TY - JOUR
T1 - Combination implementation for HIV prevention
T2 - Moving from clinical trial evidence to population-level effects
AU - Chang, Larry W.
AU - Serwadda, David
AU - Quinn, Thomas C.
AU - Wawer, Maria J.
AU - Gray, Ronald H.
AU - Reynolds, Steven J.
N1 - Funding Information:
We thank Caitlin Kennedy (Johns Hopkins University, Baltimore, MD, USA) for editorial contributions and Sarah Wendel (National Institutes of Health, Bethesda, MD, USA) for her assistance with the literature search. LWC is supported by the National Institute of Mental Health at the National Institutes of Health (5K23MH086338). TCQ and SJR are supported by the Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health. MJW and RHG have grants from the National Institutes of Health, the President's Emergency Plan for AIDS Relief, and the Bill and Melinda Gates Foundation, which supported studies of relevance to this Review. These funding sources had no involvement in the writing of the manuscript or the decision to submit it for publication. LWC had full access to all data in the study and final responsibility for the decision to submit for publication.
PY - 2013/1
Y1 - 2013/1
N2 - The promise of combination HIV prevention-the application of multiple HIV prevention interventions to maximise population-level effects-has never been greater. However, to succeed in achieving significant reductions in HIV incidence, an additional concept needs to be considered: combination implementation. Combination implementation for HIV prevention is the pragmatic, localised application of evidence-based strategies to enable high sustained uptake and quality of interventions for prevention of HIV. In this Review, we explore diverse implementation strategies including HIV testing and counselling models, task shifting, linkage to and retention in care, antiretroviral therapy support, behaviour change, demand creation, and structural interventions, and discusses how they could be used to complement HIV prevention efforts such as medical male circumcision and treatment as prevention. HIV prevention and treatment have arrived at a pivotal moment when combination efforts might result in substantial enough population-level effects to reverse the epidemic and drive towards elimination of HIV. Only through careful consideration of how to implement and operationalise HIV prevention interventions will the HIV community be able to move from clinical trial evidence to population-level effects.
AB - The promise of combination HIV prevention-the application of multiple HIV prevention interventions to maximise population-level effects-has never been greater. However, to succeed in achieving significant reductions in HIV incidence, an additional concept needs to be considered: combination implementation. Combination implementation for HIV prevention is the pragmatic, localised application of evidence-based strategies to enable high sustained uptake and quality of interventions for prevention of HIV. In this Review, we explore diverse implementation strategies including HIV testing and counselling models, task shifting, linkage to and retention in care, antiretroviral therapy support, behaviour change, demand creation, and structural interventions, and discusses how they could be used to complement HIV prevention efforts such as medical male circumcision and treatment as prevention. HIV prevention and treatment have arrived at a pivotal moment when combination efforts might result in substantial enough population-level effects to reverse the epidemic and drive towards elimination of HIV. Only through careful consideration of how to implement and operationalise HIV prevention interventions will the HIV community be able to move from clinical trial evidence to population-level effects.
UR - http://www.scopus.com/inward/record.url?scp=84871065122&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871065122&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(12)70273-6
DO - 10.1016/S1473-3099(12)70273-6
M3 - Review article
C2 - 23257232
AN - SCOPUS:84871065122
SN - 1473-3099
VL - 13
SP - 65
EP - 76
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 1
ER -