Holtgrave D R, Pinkerton S D
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, USA.
AIDS. 2000 Sep;14 Suppl 2:S27-33.
The outcome measures employed in an HIV prevention intervention study should match the research and policy questions at hand. If the question is 'did the intervention work to prevent HIV infection?', then seroincidence data may be insufficient. However, if the question is 'why did the intervention work?', then more detailed behavioral data are necessary (and sometimes behavior change itself is the real goal of an intervention study). Given the wide range of questions asked by HIV prevention policy makers, funders and researchers, a spectrum of outcome measures is needed across HIV prevention intervention studies. These include measures of behavioral determinants, HIV-related risk behaviors, HIV incidence (and other biologic markers), morbidity, mortality, and cost-effectiveness factors (such as cost per quality-adjusted life year saved). In this paper, we review the range of outcome measures used and needed in these intervention studies. Particular attention is paid to the psychometric properties of self-reported behavior change measures of sexual behavior and substance use. Additional emphasis is placed on the role of cost-effectiveness measures in intervention studies. A general framework is proposed for conceptualizing the array of outcome measure possible for any given HIV prevention intervention study.
一项HIV预防干预研究中所采用的结果指标应与手头的研究及政策问题相匹配。如果问题是“干预措施是否起到了预防HIV感染的作用？”，那么血清感染率数据可能并不充分。然而，如果问题是“干预措施为何起作用？”，那么更详细的行为数据则是必要的（有时行为改变本身就是干预研究的真正目标）。鉴于HIV预防政策制定者、资助者及研究者提出的问题范围广泛，HIV预防干预研究需要一系列的结果指标。这些指标包括行为决定因素、与HIV相关的风险行为、HIV感染率（及其他生物学标志物）、发病率、死亡率以及成本效益因素（如每挽救一个质量调整生命年的成本）。在本文中，我们回顾了这些干预研究中已使用及需要使用的结果指标范围。特别关注了性行为及物质使用的自我报告行为改变指标的心理测量特性。另外还强调了成本效益指标在干预研究中的作用。针对任何特定的HIV预防干预研究可能采用的一系列结果指标，我们提出了一个总体概念框架。
