[Preventing HIV infection: an exercise in evaluating scientific evidence in public health].
BACKGROUND
Evidence-based medicine (EBM) analyses scientific evidence for the efficacy/effectiveness of health interventions. It aims to identify and implement available interventions that have proved to be the best. This concept is now soundly established for clinical interventions, but just breaking for prevention, particularly when--as in HIV infection--transmission is associated to private behaviour.


METHODS
A search for studies evaluating the effects of HIV prevention interventions. All studies were critically evaluated.


RESULTS
Relevant evidence for the effects of the main specific HIV prevention interventions is reviewed, according to transmission group and study design, focusing on its methodological strength and weakness, and paying special attention to experimental research.


CONCLUSIONS
A wider debate on scientific evidence for public health interventions is proposed, trying to promote feasible and efficient EBM methods in HIV prevention research.
Guerra-Romero
L
L
Ministerio de Sanidad y Consumo, Madrid.
Noguer
I
I
Bolea
A
A
Suárez
M
M
Parras
F
F
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001688:Biological Products / Q000009:adverse effects / Q000592:standards; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D005260:Female; D005315:Fetal Diseases / Q000517:prevention & control; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006556:Heroin Dependence / Q000628:therapy; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D018671:Needle-Exchange Programs; D010353:Patient Education as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011634:Public Health; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous
D019380:Anti-HIV Agents; D001688:Biological Products; D008691:Methadone