Evaluating HIV prevention: A framework for national, state and local levels

The 21st century brings with it the 20th year of the human immunodeficiency virus (HIV) epidemic in the United States. HIV prevention programs have ma tured; however, evaluations of those programs have lagged behind. Nationwid e, the need for such evaluation has never been greater. It is time to compr ehensively assess the status of HIV prevention and control. We must build o n previous studies to create a comprehensive, integrated national picture t hat includes evaluations at national, state, and local levels of the qualit y, costs, and short- and long-term effectiveness of various HIV prevention programs and policies. The Centers for Disease Control and Prevention (CDC) encourages a phased approach to implementing a comprehensive evaluation st rategy. This paper, which describes the 1995-1997 evaluation framework and activities of the Program Evaluation Research Branch, National Center for H N, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention, is offered as a platform on which future efforts in determining the most effe ctive means to prevent HIV can be built. Lessons learned in developing this comprehensive evaluation framework have advanced HIV prevention. This fram ework and lessons learned may also, in this era of performance measurement and public accountability, be generalizable beyond HIV prevention to the co mprehensive and strategic evaluation of other politically complex, publical ly-funded disease prevention and health promotion programs.