O'Reilly, K.R., d'Aquila, E., Fonner, V., et al. AIDS and Behavior (March 2017), 21(3):626-642. doi: 10.1007/s10461-016-1615-3.
This study systematically reviewed existing evidence on the effect of HIV policy interventions on changing HIV-related behaviors in low- and middle-income countries. They defined "HIV policy interventions" as those in which a policy or law enacted by a local or national government or workplace was implemented with the goal of influencing HIV-related behavior change. The authors reviewed 15 interventions focused on HIV prevention policy (1990–2013) and identified strong evidence that prevention policies implemented among multiple populations can be effective in changing HIV-related behaviors. All policies examined led to significant changes in HIV-related outcomes—though some were negative and unanticipated (for example, some policies included in the review resulted in severe human rights violations). Other outcomes, such as a fourfold increase in condom use among sex workers with new clients or in pregnant women accepting HIV testing in prenatal care, suggested the potential of interventions promoted through policies. The authors found no studies examining HIV policy interventions among populations such as men who have sex with men, adult females not employed in sex work, or serodiscordant couples; a limited number examined patients with tuberculosis, students, and people who inject drugs. Their study, they said, suggested that combining behavioral interventions with policy interventions can be more effective than a behavioral intervention alone. They called for more policy evaluation.