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Methodologies and Formative Work for Combination Prevention Approaches

Concept Clearance


Cynthia Grossman, Ph.D.
HIV Treatment and Translation Science Branch, Secondary Prevention Program
Division of AIDS Research (DAR)

Susannah Allison, Ph.D.
HIV Prevention Science Branch, Prevention Program
Division of AIDS Research (DAR)


This initiative aims to encourage formative work and methodological innovations to address the complexities of combined HIV prevention intervention approaches.


Recent advances in biomedical interventions with critical behavioral aspects (e.g., PrEP, Treatment as Prevention) have changed how HIV prevention and treatment are conceptualized. Significant local, city, state, and federally funded efforts are shifting towards community-level interventions to reduce HIV incidence. HIV experts agree that reducing HIV incidence will only be achieved through implementation of combinations of interventions that include biomedical and behavioral interventions, as well as components that address social, economic, and other structural factors that influence HIV prevention and transmission.

Matching the pace of research on these social/economic/structural factors with the pace of community-level combination intervention efforts is of critical importance. Moreover, combined prevention intervention approaches rely on synergies of multiple elements that can be challenging to design, implement, and evaluate. To date, there have been few experimental trials of multi-level and combined prevention interventions. This initiative aims to support research to advance science that is needed for optimal HIV combination prevention intervention approaches including, but not limited to:

Indicator development research

  • Developing reliable indicators for prevention/behavioral intervention exposure;
  • Developing methods to capture behavioral, social, and structural data related to processes and implementation of community level interventions; and,
  • Advancing approaches to harmonize data measurement, reporting, and systems.

Enhanced understanding and use of existing datasets

  • Developing methods to improve the utility and integration of surveillance data with other datasets;
  • Developing methods to improve the use of clinic-level or other aggregate levels of data; and,
  • Conducting studies of the laws and practices related to reporting that differ across jurisdictions.

Advances in intervention development, implementation, and testing

  • Making methodological improvements in selection and evaluation of comparison “groups” in such trials;
  • Testing the utility of mathematical modeling in pre-trial planning, costing, and estimation for the best package selection for particular communities;
  • Expanding cost-effectiveness research: e.g., costing “collateral benefits” of programs besides HIV-specific benefits; and,
  • Identifying and testing best methods to handle loss to follow-up and missing data in community-level interventions.

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