Summary

This review of efficacy measures is intended to highlight the huge difficulties in applying simple measurements to the evaluation of HIV-prevention programmes. From the examples cited above, it is evident that the more robust measures of effectiveness are those forming part of an interlinked sequence of measurements which test the various assumptions underlying a programme. For example, it would be desirable in assessing the success of a nationwide HIV-prevention programme targeted at gay men to include the following as performance indicators:

  • measures of awareness of particular interventions
  • measures of understanding of messages
  • process efficiency measures of numbers reached
  • measures of baseline incidence
  • a large cohort to measure changes in incidence over time
  • a qualitative research project looking  at the sexual behaviour of cohort seroconverters, such as self–reported reasons for unprotected sex
  • proof of concept or mediator studies which test assumptions, such as that increased availability of condoms translates into increased use of condoms by people who would otherwise have engaged in unprotected anal intercourse, or, that knowledge of own or partner's HIV status influences condom use.

It has been argued in the past that randomised controlled studies in HIV prevention are extremely difficult, particularly if HIV incidence is the outcome measure used. However, there is no reason why studies which examine particular elements of a prevention strategy, and which use carefully chosen outcome measures, should not be conducted successfully.

The major difficulty in using such studies as ‘proof of concept’ investigations lies not so much in the element of randomisation or the selection of a valid control group, but in the resources needed to mount such studies. Relatively large studies are needed to draw valid conclusions, and national research networks do not yet exist in the genitourinary setting to mirror those developed by the Medical Research Council for its antiretroviral studies.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.