Q: What is the HIV/AIDS Prevention Research Synthesis (PRS) Project?

The HIV/AIDS Prevention Research Synthesis (PRS) project was initiated by the Prevention Research Branch, Division of HIV/AIDS Prevention (DHAP) at CDC in 1996 to systematically review and summarize HIV behavioral prevention research literature. The goal of PRS is to translate scientific evidence from the research literature into practical information that can be used by prevention providers, state and local health departments throughout the United States, and HIV prevention researchers. PRS activities consist of systematic reviews, including qualitative, quantitative, and meta-analytical reviews, as well as the PRS efficacy review. For a list of all PRS-related publications, go to PRS Publications.

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Q. How are the interventions in the 2008 Compendium of Evidence-Based HIV Prevention Interventions identified?

For the efficacy review, PRS conducted a comprehensive systematic search of the HIV literature that included both automated and manual searches to identify relevant reports of HIV behavioral interventions published or in press from January, 1988 to May, 2008. Then, citations were screened for inclusion according to the study eligibility criteria. Eligible citations were then reviewed using the updated PRS efficacy criteria to identify HIV behavioral interventions with scientifically proven evidence of efficacy. More information about the search strategy, eligibility criteria, and efficacy criteria can be found here.

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Q: What are the PRS efficacy criteria?

The PRS 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 risk, by either reducing HIV or STD incidence, eliminating or reducing sex- or drug-risk behaviors, or promoting safer behaviors. The efficacy criteria were developed as the result of comprehensive literature reviews by CDC staff in the Prevention Research Branch at the Division of HIV/AIDS Prevention and with multiple consultations with external HIV researchers and methodologists. The criteria focus on quality of study design, quality of study implementation, quality of analysis, and strength of findings. More information about the efficacy criteria can be found here.

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Q: Why do the efficacy criteria for individual- and group-level interventions differ from the efficacy criteria for community-level interventions?

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. Compared to ILIs and GLIs, CLI research is still in an early stage of development. 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).

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Q: How do the original 1999 Compendium and the current 2008 Compendium differ?

The main differences between the 1999 Compendium of HIV Prevention Interventions with Evidence of Effectiveness and the 2008 Compendium are the set of criteria used for determining evidence of efficacy, the time periods covered, and the quality of the search. Because the HIV behavioral intervention research field has progressed, matured, and become more rigorous since the first Compendium was published in 1999, PRS strengthened its efficacy criteria in 2004 to reflect the scientific progress of the field and to focus on those interventions with the strongest evidence for efficacy. Those interventions with the strongest evidence of efficacy have the greatest chances of reducing HIV risk within communities. More information on the rationale for the new criteria is provided in Lyles, Crepaz, Herbst, et al. Evidence-based HIV behavioral prevention from the perspective of CDC’s HIV/AIDS Prevention Research Synthesis Team. AIDS Educ Prev. 2006;18(suppl A):21-31 [18]. Regarding the time periods, the 1999 Compendium covers interventions identified from 1988 to 1998. The 2008 Compendium covers interventions published or in press from 1988 to May 2008. Lastly, the search strategy implemented for identifying relevant literature for the 1999 Compendium was mostly based on key word searching of electronic databases, manual searching of reference lists and contacting scientists. PRS developed a completely new and more comprehensive search strategy that was utilized in the PRS efficacy review of the 1988-2008 literature. More information about the efficacy criteria and the search strategy can be found here.

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Q: Can I request PRS to review my intervention for evidence of efficacy?

If you have an intervention that you would like to be reviewed by the PRS project, please first review the study eligibility criteria to make sure that your intervention is eligible for the PRS efficacy review. If you believe that your intervention meets the eligibility criteria, please send a copy of the published or in press manuscript that reports on the evaluation of your intervention and intervention materials to PRSProject@cdc.gov. In writing up your results, it might be useful to refer to CONSORT (for randomized control trials) or TREND (for non-randomized control trials). These are two groups that provide recommendations for reporting intervention evaluation findings, to ensure that all critical information is included in the manuscript.

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Q: If my intervention meets the PRS efficacy criteria for best or promising evidence, what happens next?

If PRS has determined that your intervention meets the efficacy criteria for best or promising evidence, you will be notified by PRS, and information about your intervention will be posted on the PRS website to inform HIV prevention planners, providers, and researchers about this evidence-based HIV behavioral intervention. To move the research into practice, researchers often work to get their intervention packaged for prevention providers using a variety of potential mechanisms, both private and federal. For its part, CDC periodically announces a request for applications to translate the science-based protocols of interventions meeting PRS’s efficacy criteria into intervention packages for use by prevention providers. These announcements are made by CDC’s Replicating Effective Programs (REP) project and will continue in the future pending funding. Researchers with efficacious interventions may apply for competitive funding to convert their research protocols into intervention packages.

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