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Tiers of Evidence: A Framework for Classifying HIV Behavioral Interventions
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Evidence-based Behavioral Interventions (EBIs)

Tier I – Best-evidence Behavioral Interventions have:

  • Significant and positive intervention effects on relevant outcomes
  • No significant and negative intervention effects on relevant outcomes measured in the study
  • Comparison group
  • Unbiased assignment
  • ≥ 3 months follow-up in both groups
  • ≥ 70% retention in both groups
  • Analyses adjusted for baseline differences in outcome measures (if non-RCT)
  • At least 50 participants in the analytic sample in each group

(click here for more detailed Tier I criteria)

Tier II – Promising-evidence Behavioral Interventions have:

  • Significant and positive intervention effects on relevant outcomes
  • No significant and negative intervention effects on relevant outcomes measured in the study 
  • Comparison group
  • Unbiased or moderately biased assignment
  • ≥ 1 month follow-up in both groups
  • ≥ 60% retention in both groups
  • Analyses adjusted for baseline differences in outcome measures (if non-RCT)
  • At least 40 participants in the analytic sample in each group

(click here for more detailed Tier II criteria)

Theory-based Behavioral Interventions (TBIs)

Tier III – Theory-based Interventions with positive outcome monitoring have:

  • Behavioral change theory
  • Logic model
  • Formative research
  • Positive process evaluation data demonstrating fidelity, availability, and acceptance
  • Outcome monitoring showing positive and significant before and after changes in relevant outcomes

(click here for more detailed Tier III criteria)

Tier IV – Theory-based interventions with no outcome monitoring have:

  • Behavioral change theory
  • Logic model
  • Formative research
  • Positive process evaluation data demonstrating fidelity, availability, and acceptance

(click here for more detailed Tier IV criteria)

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Last Modified: November 30, 2007
Last Reviewed: November 30, 2007
Content Source:
Divisions of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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