The PRS efficacy review process for identifying evidence-based HIV behavioral interventions is conducted using well-established systematic procedures for searching and reviewing the intervention research literature. The information presented below describes the search strategy for identifying relevant articles, study eligibility criteria for inclusion in the review, and study coding procedures for reviewing the quality of the evidence. A detailed overview of the PRS search strategy is available in the article Developing a comprehensive search strategy for evidence based systematic reviews in the open access journal Evidence Based Library and Information Practice.

Search Strategy

Using a comprehensive and systematic search strategy, PRS developed a cumulative database of the HIV, AIDS and STD prevention research literature. This cumulative database is continually updated using both automated and manual search components.

The automated search component involves the annual search of 4 electronic bibliographic databases (EMBASE, MEDLINE, PsycINFO, and Sociological Abstracts). The PRS project also conducted a systematic search of the AIDSLINE database prior to its discontinuation in December 2000. These searches identify articles that focus on HIV/AIDS or STD behavioral prevention.

The manual search component involves reviewing 35 journals to identify articles not yet indexed in the electronic databases. Biannually, PRS team members screen all issues of the journals published within the previous 6 months to locate relevant articles. To identify additional studies, PRS also examines the reference lists of published articles, HIV/AIDS Internet listservs, and unpublished manuscripts submitted by study authors.

For each eligible intervention study, the PRS cumulative database is searched to identify all articles reporting descriptive or outcome data from the same intervention. All articles describing the same intervention study are considered linked reports and are included in the review process for that study. Additional details about these search strategies and procedures can be obtained by contacting PRS.

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Study Eligibility

Once articles are identified through the systematic search, they are screened to determine eligibility for the PRS individual- and group-level intervention efficacy review. To be included in the review, studies must meet each of the following inclusion criteria.

• Outcome evaluation of an HIV, AIDS, or STD behavioral intervention
• Published or accepted for publication in a peer–reviewed journal
• Conducted in the United States or U.S. territory
• Report any of the following relevant outcome data:
  • Behaviors directly impacting HIV risk:
    • Sex risk behaviors (e.g., abstinence, mutual monogamy, number of sex partners, negotiating safer sex, condom use, refusal to have unsafe sex)
    • Drug injection behaviors (e.g., frequency of injection drug use, needle sharing)
    • HIV testing behavior
  • Biologic measures of HIV or other STD infections (e.g., prevalence or incidence measures of Hepatitis, HIV, or other STDs)

Interventions that focus on the following types of prevention are not currently included in the PRS efficacy review:

• Community-level interventions (separate efficacy review in progress)
• Substance abuse treatment only
• Needle exchange
• HIV counseling and testing only
• Partner counseling and referral services
• Policy changes
• School-based curricula

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Study Coding Procedures

Pairs of trained content analysts independently code the PRS efficacy criteria for each eligible study. This coding includes all linked articles reporting information on the same intervention study. All discrepancies between coder pairs are reconciled.

If the study does not report critical information needed to determine intervention efficacy, the PRS team contacts the principal investigator of the study to obtain the missing information or to seek additional clarification. The final efficacy determination for each study is reached by PRS team consensus.

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