Systematic Reviews and Publications: Frequently Asked Questions and Answers

A systematic review:

• summarizes individual primary studies on a topic
• provides the highest level of evidence of effectiveness
• is transparent in methods so that judgements by others can be made about the evidence
• can be used to inform recommendations or guidelines

Systematic reviews for the PRS Project are conducted in the following areas:

• intervention effectiveness (e.g., Does an intervention work?)
• prevalence of behaviors (e.g., In different populations of men who have sex with men, how many men report condomless sex after drug use?)
• prevalence of infections (e.g., In different populations of people, how many transgender women are infected with HIV?)
• barriers or facilitators (e.g., Does having a mental health condition affect retention in care?)

The PRS Project follows the steps of a systematic review below recommended by The National Academies of Sciences, Engineering, and Medicine’s (formerly the Institute of Medicine) Health and Medicine Division). These include:

• Create a team
• Develop a protocol
• Develop a comprehensive literature search
• Perform accurate screening and data abstraction
• Perform critical appraisal of individual studies
• Evaluate body of evidence
• Synthesize the data
• Develop a complete and transparent report

(adapted from Finding What Works in Health Care: Standards for Systematic Reviews (2011))

• PRS publications mirror research priorities in HIV prevention and treatment in the United States.
• Early PRS-led publications focused on behavioral interventions to reduce behaviors that can increase the chance of acquiring HIV (e.g., multiple sex partners or intravenous drug use) among persons without HIV including:
  • men who have sex with men (MSM)
  • adolescents
  • heterosexual adults
  • persons who use drugs
  • partners of these populations
• A few reviews also included persons with HIV (PWH)
• The focus expanded to interventions that promote outcomes along the HIV care continuum, including interventions to
  • improve linkage to or retention in HIV care
  • improve medication adherence
  • improve relationship between retention in HIV care and mental health
• Most recently, PRS-led reviews on:
  • epidemiological studies that estimated HIV prevalence, and prevalence of behaviors that can increase the chance of HIV infection for both transgender men and transgender women.
  • use of pre-exposure prophylaxis (PrEP) among populations who could benefit from PrEP.
  • structural interventions (i.e., interventions that alter the environment to facilitate safer behaviors or reduce the chance of HIV infection in ways that do not rely on individual change). In addition, PRS produced the first comprehensive taxonomy in the HIV literature to categorize structural interventions.