Synthesizing HIV Behavioral Intervention Effectiveness in Developing Countries
There are multiple challenges to developing comprehensive HIV prevention programs in developing countries, including: (1) a general lack of consensus on the relative efficacy of interventions, (2) an ever changing and rapidly growing evidence base on intervention efficacy, and (3) a lack of shared standards and terminology for intervention approaches. There has also been a growing interest in promising intervention approaches that target structural and socio-ecological level factors, yet there is little shared theoretical understanding of what constitutes a "structural intervention". As well, many scientific studies published in the peer-reviewed literature use common terms for intervention approaches, yet often implement programs very differently. With the dramatic growth in funding for HIV behavioral interventions in developing countries, there are multiple initiatives to better allocate these funds based on evidenced-based standards. Comparative effectiveness studies have been requested by multiple donors and agencies to meet this need. This requires up-to-date systematic reviews and meta-analyses, as well as careful evaluation of the content of interventions. These will result in improved understanding of which intervention components are proven to be most efficacious, and will advance the field in establishing clear intervention terminology and theoretical constructs. The goal of this study is to provide needed policy and program advice on what is working in HIV prevention based on the strength of evidence from the scientific literature.
In this proposed study we will systematically review and meta-analyze the impact of 15 key HIV behavioral interventions, and conduct updates on systematic reviews and meta-analyses on 12 additional interventions we have done previously. In addition, intervention case studies will be initiated for those intervention topics listed above in which there is evidence of a lack of consistency across investigators in how they are defining and implementing the intervention.
For more information, contact Michael Sweat (Principal Investigator) by phone at 843-792-4819, or by e-mail at firstname.lastname@example.org.
Related Publications and Presentations:
Denison, J.A., O'Reilly, K.R., Shmid, G.P., Kennedy, C.E., & Sweat, M.D. (2008). HIV voluntary counseling and testing and behavioral risk reduction in developing countries: A meta-analysis, 1990-2005. AIDS and Behavior, 12, 363-373.
Medley, A., Kennedy, C., O'Reilly, K., & Sweat, M. (in press). Effectiveness of peer education interventions for HIV prevention in developing countries: A systematic review and meta-analysis. AIDS Education and Prevention.