A research agenda for AIDS prevention in the developing world

Abstract

Background: In the developing world, HIV is spreading in many epidemiologic patterns, ranging from slow spread in limited segments of the population to exponential growth to mature epidemics. These differences are superimposed on widely varying cultures and patterns of behavior, creating unique challenges for prevention in each setting. Local prevention research is continually necessary to respond appropriately and effectively to local prevention needs and to best use scarce resources.

The research agenda: We propose a research agenda for AIDS prevention in the developing world, consisting of three main components: epidemiologic and behavioral surveillance; enhancing local understanding of HIV risk behavior; and testing interventions. We review examples of each. This 'bottom-up' research is contrasted with 'top-down' research conducted in the developing world by scientists from developed countries to answer questions of general interest.

Results: The articles published in this volume exemplify the scope and importance of AIDS prevention research in the developing world. They also show what can be accomplished through international collaboration directed towards meeting local needs.

PIP: In the developing world, HIV is spreading in many different epidemiologic patterns. The spread may be slow among a few population groups, exponential, or at the level of a mature epidemic. HIV is spreading across a wide range of cultures and behavior patterns. A need therefore exists to tailor prevention measures to conditions and needs at local levels. Research at the local level is needed to guide the development and implementation of appropriate HIV prevention programs. The authors propose a research agenda for AIDS prevention in the developing world which consists of the following central components: epidemiologic and behavioral surveillance, improving the local understanding of HIV risk behavior, and testing interventions. Examples of each component are reviewed. In addition, bottom-up research is contrasted with top-down research conducted in the developing world by scientists from developed countries.