Curtin University Homepage
  • Library
  • Help
    • Admin

    espace - Curtin’s institutional repository

    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item

    Investigating combination HIV prevention: Isolated interventions or complex system

    Access Status
    Fulltext not available
    Authors
    Brown, Graham
    Reeders, D.
    Dowsett, G.
    Ellard, J.
    Carman, M.
    Hendry, N.
    Wallace, J.
    Date
    2015
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Brown, G. and Reeders, D. and Dowsett, G. and Ellard, J. and Carman, M. and Hendry, N. and Wallace, J. 2015. Investigating combination HIV prevention: Isolated interventions or complex system. Journal of the International AIDS Society. 18 (1).
    Source Title
    Journal of the International AIDS Society
    DOI
    10.7448/IAS.18.1.20499
    ISSN
    1758-2652
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/67951
    Collection
    • Curtin Research Publications
    Abstract

    © 2015 Brown G et al; licensee International AIDS Society. Introduction: Treatment as prevention has mobilized new opportunities in preventing HIV transmission and has led to bold new UNAIDS targets in testing, treatment coverage and transmission reduction. These will require not only an increase in investment but also a deeper understanding of the dynamics of combining behavioural, biomedical and structural HIV prevention interventions. High-income countries are making substantial investments in combination HIV prevention, but is this investment leading to a deeper understanding of how to combine interventions? The combining of interventions involves complexity, with many strategies interacting with non-linear and multiplying rather than additive effects. Discussion: Drawing on a recent scoping study of the published research evidence in HIV prevention in high-income countries, this paper argues that there is a gap between the evidence currently available and the evidence needed to guide the achieving of these bold targets. The emphasis of HIV prevention intervention research continues to look at one intervention at a time in isolation from its interactions with other interventions, the community and the socio-political context of their implementation. To understand and evaluate the role of a combination of interventions, we need to understand not only what works, but in what circumstances, what role the parts need to play in their relationship with each other, when the combination needs to adapt and identify emergent effects of any resulting synergies. There is little development of evidence-based indicators on how interventions in combination should achieve that strategic advantage and synergy. This commentary discusses the implications of this ongoing situation for future research and the required investment in partnership. We suggest that systems science approaches, which are being increasingly applied in other areas of public health, could provide an expanded vocabulary and analytic tools for understanding these complex interactions, relationships and emergent effects. Conclusions: Relying on the current linear but disconnected approaches to intervention research and evidence we will miss the potential to achieve and understand system-level synergies. Given the challenges in sustaining public health and HIV prevention investment, meeting the bold UNAIDS targets that have been set is likely to be dependent on achieving systems level synergies.

    Related items

    Showing items related by title, author, creator and subject.

    • Improving health outcomes by preventing intensive care related infection in Malaysia Intensive Care Unit (INVEST study)
      Soh, Kim Lam (2012)
      Ventilator-associated pneumonia (VAP), catheter-related blood stream infection (CRBSI) and pressure ulcers (PU) are well recognized complications in intensive care units (ICUs). Many of these are preventable but can also ...
    • Transport disadvantage and low-income rental housing
      Burke, T.; Stone, J.; Glackin, S.; Scheurer, Jan (2014)
      Despite the plethora of rental research, a significant gap remains in understanding the relationship between rental housing and 'transport disadvantage'. This project analyses the changing spatial concentration of ...
    • Towards the identification of modifiable personal predictors of low back pain in nursing students
      Mitchell, Timothy (2008)
      Low back pain (LBP) remains one of the most common and challenging primary care issues in the developed world. Manual occupations such as nursing are known to involve a high risk of occupational LBP, which is associated ...
    Advanced search

    Browse

    Communities & CollectionsIssue DateAuthorTitleSubjectDocument TypeThis CollectionIssue DateAuthorTitleSubjectDocument Type

    My Account

    Admin

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Follow Curtin

    • 
    • 
    • 
    • 
    • 

    CRICOS Provider Code: 00301JABN: 99 143 842 569TEQSA: PRV12158

    Copyright | Disclaimer | Privacy statement | Accessibility

    Curtin would like to pay respect to the Aboriginal and Torres Strait Islander members of our community by acknowledging the traditional owners of the land on which the Perth campus is located, the Whadjuk people of the Nyungar Nation; and on our Kalgoorlie campus, the Wongutha people of the North-Eastern Goldfields.