Evaluating AIDS Prevention Programs Expanded Edition (1991) / Chapter Skim
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2 Measurement of Outcomes
2 Measurement of Outcomes
Pages 34-49
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From page 34... ...
This chapter provides an overview of goal sewing, the strengths and weaknesses of various outcome objectives, and the measurement of outcomes for AIDS prevention programs. PROGRAM OBJECTIVES CDC's overall mission has been "to prevent the spread of REV infection" (CDC, 1989)
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From page 35... ...
In addition to the overarching goal of eliminating HIV transmission, the pane! recommends that explicit objectives be written for each of the major intervention programs and that these objectives be framed as measurable biological, psychological, and behavioral outcomes.
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From page 36... ...
In He following section the parcel discusses a variety of project objectives that are suitable outcomes for HIV/AIDS prevention protons, along win the strengths and weaknesses of each. 2The test itself may be a culprit in certain cases in which it is taken involuntarily, such as in a drug treatment center, hospital, or prison.
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From page 37... ...
Table 2-l summarizes the evaluation outcome measures discussed In the following pages. Biological Outcomes New HIV infection (in the form of seroconversion rates in specific populations)
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From page 38... ...
Knowledge of AIDS and HIV transmission modes C Stigmatization of persons with AIDS and HIV infection
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From page 39... ...
those who are seropositive or at high risk of infection such as intravenous Hug users or the sexual partners of intravenous drug users. Strengths and Weaknesses of Biological Outcomes Using serological data on HIV infection as the primary outcome of an evaluation effort seems intuitively appealing.
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From page 40... ...
This approach will not only allow the detection of biological program effects but will also help in interpreting and understanding the reasons for the presence or absence of such effects. Sexually transmitted and blood-borne diseases that occur with higher incidence rates than MV can sometimes provide a biological outcome of practical value In the evaluation of AIDS prevention programs.
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From page 41... ...
Behavioral Outcomes The list of possible behavioral outcomes for evaluating HIV prevention programs is quite extensive and can be subdivided In a number of ways. The first main distinction is between those behaviors that have a direct influence on the risk of acquiring HIV infection and those that have an indirect influence.
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From page 42... ...
Nevertheless, these behaviors may be important as evaluation outcomes of HIV prevention programs. Complementary prevention behaviors include HIV antibody counseling; HIV antibody testing; enrollment in a drug treatment program; informing sexual and drug partners of one's HIV status; providing l 5Pregnancy, of course, is a condition, not a behavior.
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From page 43... ...
Strengths and Weaknesses of Behavioral Outcomes The past eight years of research on AIDS and HIV transmission have confirmed the specific behaviors that are overwhelmingly responsible for HIV infection. Consequently, it is not necessary to rely on EUV seroconversion as the primary outcome of evaluation studies of HIV prevention programs because those specific behaviors can be targeted for assessment.
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From page 44... ...
These include an awareness of AIDS and HIV and of the gravity of the problems they pose; knowledge of AIDS and HIV transmission; and stigmatization of individuals who have AIDS or who are infected with HIV. These psychological outcomes do not have a direct bearing on HIV infection in the way that intercourse, drug injection, and pregnancy (for seropositive women)
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From page 45... ...
Instead, one of the most important public health goals now should be to maintain the current high level of knowledge and awareness that exists In the population about the risk of REV transmission by sexual contact and the sharing of infected equipment and dispelling misconceptions about the risk of transmission through casual contact. Strengths and Weaknesses of Psychological Outcomes Psychological outcomes that Involve awareness of AIDS and HIV, knowIedge about AIDS and EUV transmission, and attitudes toward those who are infected and iB may be the easiest outcomes to measure and study, In the sense that these measures are easily incorporated In a survey questionna~re.
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From page 46... ...
The consequences of interventions should be measured and assessed before deciding on new or alternative stages of intervention programs, a policy that will require periodic measurement of program outcomes. In addition, even if a well-planned, well-unplemented project has been successful In meeting its specified goal or goals, periodic evaluation efforts should not cease.
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From page 47... ...
With regard to reliability, the pane} notes a small but important set of studies that have begun to exaniine the reliability of sexual behavior data, collected mainly from gay men, and a limited number of small studies that have examined the reliability of measures of behavioral change made In response to the AIDS epidemic: see, for example, Saltzman and colleagues (19871; Catania and colleagues (19901; Martin and colleagues (19891; and Martin and Dean (1989~. Differential validity, that is, nonequivalent measurement biases in treatment and control groups, is a particularly worrisome concern for outcome evaluations.
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From page 48... ...
Statistical analysis of the stages of HIV infection using a Markov model. Paper presented at the Fifth International AIDS Conference.
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From page 49... ...
(1987) Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men.
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