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HIV Risk Reduction Efficacy Review: Efficacy Criteria



The PRS risk reduction efficacy criteria are used to determine if an HIV behavioral intervention is evidence-based, that is, if there is sufficient evidence that the intervention reduced HIV-related risk behaviors. Based on the overall quality of the study, evidence-based risk reduction behavioral interventions are classified as either best-evidence or good-evidence.

Best-evidence Risk Reduction Interventions

Best-evidence interventions are HIV behavioral interventions that have been rigorously evaluated and have been shown to have significant and positive evidence of efficacy (i.e., eliminate or reduce sex- or drug-risk behaviors, reduce the rate of new HIV/STD infections, or increase HIV-protective behaviors). These interventions are considered to be scientifically rigorous and to provide the strongest evidence of efficacy. These interventions meet the PRS efficacy criteria for best evidence ILIs/GLIs/CPLs or efficacy criteria for best evidence CLIs.

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Good-evidence Risk Reduction Interventions

Good-evidence interventions are HIV behavioral interventions that have been sufficiently evaluated and have been shown to have significant and positive evidence of efficacy (i.e., eliminate or reduce sex- or drug-risk behaviors, reduce the rate of new HIV/STD infections, or increase HIV-protective behaviors). While the evaluations of these interventions do not meet the same level of rigor as the best-evidence interventions, they are considered to be scientifically sound, provide sufficient evidence of efficacy, and address the HIV prevention needs of many communities by targeting high-risk populations. These interventions meet the PRS efficacy criteria for good evidence ILIs/GLIs/CPLs or efficacy criteria for good evidence CLIs.

History of Efficacy Review Criteria and Process

The first PRS risk reduction efficacy review (CDC, 1999) and the update (Kay, 2003), were based on the original criteria used for the Compendium of HIV Prevention Interventions with Evidence of Effectiveness.

Since that time, the HIV behavioral prevention research field has matured and become more rigorous. In 2004, to reflect the scientific progress in the field and focus on those interventions with the strongest evidence of efficacy, PRS strengthened its criteria for identifying evidence-based, individual-, group-, and couple-level behavioral risk reduction interventions. These revised criteria were developed as the result of multiple consultations with methodologists and HIV prevention researchers. These revised criteria focus on quality of study design, quality of study implementation and analysis, and strength of evidence of efficacy.

Because most community-level interventions (CLIs) have study and design characteristics that do not lend themselves to evaluation with the efficacy criteria for ILIs/GLIs/CPLs, PRS developed efficacy criteria specific for identifying evidence-based CLIs in 2008. These revised criteria were developed as the result of multiple consultations with methodologists and HIV prevention researchers. The CLI efficacy criteria, like the ILI/GLI/CPL criteria, focus on quality of study design, quality of study implementation and analysis, and strength of evidence of efficacy. The CLI EBIs are also classified as either best- or good-evidence.

Back to HIV Risk Reduction Efficacy Review Methods

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