HIV behavioral interventions have been conducted at various levels of delivery – individual, group, and community. Because most community-level interventions (CLIs) have study and design characteristics that differ from individual- and group-level interventions (ILIs/GLIs), they require efficacy criteria that differ somewhat from those for evaluating ILIs and GLIs. PRS developed efficacy criteria specific for identifying evidence-based CLIs after multiple consultations with methodologists and HIV researchers. The efficacy criteria for best-evidence CLIs and efficacy criteria for promising-evidence CLIs reflect the current state of community-level HIV behavioral intervention research published to date (January, 1988 through May, 2008). Compared to ILIs and GLIs, CLI research is still in an early stage of development. Based on the recommendations of our consultants, future CLI evaluation studies are strongly encouraged to include a larger number of communities per study arm, have more rigorous design features, and provide transparent reporting of issues related to evaluation of internal and external validity (e.g., refusal rate at each assessment wave).

A CLI study is considered to be eligible for the efficacy review if it meets the definition of “community” and “community-level intervention study” listed below:

Community – A group of individuals that exists prior to the intervention whose members share one or more common characteristics and a common geographic area, and relate with one another in a way that may influence their HIV risk.

• Common characteristic – a shared trait or feature or quality, which may include, but is not limited to, race/ethnicity, culture, religion, social economic status, education level, behavior, identity, customary beliefs or practices, social norms, and other underlying motivators.
• Geographic area – a physical region, area, or medium (e.g., internet) where people live, congregate, or frequent.

Community-level intervention (CLI) study– An evaluation study of an intervention intended to reduce the HIV risk of an entire community. A CLI study does the following:

• Directly or indirectly influences the knowledge, attitudes, social norms, or behaviors of individuals in the targeted community.
• Provides the intervention where individuals of the targeted community are likely to be; and
• Delivers the intervention broadly (not only to those assessed) and broadly assesses community members (not only those who received the intervention).