Authors' objectives:

This study aims to make a comprehensive list of interventions that are likely to be effective and cost-effective under the Thai setting and to identify information gaps at both the national and international levels concerning HIV prevention interventions.

Authors' recommendations: The review focused on the local evidence in Thailand using both published and unpublished (grey) literature. If the local data was not available, systematic searches of evidence from international databases were conducted. The authors classified and defined HIV prevention interventions using standard guidelines recommended by UNAIDS. The findings demonstrated that male/female condoms, street outreach programmes, programmes for the prevention of mother-to-child HIV transmission, improvement of sexually transmitted infection treatment services and male circumcision were the only interventions to show strong evidence of reducing HIV infection among target populations. Although it was recommended in the document ‘Disease Control Priorities in Developing Countries’, there was a lack of significant evidence to prove that community-based education offered good value for money in the prevention of HIV infection, in either low or high HIV prevalence settings. This review found that there was potential for interventions that aim to mitigate barriers to prevention and minimize the negative social outcomes of HIV infection e.g. increased alcohol tax, financial and in-kind sustenance support. We found very limited local evidence regarding the effectiveness of HIV interventions among the high risk populations in Thailand i.e. injecting drug users, MSM, female sex workers, and young people. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups. This review demonstrated several limitations in using effectiveness and costeffectiveness evidence for policy decision making concerning HIV/AIDS. First, a lack of proper assessment about the effectiveness and/or cost-effectiveness outcomes of many interventions poses a significant challenge in making evidence-based health policy decisions and programme reorientation. Second, although good quality of evidence was observed for assessing intervention effectiveness, a major concern is the strength of evidence used to generate the cost-effectiveness information. Third, given that we put more effort into identifying local information for HIV prevention, a majority of the studies included in the final analysis were identified from international databases rather than local sources, and may not be applicable in the Thai context.

Project Status: Completed

URL for project: http://www.hitap.net/backoffice/report/reports_display2_en.php?id=173

Year Published: 2008

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Thailand

Organisation Name: Health Intervention and Technology Assessment Program

Contact Address: 6th Floor, 6th Building, Department of Health, Ministry of Public Health Tiwanon Road, Muang, Nonthaburi 11000, Thailand www.hitap.net

Contact Name: hitap@hitap.net

Contact Email: hitap@hitap.net

Copyright: Health Intervention and Technology Assessment Program (HITAP)