AEGiS-14IAC: Descriptive mapping of evaluation research in HIV prevention in Africa and Asia.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Descriptive mapping of evaluation research in HIV prevention in Africa and Asia.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrD1351)

Peersman G, Reed K, Rugg D
Centers for Disease Control and Prevention / Global AIDS Program, Atlanta, GA, United States

BACKGROUND: Several literature reviews of evaluation research have been conducted, but few have focused on the effectiveness of HIV prevention in low-income countries. The CDC/Global AIDS Program is undertaking a systematic effort to identify and integrate the findings from evaluation studies conducted in low-income countries.

METHODS: Systematic searches were undertaken to identify outcome evaluation studies of HIV/AIDS behavioral interventions in Africa and Asia. Full reports were obtained and classified according to key characteristics of the study population, the intervention, and the evaluation.

RESULTS: Searches identified 2041 citations relevant to HIV prevention in low-income countries of which only 145 (7%) were outcome evaluations. These evaluations focused mostly on commercial sex work (28%), HIV-testing and counseling (20%), and school-based interventions (16%). Interventions typically included provision of information (73%) and risk reduction supplies (49%), counseling (29%), provision of services (21%), and skills practicing (16%). Few studies were conducted in rural settings (21%); or included information on cost (6%). The vast majority of studies were one-group designs (70%); 18% were non-randomized trials; and 12% were randomized trials. The rigor of these studies was low as rated by 4 basic methodological quality criteria. Age and gender was not specified in 21% and 6% of studies, respectively; 24% of studies failed to mention the intervention provider, and 9% did not provide any information on the intervention setting.

CONCLUSIONS: (1) Critical analysis of the evaluation research literature shows that the evidence for HIV prevention is not as solid as anticipated; (2) More funding is needed for well-planned evaluations; (3) The public health impact of scaling-up programs without solid evidence of their effectiveness may ultimately compromise our ability to control the epidemic in Africa and Asia.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Evaluation Studies, HIV Infections, Africa, Centers for Disease Control and Prevention (U.S.), Counseling, Asia, Public Health, Behavior Therapy, prevention & control

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