Structural Interventions in HIV Prevention: A Taxonomy and Descriptive Systematic Review

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• HIV prevention strategies increasingly focus on structural interventions.
• Existing frameworks for structural interventions lack comprehensive breadth and depth.
• A systematic approach is needed to categorize and understand diverse structural interventions.

Purpose of the Study:

• To develop a comprehensive and well-defined taxonomy of structural interventions for HIV prevention.
• To systematically review and categorize existing structural interventions.
• To provide a framework for understanding and implementing effective HIV prevention strategies.

Main Methods:

• Conducted a systematic review of the CDC's HIV/AIDS Prevention Research Synthesis Project database (1988-2013).
• Employed an iterative process to develop a classification taxonomy for structural interventions.
• Identified and categorized 213 distinct structural interventions.

Main Results:

• A taxonomy with 7 main categories and 20 subcategories was developed.
• The most prevalent intervention categories were Access (65%), Policy/Procedure (32%), and Mass Media (29%).
• Forty percent of interventions targeted high-risk populations, including people who inject drugs (12%).

Conclusions:

• The developed taxonomy effectively accommodates a wide range of structural interventions.
• This comprehensive classification aids in understanding the landscape of HIV prevention structural approaches.
• The taxonomy can inform the design and implementation of more effective public health interventions to prevent HIV infection.