Author(s):  
Anita Svadzian ◽  
Giorgia Sulis ◽  
Genevieve Gore ◽  
Madhukar Pai ◽  
Claudia M Denkinger

IntroductionAlthough universal drug susceptibility testing (DST) is a component of the End-TB Strategy, over 70% of drug-resistant tuberculosis (DR-TB) cases globally remain undetected. This detection gap reflects difficulties in DST scale-up and substantial heterogeneity in policies and implemented practices. We conducted a systematic review and meta-analysis to assess whether implementation of universal DST yields increased DR-TB detection compared with only selectively testing high-risk groups.MethodsPubMed, Embase, Global Health, Cochrane Library and Web of Science Core Collection were searched for publications reporting on the differential yield of universal versus selective DST implementation on the proportion of DR-TB, from January 2007 to June 2019. Random-effects meta-analyses were used to calculate respective pooled proportions of DR-TB cases detected; Higgins test and prediction intervals were used to assess between-study heterogeneity. We adapted an existing risk-of-bias assessment tool for prevalence studies.ResultsOf 18 736 unique citations, 101 studies were included in the qualitative synthesis. All studies used WHO-endorsed DST methods, and most (87.1%) involved both high-risk groups and the general population. We found only cross-sectional, observational, non-randomised studies that compared universal with selective DST strategies. Only four studies directly compared the testing approaches in the same study population, with the proportion of DR-TB cases detected ranging from 2.2% (95% CI: 1.4% to 3.2%) to 12.8% (95% CI: 11.4% to 14.3%) with selective testing, versus 4.4% (95% CI: 3.3% to 5.8%) to 9.8% (95% CI: 8.9% to 10.7%) with universal testing. Broad population studies were very heterogeneous. The vast majority (88/101; 87.1%) reported on the results of universal testing. However, while 37 (36.6%)/101 included all presumptive TB cases, an equal number of studies applied sputum-smear as a preselection criterion. A meaningful meta-analysis was not possible.ConclusionGiven the absence of randomised studies and the paucity of studies comparing strategies head to head, and selection bias in many studies that applied universal testing, our findings have limited generalisability. The lack of evidence reinforces the need for better data to inform policies.


2020 ◽  
pp. sextrans-2020-054706
Author(s):  
Meng Yin Wu ◽  
Hui Zi Gong ◽  
Kui Ru Hu ◽  
He-yi Zheng ◽  
Xia Wan ◽  
...  

ObjectivesCo-infection of syphilis and HIV remains hard to manage and its morbidity shows a rising tendency. Syphilis has been associated with increased risk of HIV acquisition in high-risk groups, especially in men who have sex with men (MSM). This systematic review and meta-analysis estimates the effect of syphilis infection on subsequent HIV acquisition, and assesses its difference between MSM and other high-risk populations.MethodsFive electronic databases were searched for literature published to 21 September 2019 without language restrictions. Longitudinal studies that enrolled key populations to compare the incidence of HIV with and without syphilis exposure were included. We used a random-effects model to estimate the effect of syphilis infection on HIV acquisition among high-risk populations, which include MSM, sex workers, serodiscordant couples, people who inject drugs and attendees of STD clinics.ResultsA total of 17 cohorts and 5 case-control studies involving 65 232 participants were included. HIV incidence showed a two-time increase after syphilis exposure, compared with a control group (relative risk (RR) 2.67 (95% CI 2.05 to 3.47); p<0.05 for prevalence; RR 3.21 (95% CI 2.26 to 4.57); p=0.419 for incidence). No significant differences were observed between MSM and other high-risk groups in syphilis infection prevalence (RR 2.60 (95% CI 1.78 to 3.80); p<0.05 vs RR, 2.98 (95% CI 2.15 to 4.14); p<0.05; ratio of relative risk 0.76 (95% CI 0.49 to 1.17)).ConclusionsSyphilis infection increases the risk of HIV acquisition in high-risk populations. There is no evidence to suggest MSM are at greater risk than other high-risk populations. Prompt diagnosis, timely treatment, preventive interventions against syphilis infection would be a worthwhile investment for reducing HIV incidence. Strategies to combat stigma and discrimination targeted at MSM are pragmatically needed.


2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Ethan Gough ◽  
Mirjam C Kempf ◽  
Laura Graham ◽  
Marvin Manzanero ◽  
Edward W Hook ◽  
...  

2021 ◽  
Author(s):  
MY Cynthia Stafford ◽  
Colin E Willoughby ◽  
Colum P Walsh ◽  
Declan J McKenna

Elevated levels of miR-21 expression are associated with many cancers, suggesting it may be a promising clinical biomarker. In prostate cancer (PCa), however, there is still no consensus about the usefulness of miR-21 as an indicator of disease progression. This systematic review and meta-analysis was conducted to investigate the value of miR-21 expression as a prognostic measurement in PCa patients. Medline (Ovid), EMBASE, Web of Science, Scopus and Cochrane Library databases were systematically searched for relevant publications between 2010 to 2021. Studies exploring the relationship between miR-21 expression, PCa prognosis and clinicopathological factors were selected for review. Those reporting hazard ratio (HR) and 95% confidence intervals (CIs) were subject to meta-analyses. Fixed-effect models were employed to calculated pooled HRs and 95% CIs. Risk of bias in each study was assessed using QUIPS tool. Certainty of evidence in each meta-analysis was assessed using GRADE guidelines. A total of 64 studies were included in the systematic review. Of these, 11 were eligible for inclusion in meta-analysis. Meta-analyses revealed that high miR-21 expression was associated with poor prognosis: HR=1.58 (95% CI=1.19-2.09) for biochemical recurrence, MODERATE certainty; HR=1.46 (95% CI=1.06-2.01) for death, VERY LOW certainty; and HR=1.26 (95% CI=0.70-2.27) for disease progression, VERY LOW certainty. Qualitative summary revealed elevated miR-21 expression was significantly positively associated with PCa stage, Gleason score and risk groups. This systematic review and meta-analysis suggests that elevated levels of miR-21 are associated with poor prognosis in PCa patients. miR-21 expression may therefore be a useful prognostic biomarker in this disease.


2020 ◽  
Author(s):  
Xiaoqin Xiong ◽  
Tiantian Xu ◽  
Xinhong Wang ◽  
Wenguang Qin ◽  
Ting Yu ◽  
...  

Abstract Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from one month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.


2020 ◽  
pp. 1357633X2091781
Author(s):  
Chuqing Zhou ◽  
Hua Hu ◽  
Chunyi Wang ◽  
Ziyu Zhu ◽  
Gengchen Feng ◽  
...  

Introduction Postpartum depression (PPD) is a common psychiatric condition during the postnatal period that negatively impacts the well-being of both the mother and her infant. This study describes a systematic review and preliminary meta-analysis to assess the efficacy of mobile health (mHealth) interventions, which is defined as the use of portable electronic devices to support public health and medical practice, in addressing depressive symptoms among postpartum women. Methods Databases including PubMed, PsycINFO, the Cochrane Library, Embase and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) assessing the effectiveness of mHealth interventions on PPD from database inception to December 2019. Results The initial search identified 754 studies, of which, 11 studies fulfilled the inclusion criteria. These studies evaluated four types of distinct mHealth interventions and involved 2424 participants across six countries. Pooled results demonstrated that compared to the controls, the Edinburgh Postnatal Depression Scale score decreased in the mHealth intervention group (mean difference: –1.09, 95% confidence interval: –1.39 to –0.79). Discussion Our study suggested that mHealth interventions may be a promising tool to complement routine clinical care in the prevention and treatment of PPD, but the clinical effectiveness of mHealth interventions needs to be better established. While most studies focused on telephone-based interventions, recent researches have also suggested the superiority and effectiveness of short messaging service (SMS) and smartphone applications, but the exact efficacy needs further evaluation. Therefore, more high-quality RCTs on app-based and SMS-based interventions are needed before the large-scale roll-out of these interventions in clinical practice.


2021 ◽  
Author(s):  
Salvatore Crisafulli ◽  
Nicoletta Luxi ◽  
Janet Sultana ◽  
Andrea Fontana ◽  
Federica Spagnolo ◽  
...  

Objective: To date, no systematic reviews and meta-analysis on the global epidemiology of acromegaly are available in literature. The aims of this study are to provide a systematic review and a meta-analysis of the global epidemiology of acromegaly and to evaluate the quality of study reporting for the identified studies. Methods: MEDLINE, EMBASE and The Cochrane Library databases were searched for studies assessing the epidemiology of acromegaly from inception until 31st January 2020. We included original observational studies written in English, reporting acromegaly prevalence and/or incidence for a well-defined geographic area. Two reviewers independently extracted data and performed quality assessments. Prevalence and incidence pooled estimates were derived performing a random-effects meta-analysis. Results: A total of 32 studies were included in the systematic review, and 22 of them were included in the meta-analysis. The pooled prevalence of acromegaly was 5.9 (95%CI: 4.4-7.9) per 100,000 persons, while the incidence rate (IR) was 0.38 (95%CI: 0.32-0.44) cases per 100,000 person-years. For both prevalence and IR, a considerable between-study heterogeneity was found (I2= 99.3% and 86.0%, respectively). The quality of study reporting was rated as medium for 20 studies and low for 12 studies. Conclusions: Although the largest amount of heterogeneity was due to the high precision of the studies’ estimates, data source and geographic area could represent relevant study-levels factors which could explain about 50% of the total between-study variability. Large-scale high quality studies on the epidemiology of acromegaly are warranted to help the public health system in making decisions.


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