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Economic strengthening for HIV prevention and risk reduction: a review of the evidence

机译：经济加强艾滋病毒预防和减少风险：对证据的审查

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Household economic strengthening (HES) is increasingly implemented alongside HIV programing to address economic drivers of the epidemic. The evidence base on HES for HIV outcomes is growing, and this evidence review aimed to comprehensively consolidate and synthesize the research linking 15 types of HES interventions with a range of HIV prevention and treatment outcomes. The review was conducted between November 2015 and October 2016 and consisted of an academic database search, citation tracking of relevant articles, examination of secondary references, expert consultation, and a gray literature search. Studies were included if they evaluated an HES intervention(s), reported on an HIV outcome(s), were available in English, and were relevant to low-income contexts or vulnerable populations. All evidence was assessed for quality. Over 108 citations were included and a matrix framework was used to map the evidence, linking each HES intervention with each HIV outcome, providing a precise visual depiction of the evidence base.Given the volume of evidence, the results are presented and discussed in three papers, each focused on a different HIV outcome area. This is the first paper in the series and focuses on the 64 studies that reported HIV prevention outcomes. Conditional and unconditional cash transfers, and educational support were each associated with reductions in self-reported risk behaviors, particularly among adolescents. Food assistance in combination with other support also shows a positive trend for adolescent risk reduction. Most studies relied on self-reported behavioral data, and clinical outcomes such as HIV or other sexually transmitted infection (STI) incidence or prevalence were mostly null or underpowered, calling into question the true effectiveness of these interventions in preventing HIV. Limited evidence also supports the effectiveness of financial incentives in increasing voluntary medical male circumcision. Well-designed vocational/entrepreneurial training and savings interventions could bolster HIV prevention efforts for female sex workers, while findings are less conclusive for adolescents.
机译：家庭经济加强（HES）越来越多地实施艾滋病毒计划以解决流行病的经济驱动因素。关于HIV成果的证据基础正在增长，这一证据审查旨在全面巩固和综合与一系列艾滋病毒预防和治疗成果联系起合15种HES干预的研究。该审查是在2015年11月和2016年10月之间进行的，并由学术数据库搜索，引文跟踪相关文章，审查二次参考，专家咨询和灰色文献搜索。如果他们评估了他的干预，则包括研究，以艾滋病毒结果报告，以英文提供，与低收入环境或弱势群体有关。所有证据都被评估了质量。包括在108个引文中，并使用矩阵框架来映射证据，将每个HER的干预与每个HIV结果联系起来，提供了对证据基础的精确视觉描述。使证据量的数量，结果呈现并讨论了三篇论文，每个都集中在不同的艾滋病毒结果区。这是该系列中的第一个论文，并专注于报告艾滋病毒预防结果的64项研究。条件和无条件的现金转移以及教育支持各自与自我报告的风险行为减少有关，特别是青少年。与其他支持相结合的食品援助也显示出青少年风险减少的积极趋势。大多数研究依赖于自我报告的行为数据，以及艾滋病毒或其他性传播感染（STI）发病率或患病率如临床结果大多是无效的或受到动态的，呼吁质疑这些干预患者预防艾滋病毒的真正有效性。有限的证据还支持财务激励措施增加自愿医学男性割礼的有效性。精心设计的职业/企业家培训和储蓄干预措施可以为女性性工作者进行艾滋病毒预防努力，而发现的发现对于青少年而言则不太决定。

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