Background: HIV prevention and health promotion interventions operate at a number of levels ranging from individual through to broad community and structural levels. With the mobilisation of combination prevention, it is critical that we understand how the different levels work, and work in synergy. Methods: The ESAPP (Evidence Synthesis and Application for Policy and Practice) Project aimed to • Identify the areas of community HIV prevention where the published evidence of effectiveness and quality practice is most, modestly, and least developed; • Identify where the monitoring and evaluation methods used in day to day practice in community organisations to contribute to that evidence are most, modestly, and least developed; The project focused on concentrated epidemics similar to Australia. A systematic literature search was undertaken of recent published and unpublished articles and reports, and this was supplemented through liaison with key community organisations in Australia as well as Europe and North America. Over 600 documents were utilised in the review. Results: The investment in developing effective approaches to building evidence has not been consistent across health promotion approaches. While individual focused behavioural strategies have had the most attention, evaluation of key aspects of combination prevention at the community and structural level have had little investment. The evaluation of the synergies between strategies – central to combination prevention – has had even less attention. Conclusion: There is inconsistent evidence across HIV prevention and synergies of combination prevention are not well understood. Practitioners and policy makers need evaluation to be driven by an understanding of the program within a broader system and positioned as a quality improvement and strengthening processes. Without the strengthening and sharing the evaluation of interventions conducted outside of research trial contexts then most real time/real world evidence will be lost and result in policy and strategy based on incomplete evidence. Disclosure of Interest Statement: The ESAPP Project was funded by the Commonwealth Department of Health and Aging. The Australian Research Centre in Sex, Health and Society (ARCSHS) receives funding from the State, Territory and Commonwealth Government Departments. No pharmaceutical grants were received in the development of this study. ARCSHS is affiliated with La Trobe University.