Abstract
BackgroundHIV prevention continues to be problematic in the UK, as it does globally. The UK Department of Health has a strategic direction with greater focus on prevention as part of its World Class Commissioning Programme. There is a need for targeted evidence-based prevention initiatives. This is an exploratory study to develop an evidence mapping tool in the form of a matrix: this will be used to identify important gaps in contemporary HIV prevention evidence relevant to the UK. It has the potential to aid prioritisation in future research.MethodsCategories for prevention and risk groups were developed for HIV prevention in consultation with external experts. These were used as axes on a matrix tool to map evidence. Systematic searches for publications on HIV prevention were undertaken using electronic databases for primary and secondary research undertaken mainly in UK, USA, Canada, Australia and New Zealand, 2006-9. Each publication was screened for inclusion then coded. The risk groups and prevention areas in each paper were counted: several publications addressed multiple risk groups. The counts were exported to the matrix and clearly illustrate the concentrations and gaps of literature in HIV prevention.Results716 systematic reviews, randomised control trials and other primary research met the inclusion criteria for HIV prevention. The matrix identified several under researched areas in HIV prevention.ConclusionsThis is the first categorisation system for HIV prevention and the matrix is a novel tool for evidence mapping. Some important yet under-researched areas have been identified in HIV prevention evidence: identifying the undiagnosed population; international adaptation; education; intervention combinations; transgender; sex-workers; heterosexuals and older age groups.Other research recommendations: develop the classification system further and investigate transferability of the matrix to other prevention areas; evidence syntheses may be appropriate in areas dense with research; have studies with positive findings been translated to practice?The authors of this study invite research suggestions relating to the evidence gaps identified within remits of Public Health or any appropriate NETSCC programme.Follow the 'Suggest Research' links from:http://www.netscc.ac.uk/. Enter - HIVProject - in optional ID for HTA or in first information box for other programmes.
Highlights
HIV prevention continues to be problematic in the UK, as it does globally
Some important yet under-researched areas have been identified in HIV prevention evidence: identifying the undiagnosed population; international adaptation; education; intervention combinations; transgender; sexworkers; heterosexuals and older age groups
Other research recommendations: develop the classification system further and investigate transferability of the matrix to other prevention areas; evidence syntheses may be appropriate in areas dense with research; have studies with positive findings been translated to practice?
Summary
HIV prevention continues to be problematic in the UK, as it does globally. The UK Department of Programme. There is a need for targeted evidence-based prevention initiatives. HIV/AIDS persists as a major global health priority with the number of people living with HIV continuing to increase[1]. Working Group, a panel of leading AIDS experts, warned that prevention efforts are not keeping pace with the gains being made in treating people infected with HIV[2]. In the UK 6,630 people were newly diagnosed as HIVinfected in 2009; half were diagnosed late in infection progression; approximately 22,000 are living with HIV but remain undiagnosed (from unlinked anonymous testing)[4]. Undiagnosed infection presents two major problems: i) unaware onward transmission of HIV to others, ii) complications in presentation and treatment when late stage HIV is detected
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