Systematic review Of interventions for preventing HIV-infection in low-income countries

Article type
Authors
Peersman G, Tate R, Thomas P, Eke A, Flores S
Abstract
Background: Prevention efforts continue to be a key component in combatting the spread of HIV/AIDS world-wide. Several reviews have been conducted to establish what is known about the effectiveness of HIV prevention, but few have focused on studies from low-income countries where the vast majority of people with HIV/ AIDS live. The Centers for Disease Control and Prevention (CDC) is increasing its support for HIV prevention in those countries as part of the Leadership and Investment in Fighting an Epidemic (LIFE) initiative. A systematic effort to identify and integrate the findings from published as well as unpublished studies is urgently needed to guide the design and tailoring of prevention programs. Objectives: To conduct a comprehensive systematic review of the implementation and impact of behavioral interventions for preventing HIV infection in low-income countries.

Methods: The review process includes the following steps: 1. Consultations with program experts to formulate review questions specific to LIFE program areas; 2. Extensive systematic searching for published as well as unpublished studies; 3. Standardized coding of all identified HIV/AIDS-related studies in terms of: country where the study was carried out, type of study, study population characteristics; and where applicable also intervention components, setting, and provider; evaluation design, and types of outcomes measured; 4. Critical review of evaluation studies of HIV behavioral interventions addressing (a) the development, content, delivery, and setting of the intervention, and its acceptability to the target population; and (b) methodological quality of the study including: inclusion of a control/comparison group, method of assignment to different groups, sample size, attrition rate, reporting on all targeted outcomes. 5. Synthesis of the evaluation findings based on the methodological quality of the studies, and focused on outcome data but including process and cost data, where available; 6. Consultations with users of the review to identify the most appropriate dissemination products.

Results: Preliminary results will be presented including: * Findings from the consultations; * Search results; * A descriptive mapping of the characteristics of o all identified studies; and o all evaluation studies; * Status of the critical review and synthesis of evaluation findings; * Lessons learned. Conclusion: In addition to providing guidance in the planning and implementation of LIFE programs, the review will serve as a reference for best practices in evaluation, and can be readily updated with the findings from evaluations of newly implemented LIFE programs.