Appropriate evaluation of HIV prevention interventions: from experiment to full-scale implementation
Appropriate evaluation of HIV prevention interventions: from experiment to full-scale implementation
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DOI：
10.1136/sti.2006.023663
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发表时间：
2007-08-01
影响因子：
3.6
通讯作者：
Garnett, Geoff P.
中科院分区：
文献类型：
--
作者：
Hallett, Timothy B.;White, Peter J.;Garnett, Geoff P.
背景：预防艾滋病毒感染仍然是应对艾滋病毒/艾滋病流行的重要目标。人们对如何最好地降低艾滋病毒发病率知之甚少，因为大多数试验的重点是减少危险行为并假设对艾滋病毒发病率有影响。目的：讨论艾滋病毒预防策略有效性的证据，探索不同类型的可用证据：个人和社区随机对照试验以及观察性研究。结果：虽然提供了证据的黄金标准，但试验的范围有限，难以解释和概括。在监测数据中发现并通过行为和模型研究了解了国家层面在预防艾滋病毒方面取得成功的例子。这些方法的优点是规模化并表明有效性而不是功效。结论：尽管随机试验因其科学严谨性而很重要，但来自观察流行病学的证据也不能被忽视也很重要。只有获得高质量、一致的数据，才能适当分析艾滋病毒流行的历史。
Background: Preventing HIV infection is still an essential goal in tackling the HIV/AIDS pandemic. Remarkably little is known about how best to reduce HIV incidence because most trials focus on the reduction of risk behaviours and assume an effect on HIV incidence.Objective: To discuss the evidence for the effectiveness of HIV prevention strategies, exploring the different types of evidence available: individual and community randomised controlled trials, and observational studies.Results: Although providing a gold standard for evidence, trials have been limited in their scope and are difficult to interpret and generalise. There have been examples of national level successes in preventing HIV which have been detected in surveillance data and understood through behavioural and modelling studies. These have the advantage of being to scale and indicating effectiveness rather than efficacy.Conclusions: Although randomised trials are important because of their scientific rigor, it is also important that evidence from observational epidemiology is not overlooked. Only if good quality, consistent data are available can the history of the HIV epidemic be appropriately analysed.