Laura Balzer of the department of biostatistics and epidemiology at the University of Massachusetts Amherst will present "Estimating the Impact of Cluster-Based Interventions: The SEARCH Trial and HIV Prevention in East Africa."
Evaluation of cluster-based interventions presents significant methodological challenges. In this talk, we describe the design and analysis of the SEARCH trial, an ongoing community randomized trial to evaluate the impact of early HIV diagnosis and immediate treatment with streamlined care in rural Uganda and Kenya. We focus on three choices to optimize the design and analysis. These choices are compared theoretically and with finite sample simulations. We demonstrate how each choice improves efficiency relative to standard practice, while maintaining nominal confidence interval coverage. We conclude with practical implications and some ongoing challenges.