Effectiveness of Health Interventions towards HIV/AIDS in Developing Countries: A Systematic Review

Abstract

Background: Plentiful development has been achieved in interventions for the prevention of HIV. Although, progression of prevention programs based on evidence – informed methods that interpret the effectiveness of these approaches in population is still a challenge. In developing countries, not many interventions are implemented for reduction of HIV burden. The single most important identified problem is lack of demand, supply, and adherence approaches. In current systemic review, recent evidence for the prevention of HIV in a cascade manner is described to see status of current interventions and further needs for improvements. Methodology: Systemic reviews regarding effectiveness on interventions of HIV prevention were searched. Primary studies were identified from eligible review that evaluated one of following factors: prevalence of HIV, incidence of HIV, testing uptake of HIV and use of condom. Interventions were categorized that pursued demand for prevention of HIV, improvement in supply for preventive approaches, support related to preventive behaviors or prevent HIV directly. A rating was assigned for each intervention based on evidence strength or randomized controlled trials. Results: Out of 91 eligible reviews, 264 primary studies were included in this review. Primary studies related to direct mechanisms of prevention that showed strong data for circumcision and effectiveness of pre – exposure prophylaxis. Evidence implies that interventions related to increased supply of preventive methods including clean needles or condoms can be operative. Interventions related to demand – side and adherence approaches were less clear with some studies showing effectiveness. Quality evidence was assessed among various categories. Various interventions showed supportive outcomes and results. In our findings, it was observed that difference between behavioral and structural has not evidently distinguished the interventions. Conclusion: Growing data is present for the support of effectiveness of products, behaviors, and procedures for prevention of HIV. In developing countries, negligible data is present for implementation of such approaches on community level. Interventions will be required for transforming this evidence to produce impact on population. It will empower the demand for prevention of HIV, supply of preventive technologies and utilization of preventive approaches against HIV. The findings can be eye opener to see actual burden of HIV and their implanted interventions and can be useful to design further intervention programs in future.