The Centers for Disease Control and Prevention (CDC) has updated its list of evidence-based intervention programs that reduce the prevalence of HIV/AIDS in at-risk populations.

This update, the first since 2002, identifies 18 new behavioral interventions as "best-evidence" programs--those that have shown demonstrable results using top-notch research methods

For example, one new program, "Focus on Kids plus ImPACT," is designed to reduce substance abuse and sexually risky behavior among African-American youth in low-income urban settings by emphasizing goal setting, open communication, negotiation and consensual relationships.

Another program, Personalized Cognitive Risk-Reduction Counseling, targets men who have sex with men and encourages them to confront the conditions of their last risky sexual decision and come up with strategies to avoid them in the future.

Such programs reflect a growing appreciation within the medical and research community for the role of behavioral interventions in stemming the spread of HIV/AIDS. At the same time, they allow communities and funding organizations to spend money more efficiently on programs proven to be effective.

"For a long time, people in these organizations did what they thought was good," says Hank Tomlinson, former director of APA's Healthy Lesbian, Gay and Bisexual Students Project, who works closely with the CDC. [The new list] "allows community-based organizations to choose interventions that have been shown to be effective."

The revised list also introduces a four-tier system for classifying the relative evidence-based strength of available programs.

A panel of multidisciplinary scientists evaluated the programs and sorted them into the different tiers based on studies of the programs' efficacy and the scientific rigor behind their designs.

As programs build evidence, they can slide up the tier system, which should serve as a yardstick for researchers looking to increase the validity and exposure of their work, Tomlinson says.

-M. Price

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