San Francisco AIDS Foundation’s public policy efforts happen at the nexus of science and community. Our approach promotes the development and implementation of evidence-based HIV prevention, but recognizes that “evidence” can be derived from diverse sources—including the lived experiences of individuals and communities affected by HIV/AIDS.
In recent years, funding sources have increasingly defined evidence as a product of randomized controlled trials (RCTs)—putting the development of new HIV prevention interventions beyond the reach of most community-based organizations (CBOs) and AIDS services organizations (ASOs), which typically lack the resources to hire professional researchers.
For example, the U.S. Centers for Disease Control and Prevention (CDC), the primary funding agent of HIV prevention programs in the country, promotes a “tiers of evidence” paradigm that places RCTs at the highest, most fundable level. CDC encourages, if not requires, eligible CBOs and ASOs to adopt prevention models from a list of RCT-derived behavioral interventions that CDC deems efficacious.
Additionally, other funding sources are requiring more rigorous evaluation of data than in the past to demonstrate the efficacy of the grassroots programs established by CBOs and ASOs. However, most organizations do not have the requisite scientific training to determine what constitutes appropriate evidence of program effectiveness, and most of them lack the financial resources to hire professional researchers.
San Francisco AIDS Foundation believes that public health research, practice, and policy intersect best where diverse methodologies and outcome data are used to establish efficacy.
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