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Effects of the Frontiers Prevention Project in Ecuador on sexual behaviours and sexually transmitted infections amongst men who have sex with men and female sex workers: challenges on evaluating complex interventions

In this study, the authors evaluate the impact of the Frontiers Prevention Project (FPP), a community-based strategy for HIV prevention amongst female sex workers (FSW) and men who have sex with men (MSM) in Ecuador. The FPP impact evaluation methodology consisted of a community trial with randomised intervention/comparison assignment and pre-post surveys in six cities in Ecuador (2003–2007). The results suggest prevention strategies involving key populations in their design and implementation can contribute to abating risk behaviours in Ecuador. However, the FPP experience also shows that implementing and evaluating large-scale HIV prevention programmes still present important challenges.