Evaluation of Large-Scale Combination HIV Prevention Programs: Essential Issues

被引:32
作者
Padian, Nancy S. [2 ,3 ,4 ]
McCoy, Sandra I. [1 ]
Manian, Shanthi
Wilson, David [5 ]
Schwartlaender, Bernhard [6 ]
Bertozzi, Stefano M. [4 ,7 ,8 ]
机构
[1] Univ Calif Berkeley, Padian Res Grp, Inst Business & Econ Res, Berkeley, CA 94704 USA
[2] US Dept State, Off US Global AIDS, Washington, DC 20520 USA
[3] Univ Calif Berkeley, Dept Epidemiol, Berkeley, CA 94720 USA
[4] Bill & Melinda Gates Fdn, Seattle, WA USA
[5] World Bank, Washington, DC 20433 USA
[6] Joint United Nations Programme HIV AIDS UNAIDS, Geneva, Switzerland
[7] Univ Washington, Seattle, WA 98195 USA
[8] INSP, Cuernavaca, Morelos, Mexico
基金
比尔及梅琳达.盖茨基金会;
关键词
HIV; implementation science; impact evaluation; monitoring and evaluation; operations research; TRANSMITTED-DISEASES; PUBLIC-HEALTH; INTERVENTIONS; IMPACT; NUTRITION; INFECTION; DESIGNS;
D O I
10.1097/QAI.0b013e318227af37
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
HIV prevention research has shifted to the evaluation of combination prevention programs whereby biomedical, behavioral, and structural interventions are implemented concurrently to maximize synergies among interventions. However, these kinds of combination prevention packages, particularly when implemented at scale, pose significant evaluation challenges, including how best to determine impact and how and whether to measure the effectiveness of component strategies. In addition, methodological challenges unique to HIV infection such as the absence of a reliable incidence assay, the lack of naive control groups, and no suitable surrogates further complicate rigorous evaluation. In this commentary, we discuss the key considerations for planning impact evaluations of combination HIV prevention programs in light of these challenges, including defining the evaluable package, determining which component programs require independent assessment of impact, choosing study designs with valid counterfactuals, selecting appropriate outcomes of interest, and the importance of mid-course program corrections.
引用
收藏
页码:E23 / E28
页数:6
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