Investigating combination HIV prevention: isolated interventions or complex system

摘要: Introduction : Treatment as prevention has mobilized new opportunities in preventing HIV transmission and led to bold UNAIDS targets testing, treatment coverage reduction. These will require not only an increase investment but also a deeper understanding of the dynamics combining behavioural, biomedical structural interventions. High-income countries are making substantial investments combination prevention, is this leading how combine interventions? The interventions involves complexity, with many strategies interacting non-linear multiplying rather than additive effects. Discussion Drawing on recent scoping study published research evidence high-income countries, paper argues that there gap between currently available needed guide achieving these targets. emphasis intervention continues look at one time isolation from its interactions other interventions, community socio-political context their implementation. To understand evaluate role we need what works, circumstances, parts play relationship each other, when needs adapt identify emergent effects any resulting synergies. There little development evidence-based indicators should achieve strategic advantage synergy. This commentary discusses implications ongoing situation for future required partnership. We suggest systems science approaches, which being increasingly applied areas public health, could provide expanded vocabulary analytic tools complex interactions, relationships Conclusions Relying current linear disconnected approaches miss potential system-level Given challenges sustaining health investment, meeting have been set likely be dependent level Keywords: prevention; evaluation; evidence; systems; research; prevention. (Published: 14 December 2015) Citation: Brown G et al. Journal International AIDS Society 2015, 18 :20499 http://www.jiasociety.org/index.php/jias/article/view/20499 | http://dx.doi.org/10.7448/IAS.18.1.20499