Measuring outcomes of behavioural interventions for STD/HIV prevention

Sexually transmitted disease (STD)/HIV specialists present a structured overview of the major challenges facing the behavioral intervention field today especially as they apply to STD/HIV prevention. Outcome measures are essential for intervention research program evaluation and surveillance. The implications of using a particular outcome measure for the conclusions and interpretation to be deduced from the findings may differ depending on whether it is used in the context of intervention research program evaluation or surveillance. Outcomes may be measured at the individual or population level. The analysis of the various aspects revolving around the selection definition and empirical specification of outcome measures associated with STD/HIV prevention-related behavioral interventions has resulted in three conclusions concerning the choice of outcome measures in STD/HIV prevention. The highest priority is to identify and define conceptually and operationally the outcome of interest. The researchers needs to consider carefully the implications of context (surveillance program evaluation and intervention research) and level of measurement (individual vs. population). The proper choice of the outcome of interest is more important than issues of measurement error. The next conclusion is that researchers should focus carefully on the issue of the use of surrogate measures (e.g. behavioral outcomes as surrogates for biomedical outcomes of interest). They should clearly state all assumptions made in choosing a particular surrogate outcome. The last conclusion is that consideration of context is very important when choosing outcome measures. Each context (surveillance vs. program evaluation vs. intervention research) implies a distinct set of strengths and weaknesses for each possible outcome of interest.