"Scaling up"

One catchphrase that permeated the conference this past week was "scaling up." I just want to wrap up my posting here with a brief discussion of what that is, and what that means as far as HIV/AIDS prevention and treatment.

Readers who are scientists or who have some kind of science background will probably be famililar with the concept of a "pilot study." This is a study, generally small in scale, where new ideas are tested, and preliminary data are gathered. For example, a pilot study looking at how the ABCs of prevention work may take 100 individuals and split them into two groups: 50 who are taught about Abstinence, Be faithful, and Condoms, while the other group may be given no additional information, or be taught only about abstinence, for example. These two populations then can be followed and, depending on the study, outcomes measured. (Did they acquire HIV at a similar rate over, say, the next 2 years? Did faithfulness within a relationship increase in the group who were taught the ABCs? Did the abstinence-only group actually practice abstinence outside of the context of a marriage?) When the final data were examined, then, the researchers will decide whether the pilot study has achieved the outcomes specified in the beginning. If it had, these interventions could then be applied to a much larger group; it can be "scaled up" in terms of money and population.

(Continued at AIDS at 25)