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BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Correspondence

Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people

Authors: Elie A Akl, Caitlin Kennedy, Kelika Konda, Carlos F Caceres, Tara Horvath, George Ayala, Andrew Doupe, Antonio Gerbase, Charles Shey Wiysonge, Eddy R Segura, Holger J Schünemann, Ying-Ru Lo

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

The World Health Organization (WHO) Department of HIV/AIDS led the development of public health guidelines for delivering an evidence-based, essential package of interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender people in the health sector in low- and middle-income countries. The objective of this paper is to review the methodological challenges faced and solutions applied during the development of the guidelines.

Methods

The development of the guidelines followed the WHO guideline development process, which utilizes the GRADE approach. We identified, categorized and labeled the challenges identified in the guidelines development process and described the solutions through an interactive process of in-person and electronic communication.

Results

We describe how we dealt with the following challenges: (1) heterogeneous and complex interventions; (2) paucity of trial data; (3) selecting outcomes of interest; (4) using indirect evidence; (5) integrating values and preferences; (6) considering resource use; (7) addressing social and legal barriers; (8) wording of recommendations; and (9) developing global guidelines.

Conclusion

We were able to successfully apply the GRADE approach for developing recommendations for public health interventions. Applying the general principles of the approach while carefully considering specific challenges can enhance both the process and the outcome of guideline development.
Appendix
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Metadata
Title
Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people
Authors
Elie A Akl
Caitlin Kennedy
Kelika Konda
Carlos F Caceres
Tara Horvath
George Ayala
Andrew Doupe
Antonio Gerbase
Charles Shey Wiysonge
Eddy R Segura
Holger J Schünemann
Ying-Ru Lo
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-386

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