Most organizations heavily involved in HIV/AIDS interventions have over the years used a distinct monitoring and evaluation framework as a management tool for measuring performance of prevention programs. Prevalence is determined by various factors; most specifically for chronic diseases defined by WHO as diseases with long duration but generally slow progression is a complex of factors that include environmental issues, nutrition, socio-economic dynamics, other prevention interventions as well as access and availability of life prolonging drugs. The HIV/AIDS prevention interventions referred to as the minimum package of services including counseling and testing, voluntary medical male circumcision, promotion of correct and consistent condom use, reduction of the number and frequency of sexual partnerships remain crucial in bringing down the HIV/AIDS pandemic.
A more accurate measure of the performance of this set of interventions is incidence rather than prevalence since prevalence is confounded by the factors alluded to earlier in this text. In the presence of life prolonging drugs (ARVs), prevalence can remain high due to a longer survival period (characteristic of a chronic disease) of an infected population. Unless we do a regression analysis of the confounding factors or otherwise use a more accurate measure I regard as incidence of new infections.