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Evaluation of PEPFAR (2013) / Chapter Skim
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5 Prevention-Main Messages
Pages 159-162

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From page 159...
... • Although PEPFAR has articulated a commitment to overarching goals for prevention, PEPFAR lacks clear target outcomes and objectives across all prevention modalities; this is especially the case for behav ioral and structural interventions for prevention of sexual transmission, the primary global driver of HIV infection. To achieve its overall goal of reducing new infections and stopping the spread of the epidemic, PEPFAR will need a more comprehensive and balanced approach, with greater clarity in its operational guidance and mechanisms to support the development, implementation, monitoring, and evalu ation of prevention portfolios in country programs that are aligned with the drivers of epidemics and the needs for prevention services.
From page 160...
... There is a critical need for improved application of advances in social and behavioral science–based research and eval uation science for prevention to determine the most effective combi nation of prevention interventions in diverse country contexts. Given the scale of its programs and its commitment to implementation research, PEPFAR can contribute to a more effective HIV response by serving as a platform for innovation to fill the gap in knowledge and availability of effective interventions.
From page 161...
... Further considerations for implementation of this recommendation: • PEPFAR has made a commitment to overarching goals for prevention and for achieving an AIDS-free generation, but this does not consti tute a long-term prevention strategy that clearly states prevention objectives and the pathways to achieving them. The following ele ments will be critical for a more comprehensive strategy to achieve successful execution of prevention programs: PEPFAR should continue to enhance its efforts to involve partner o  country stakeholders and incorporate country-specific epidemi ology, context, and priorities in planning appropriately matched prevention programs that achieve a balanced approach to HIV prevention across the available modalities.
From page 162...
... o PEPFAR's prevention strategy should include balanced support for innovation, research, and evaluation to contribute to the evolving evidence base and advance understanding of the effectiveness of interventions within all prevention modalities. To define and ensure this balance, OGAC should, through its existing mechanisms, con vene and use expertise spanning behavioral, structural, and bio medical prevention intervention approaches.

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