Evaluating AIDS prevention interventions using behavioral and biological outcome measures

Objective: To begin a dialogue on the role of behavioral and biological out come measures in evaluating the effectiveness of behavior change interventi ons to reduce the risk of transmitting and acquiring HIV and other sexually transmitted diseases (STDs), Methods: A selective review of the literature was undertaken to identify is sues and problems associated with the use of behavioral and biological outc ome measures. In particular, the article considers the validity of self-rep orts and the theoretical relationships between behavioral and biological me asures. Results: Available data suggest that when proper care is taken, behavioral self-reports are valid. Similarly, sensitive and specific diagnostic tests are available, particularly for bacterial STDs, However, even when diagnost ic tests and behavioral self-reports provide valid data, one should not exp ect a simple relationship between behavioral and biological measures. Conclusion: Both behavioral and biological measures are important outcomes for studying the efficacy and effectiveness of behavior-change intervention s. However, one measure cannot substitute for or validate the other, and ne ither serves as a true surrogate for HIV prevalence or incidence. Therefore , it is important to better understand the relationship among STDs, HIV, an d self-reported condom use. To do this, it will first be use.