Abstract

Catalyzing quality improvements in HIV prevention

J. Ogden¹, G. Maguerez<sup>2

1</sup>Ogden Health & Develoment Connections, Lovettsville, United States, ²College Maurice Gallouen, São Paulo, Brazil

Issues: Concerns prevail about the ad hoc nature and smallness of scale that characterize many HIV prevention programs, the lack of comparability across contexts, and difficulties in measuring effectiveness. As the AIDS community gears-up to intensify HIV prevention and ensure universal access, interest in improving the quality of HIV prevention is growing, presenting a critical opportunity to develop a harmonizing conceptual framework and common language of 'quality' to apply to HIV prevention globally.
Description: This discussion paper is part of an effort by UNAIDS and the HIV Prevention Reference Group improve quality in HIV prevention. The paper proposes an approach that applies industrial sector 'quality' concepts and methods to HIV prevention, and introduces the Quality Improvement in HIV Prevention Grid. Providing a broad perspective, the grid is expected to fit any situation and any context but at the same time integrate universal evidence-based standards. There are no criteria to follow, no path imposed; it is a framework to classify actions according to the quality concept that best suits them.
Lessons learned: The authors tested the grid on the 23 services of UNAIDS' HIV Prevention Glossary. Widespread use of the grid could provide of a common language among HIV prevention stakeholders, create a culture of dialogue and stimulate exchange of experiences across diverse settings. The grid empowers those at the sharp end of prevention (the providers, implementers and beneficiaries) because it takes their knowledge, their needs and expectations seriously, and incorporates them into plans for quality improvement.
Next steps: The grid offers a potential alternative to current Quality approaches to HIV prevention, yet requires further development for field application. Because it requires a shift in perspective from orthodox public health approaches, next steps will include broad-scale dissemination incorporating opportunities for dialogue and exchange.