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Evaluating HIV prevention effectiveness: the perfect as the enemy of the good

Laga, Mariea; Rugg, Deborahb; Peersman, Greetc; Ainsworth, Marthad

doi: 10.1097/QAD.0b013e328351e7fb

There is a need to better understand the effectiveness of HIV-prevention programs. Cluster randomized designs have major limitations to evaluate such complex large-scale combination programs. To close the prevention evaluation gap, alternative evaluation designs are needed, but also better articulation of the program impact pathways and proper documentation of program implementation. Building a plausible case using mixed methods and modeling can provide a valid alternative to probability evidence. HIV prevention policies should not be limited to evidences from randomized designs only.

aDepartment of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

bInspection and Evaluation Division, UN, OIOS, New York

cPayson Center for International Development, Tulane University, New Orleans

dIndependent Evaluation Group, World Bank, Washington, District of Columbia, USA.

Correspondence to Marie Laga, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. Tel: +32 3 24763 16; fax: +32 3 24765 32; e-mail:

Received 13 October, 2011

Revised 5 January, 2012

Accepted 27 January, 2012

© 2012 Lippincott Williams & Wilkins, Inc.