Interventions for preventing late postnatal mother-to-child transmission of HIV.

PubMed

Horvath, Tara; Madi, Banyana C; Iuppa, Irene M; Kennedy, Gail E; Rutherford, George; Read, Jennifer S

2009-01-21

Worldwide, mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV) represents the most common means by which children acquire HIV infection. Efficacious and effective interventions to prevent in utero and intrapartum transmission of HIV infection have been developed and implemented. However, a large proportion of MTCT of HIV occurs postnatally, through breast milk transmission. The objectives of this systematic review were to collate and assess the evidence regarding interventions to decrease late postnatal MTCT of HIV, and to determine the efficacy of such interventions in decreasing late postnatal MTCT of HIV, increasing overall survival, and increasing HIV-free survival. Electronic searches were undertaken using PubMed, EMBASE and other databases for 1980-2008. Hand searches of reference lists of pertinent reviews and studies, as well as abstracts from relevant conferences, were also conducted. Experts in the field were contacted to locate any other studies. The search strategy was iterative. Randomized clinical trials assessing the efficacy of interventions to prevent MTCT of HIV through breast milk were included in the analysis. Other trials and intervention cohort studies with relevant data also were included, but only when randomization was not feasible due to the nature of the intervention (i.e., infant feeding modality). Data regarding HIV infection status and vital status of infants born to HIV-infected women, according to intervention, were extracted from the reports of the studies. Six randomized clinical trials and one intervention cohort study were included in this review. Two trials addressed the issue of shortening the duration of (or eliminating) exposure to breast milk. In a trial of breastfeeding versus formula feeding, formula feeding was efficacious in preventing MTCT of HIV (the cumulative probability of HIV infection at 24 months was 36.7% in the breastfeeding arm and 20.5% in the formula arm [p = 0.001]), but the

HIV prevention for South African youth: which interventions work? A systematic review of current evidence

PubMed Central

2010-01-01

Background In South Africa, HIV prevalence among youth aged 15-24 is among the world's highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges. Conclusions Key recommendations include: address HIV social risk factors, such as gender, poverty and alcohol; target the structural and institutional context; work to change social norms; and engage schools in new ways, including participatory learning. PMID:20187957

The 'third wave' of HIV prevention: filling gaps in integrated interventions, knowledge, and funding.

PubMed

Sepúlveda, Jaime

2012-07-01

There is growing optimism in the global health community that the HIV epidemic can be halted. After decades of relying primarily on behavior change to prevent HIV transmission, a second generation of prevention efforts based on medical or biological interventions such as male circumcision and preexposure prophylaxis--the use of antiretroviral drugs to protect uninfected, at-risk individuals--has shown promising results. This article calls for a third generation of HIV prevention efforts that would integrate behavioral, biological, and structural interventions focused on the social, political, and environmental underpinnings of the epidemic, making use of local epidemiological evidence to target affected populations. In this third wave, global programs should deliver HIV prevention services together with cost-effective interventions for reproductive health and for tuberculosis, malaria, and other diseases. Additionally, new efforts are needed to address gaps in HIV prevention research, evaluation, and implementation. Increased and sustained funding, along with evidence-based allocation of funds, will be necessary to accelerate the decline in new HIV infections.

HIV Prevention Interventions in Chennai, India: Are Men Who Have Sex with Men Being Reached?

PubMed Central

Thomas, Beena; Mayer, Kenneth H.; Johnson, Carey V.; Menon, Sunil; Chandrasekaran, V.; Murugesan, P.; Swaminathan, Soumya; Safren, Steven A.

2009-01-01

Abstract India has the greatest number of HIV infections in Asia and the third highest total number of infected persons globally. Men who have sex with men (MSM) are considered by the Government of India's National AIDS Control Organization (NACO) a “core risk group” for HIV in need of HIV prevention efforts. However there is a dearth of information on the frequency of participation in HIV prevention interventions and subsequent HIV risk and other correlates among MSM in India. Recruited through peer outreach workers, word of mouth and snowball sampling techniques, 210 MSM in Chennai completed an interviewer-administered assessment, including questions about participating in any HIV prevention interventions in the past year, sexual risk taking, demographics, MSM identities, and other psychosocial variables. Bivariate and multivariable logistic regression procedures were used to examine behavioral and demographic correlates with HIV prevention intervention participation. More than a quarter (26%) of the sample reported participating in an HIV prevention intervention in the year prior to study participation. Participants who reported engaging in unprotected anal sex (UAS; odds ratio [OR] = 0.28; p = 0.01) in the 3 months prior to study enrollment were less likely to have participated in an HIV prevention program in the past year. MSM who were older (OR = 1.04; p = 0.05), kothis (feminine acting/appearing and predominantly receptive partners in anal sex) compared to panthis (masculine appearing, predominantly insertive partners; OR = 5.52, p = 0.0004), those with higher educational attainment (OR = 1.48, p = 0.01), being “out” about having sex with other men (OR = 4.03, p = 0.0001), and MSM who reported ever having been paid in exchange for sex (OR = 2.92, p = 0.001) were more likely to have reported participation in an HIV prevention intervention in the preceding year. In a multivariable model, MSM reporting UAS

Adapting an Evidence-Based HIV-Prevention Intervention for Women in Domestic Violence Shelters

PubMed Central

Cavanaugh, Courtenay E.; Campbell, Jacquelyn; Braxton, Nikia; Harvey, Jenna; Wingood, Gina

2016-01-01

Objective Despite the documented intersection of intimate partner violence and HIV, there is a paucity of evidence-based HIV prevention interventions for female survivors of intimate partner violence in the United States. This paper describes the adaptation of an effective HIV prevention intervention, Sisters Informing Sisters about Topics on AIDS (SISTA), for women in domestic violence shelters and the steps taken to improve the adapted intervention’s implementation. Method The adaptation process was guided by the ADAPT-ITT framework and data collected from directors, direct client service providers, and residents of two domestic violence shelters located in urban areas, as well as topical experts. Results Eleven of 12 shelter staff (92%) reported that HIV interventions had never been implemented at their shelter and 64% reported they had not provided residents with educational brochures about HIV prevention. Changes made to adapt SISTA for this population and enhance the implementation of the intervention included reducing the intervention’s duration; adding education about the intersection of intimate partner violence, substance use, and HIV; and adding an HIV risk assessment and safety plan. Conclusions Next steps will include implementing the adapted intervention and evaluating its perceived acceptability and efficacy, and assessing whether contextual factors influence the intervention’s implementation. PMID:27398257

Operational fidelity to an evidence-based HIV prevention intervention for people living with HIV/AIDS.

PubMed

Kalichman, Seth C; Hudd, Katie; Diberto, Giorgio

2010-08-01

Evidence-based interventions are often disseminated in public health education with little known about their operational fidelity. This study examined the delivery of intervention components (operational fidelity) of a widely disseminated HIV prevention program designed for people living with HIV/AIDS named Healthy Relationships. Two hundred ninety-nine agencies that had been trained in the intervention by the Centers for Disease Control and Prevention were contacted, and 122 (41%) completed confidential interviews. Among the 93 agencies that implemented the program, 39 (40%) adapted at least one core element activity, and 21 (23%) dropped an activity. Most adaptations were intended to improve the community fit of the intervention. Agencies believed that funders demand that they implement the intervention with fidelity. Models of technology transfer that emphasize behavior change processes rather than specific curriculum content may advance prevention program dissemination.

Reducing HIV Risks in the Places where People Drink: Prevention Interventions in Alcohol Venues

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.

2015-01-01

Apart from individual alcohol drinking behavior, the context or places where people drink play a significant role in HIV transmission risk. In this paper, we review the research that has been conducted on alcohol venues to identify the social and structural factors (e.g., social norms, sexual behavior) that are associated with HIV risk in these places, to review HIV prevention interventions based in alcohol venues, and to discuss appropriate methodologies for alcohol venue research. Alcohol venues are defined here as places that sell or serve alcohol for onsite consumption, including bars, bottle stores, nightclubs, wine shops, and informal shebeens. Despite the many established HIV risk factors at play in alcohol venues, limited prevention strategies have been implemented in such places. A total of 11 HIV prevention interventions or programs were identified. HIV prevention interventions in alcohol venues may be conducted at the individual, social, or structural level. However, multilevel interventions that target more than one level appear to lead to the most sustainable behavior change. Strategies to incorporate alcohol venues in biomedical prevention strategies including antiretroviral therapy for alcohol users are also discussed. PMID:26099244

Understanding the Potential Impact of a Combination HIV Prevention Intervention in a Hyper-Endemic Community

PubMed Central

Alsallaq, Ramzi A.; Baeten, Jared M.; Celum, Connie L.; Hughes, James P.; Abu-Raddad, Laith J.; Barnabas, Ruanne V.; Hallett, Timothy B.

2013-01-01

Objectives Despite demonstrating only partial efficacy in preventing new infections, available HIV prevention interventions could offer a powerful strategy when combined. In anticipation of combination HIV prevention programs and research studies we estimated the population-level impact of combining effective scalable interventions at high population coverage, determined the factors that influence this impact, and estimated the synergy between the components. Methods We used a mathematical model to investigate the effect on HIV incidence of a combination HIV prevention intervention comprised of high coverage of HIV testing and counselling, risk reduction following HIV diagnosis, male circumcision for HIV-uninfected men, and antiretroviral therapy (ART) for HIV-infected persons. The model was calibrated to data for KwaZulu-Natal, South Africa, where adult HIV prevalence is approximately 23%. Results Compared to current levels of HIV testing, circumcision, and ART, the combined intervention with ART initiation according to current guidelines could reduce HIV incidence by 47%, from 2.3 new infections per 100 person-years (pyar) to 1.2 per 100 pyar within 4 years and by almost 60%, to 1 per 100 pyar, after 25 years. Short-term impact is driven primarily by uptake of testing and reductions in risk behaviour following testing while long-term effects are driven by periodic HIV testing and retention in ART programs. If the combination prevention program incorporated HIV treatment upon diagnosis, incidence could be reduced by 63% after 4 years and by 76% (to about 0.5 per 100 pyar) after 15 years. The full impact of the combination interventions accrues over 10–15 years. Synergy is demonstrated between the intervention components. Conclusion High coverage combination of evidence-based strategies could generate substantial reductions in population HIV incidence in an African generalized HIV epidemic setting. The full impact could be underestimated by the short assessment

Systematic review of HIV prevention interventions in China: a health communication perspective.

PubMed

Xiao, Zhiwen; Noar, Seth M; Zeng, Lily

2014-02-01

To examine whether communication strategies and principles have been utilized in the HIV prevention intervention programs conducted in China. Comprehensive literature searches were conducted using PsycINFO, Medline, and Academic Search Complete with combinations of a number of keywords. Studies were included if they (1) were conducted in China and published prior to October 2011; (2) tested interventions promoting HIV/sexual risk reduction; and (3) reported empirical outcome evaluations on HIV knowledge, condom use and other condom-related variables. Data on 11 dimensions were extracted and analyzed, including formative research, theory, message targeting, messenger and channels, process evaluation, evaluation design, outcome measures. The majority of the 45 intervention studies were not theory-based, did not report conducting formative research or process evaluation, used pretest-posttest control group designs, combined nonmedia channels, printed and visual materials, and employed HIV knowledge and condom use as outcome measures. Many HIV prevention interventions in China have been successful in reducing HIV risk-related outcomes. This literature has its weaknesses; however, the current review illuminates gaps in the literature and points to important future directions for research.

Life skills: evaluation of a theory-driven behavioral HIV prevention intervention for young transgender women.

PubMed

Garofalo, Robert; Johnson, Amy K; Kuhns, Lisa M; Cotten, Christopher; Joseph, Heather; Margolis, Andrew

2012-06-01

Young transgender women are at increased risk for HIV infection due to factors related to stigma/marginalization and participation in risky sexual behaviors. To date, no HIV prevention interventions have been developed or proven successful with young transgender women. To address this gap, we developed and pilot tested a homegrown intervention "Life Skills," addressing the unique HIV prevention needs of young transgender women aged 16-24 years. Study aims included assessing the feasibility of a small group-based intervention with the study population and examining participant's engagement in HIV-related risk behaviors pre- and 3-months-post-intervention. Fifty-one (N = 51) young transgender women enrolled in the study. Our overall attendance and retention rates demonstrate that small group-based HIV prevention programs for young transgender women are both feasible and acceptable. Trends in outcome measures suggest that participation in the intervention may reduce HIV-related risk behaviors. Further testing of the intervention with a control group is warranted.

Peer Group Intervention for HIV Prevention among Health Workers in Chile

PubMed Central

Norr, Kathleen F.; Ferrer, Lilian; Cianelli, Rosina; Crittenden, Kathleen S.; Irarrázabal, Lisette; Cabieses, Báltica; Araya, Alejandra; Bernales, Margarita

2011-01-01

We tested the impacts of a professionally assisted peer group intervention on Chilean health workers' HIV-related knowledge, attitudes, and behaviors using a quasi-experimental design with a pretest and 3-month posttest. Two Santiago suburbs were randomly assigned to the intervention or delayed intervention control condition, and five community clinics per suburb participated. Interested workers at the intervention (n = 262) and control (n = 293) clinics participated and completed both evaluations. At posttest, intervention clinic workers had higher knowledge and more positive attitudes regarding HIV, condoms, stigmatization, and self-efficacy for prevention. They reported more partner discussion about safer sex, less unprotected sex, and more involvement in HIV prevention activities in the clinic and the community, but they did not report fewer sexual partners or more standard precautions behaviors. Because of these positive impacts, the program will become a regular continuing education unit that can be used to meet health worker licensing requirements. PMID:21497113

Mano a Mano-Mujer: an effective HIV prevention intervention for Chilean women.

PubMed

Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L; McElmurry, Beverly

2012-01-01

The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries.

Enhancing HIV Prevention Among Young Men Who Have Sex With Men: A Systematic Review of HIV Behavioral Interventions for Young Gay and Bisexual Men.

PubMed

Hergenrather, Kenneth C; Emmanuel, Diona; Durant, Sarah; Rhodes, Scott D

2016-06-01

Men who have sex with men (MSM) represent 64.0% of people living with HIV (PLWH) over the age of 13 years. Young men who have sex with men (YMSM) are particularly affected by HIV/AIDS; the rate of HIV infection for YMSM between the ages of 13 and 24 represents 72.0% of new infections among youth. To understand the current state of the science meant to prevent HIV for YMSM, we reviewed studies of HIV behavioral prevention interventions for YMSM. Five literature databases were searched, from their inception through October 2015, using key words associated with HIV prevention intervention evaluation studies for YMSM. The review criteria included behavioral HIV/AIDS prevention interventions, articles published in English-language peer-reviewed journals, YMSM between 13 and 24 years of age, and longitudinal repeated measures design. A total of 15 YMSM behavioral HIV prevention intervention studies were identified that met inclusion criteria and reported statistically significant findings. Common outcomes included unprotected sexual intercourse, HIV/AIDS risk behavior, condom use, HIV testing, safer sex attitude, and HIV prevention communication. Participant age, representation of Black/African American YMSM, application of theoretical and model underpinnings, congruence of assessment measures used, follow-up assessment times, and application of process evaluation were inconsistent across studies. To advance HIV prevention intervention research for YMSM, future studies should be theory-based, identify common constructs, utilize standard measures, include process evaluation, and evaluate sustained change over standard periods of time. HIV prevention interventions should incorporate the needs of the diverse, well-educated, web-connected millennial generation and differentiate between adolescent YMSM (13 to 18 years of age) and young adulthood YMSM (19 to 24 years of age). Because Black/African American YMSM represent more than 50% of new HIV infections, future HIV

Are HIV/AIDS Prevention Interventions for Heterosexually Active Men in the United States Gender-Specific?

PubMed Central

Fullilove, Robert E.; Peacock, Dean

2009-01-01

Although gender-specific theories are often deployed in interventions to reduce women's HIV risks, the same is often not true for interventions among men. Theories of masculinity are not guiding most US research on the risky sexual behavior of heterosexual men or on what can be done to intervene. We first assess the extent to which evidence-based HIV-prevention interventions among heterosexually active men in the United States draw upon relevant theories of masculinity. Next, we introduce a useful framework within masculinity and gender studies that can be applied to HIV-prevention interventions with heterosexually active men. Finally, we make suggestions to improve the gender specificity of HIV-prevention interventions for heterosexually active men in the United States. PMID:19372506

Intervention Mapping as a Participatory Approach to Developing an HIV prevention Intervention in Rural African American Communities

PubMed Central

Corbie-Smith, Giselle; Akers, Aletha; Blumenthal, Connie; Council, Barbara; Wynn, Mysha; Muhammad, Melvin; Stith, Doris

2011-01-01

Southeastern states are among the hardest hit by the HIV epidemic in this country, and racial disparities in HIV rates are high in this region. This is particularly true in our communities of interest in rural eastern North Carolina. Although most recent efforts to prevent HIV attempt to address multiple contributing factors, we have found few multilevel HIV interventions that have been developed, tailored or tested in rural communities for African Americans. We describe how Project GRACE integrated Intervention Mapping (IM) methodology with community based participatory research (CBPR) principles to develop a multi-level, multi-generational HIV prevention intervention. IM was carried out in a series of steps from review of relevant data through producing program components. Through the IM process, all collaborators agreed that we needed a family-based intervention involving youth and their caregivers. We found that the structured approach of IM can be adapted to incorporate the principles of CBPR. PMID:20528128

Should structural interventions be evaluated using RCTs? The case of HIV prevention.

PubMed

Bonell, Christopher; Hargreaves, James; Strange, Vicki; Pronyk, Paul; Porter, John

2006-09-01

Structural interventions addressing macro-social determinants of risk have been suggested as potentially important adjuncts to biomedical and behavioural interventions for the prevention of HIV and other diseases. A few interventions of this type have been evaluated using randomised controlled trials (RCTs), the most rigorous design to evaluate the effects of biomedical and behavioural interventions. The appropriateness of applying RCTs to structural interventions is however debated. This paper considers whether issues of ethics, feasibility and utility preclude the use of RCTs in evaluations of structural interventions for HIV prevention. We conclude there is nothing particular to this category of interventions prohibiting use of RCTs. However, we suggest that RCTs may prove unacceptable, unfeasible or not useful in certain circumstances, such as where an intervention brings important benefits other than HIV prevention (such as increased income); where leaders of clusters do not allow decisions about macro-social policies to be determined randomly; where the unit of social organization addressed by an intervention is so large that recruitment of adequate numbers of clusters is impossible; and where the period required to trial interventions extends beyond practical decision-making time-scales. In such cases, alternative evaluative designs must be assessed for their ability to provide evidence of intervention effectiveness.

Interventions for preventing mother-to-child HIV transmission: protocol of an overview of systematic reviews.

PubMed

Wariki, Windy Mariane Virenia; Ota, Erika; Mori, Rintaro; Wiysonge, Charles S; Horvath, Hacsi; Read, Jennifer S

2017-06-21

Various interventions to prevent mother-to-child-transmission (MTCT) of HIV have been investigated and implemented. A number of systematic reviews assessing the efficacy of interventions for the prevention of MTCT of HIV reported antiretroviral prophylaxis, caesarean section before labour and before ruptured membranes, and complete avoidance of breastfeeding were efficacious for preventing MTCT of HIV. Recent WHO guidelines recommend lifelong antiretroviral therapy for all pregnant women for treatment of the woman's own HIV infection and for prevention of MTCT of HIV. Therefore, the objective of this overview is to evaluate the currently available systematic reviews of interventions for preventing MTCT of HIV, and to identify the current best evidence-based interventions for reducing the risk of MTCT of HIV. We will include only peer-reviewed systematic reviews of randomised or quasi-randomised controlled trials assessing the effects of interventions for preventing MTCT of HIV that target both HIV-infected women and children aged 2 years and younger born to HIV-infected women. We will search the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effectiveness, Ovid MEDLINE and EMBASE. We will assess review eligibility, the methodological quality of included systematic reviews using A Measurement Tool to Assess The Systematic Reviews and will extract data, comparing our results and resolving discrepancies by consensus. Finally, we will independently assess the certainty of the evidence using Grades of Recommendation, Assessment, Development and Evaluation. Ethics approval is not required. We will publish the results in a peer-reviewed journal and present at conferences, which will inform future research and will be useful for healthcare managers, administrators and policymakers to guide resource allocation decisions and optimisation of interventions to prevent the MTCT of HIV. © Article author(s) (or their employer(s) unless

Achievement of interventions on HIV infection prevention among migrants in China: A meta-analysis.

PubMed

Zhang, Rui; Chen, Ling; Cui, Ya Deng; Li, Ge

2018-12-01

In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for human immunodeficiency virus (HIV) infection prevention for migrants in China and to identify factors associated with intervention efficacy. A computerized literature search of the Chinese National Knowledge Infrastructure, Wan Fang, and PubMed databases was conducted to collect related articles published in China. Only self-control intervention studies or studies containing sections regarding self-control interventions wherein the method of intervention was health education were included. Rev Manager 5.3 software was used to analyze the intervention effects in terms of knowledge, attitude, and behavior indexes. Relative to pre-intervention, the HIV interventions showed statistically significant efficacy in terms of sexual transmission of HIV, condom use for HIV prevention, change in attitude towards HIV/AIDS patients, incidence of commercial sex behavior, and recent condoms use during sex (P < .01). Moreover, the baseline rate of migrants, intervention time, peer education, region, and education background were factors influencing the efficacy of the intervention. Significant improvement in terms of knowledge of sexual transmission of HIV and attitudes and behaviors among migrants was observed; however, based on the findings of previous studies, the interventions should be customized for different people from different districts in China. Further research is needed to evaluate subgroups of migrants in China according to their baseline characteristics.

Evidence-based HIV/STD prevention intervention for black men who have sex with men.

PubMed

Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

2014-04-18

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Interventions to prevent HIV/AIDS among adolescents in less developed countries: are they effective?

PubMed

Magnussen, Lesley; Ehiri, John E; Ejere, Henry O D; Jolly, Pauline E

2004-01-01

The objective of this study was to summarize and critically assess the effects of interventions to prevent HIV/AIDS among adolescents in less developed countries. Reports of studies that evaluated interventions for preventing HIV/AIDS/STDs among persons aged 11-25 years were obtained from online computer databases, by searching conference proceedings and relevant journals, and by following up references cited in published reports. Studies were included if they investigated any educational, behavioral, psychosocial or other intervention that aimed to prevent or reduce HIV/AIDS/STD among persons aged 11-25 years in a less developed country. Only studies that included a control group, and which involved pre- and post-intervention assessments were included. Outcome measures included: (i) changes in safe sex practices (abstinence, condom use, limitation of sexual partners, avoidance of casual sex), (ii) knowledge about HIV/AIDS transmission and prevention methods, (iii) perception of HIV/AIDS/STD risks, (iv) self-efficacy with regard to condom negotiation and refusal of sex, (v) uptake of voluntary counseling and testing (VCT), and (vi) reduction in incidence of HIV/AIDS/STDs. Studies were assessed in terms of intervention format (e.g., education, role-play, video), duration, and setting (school or community). Reported improvements in outcome measures in intervention versus control groups were assessed. Sixteen studies met the inclusion criteria. Thirteen of these were conducted in Africa and three in Latin America. Twelve of the sixteen studies were school-based, and four were community-based. The interventions reviewed were not resoundingly successful in achieving their goals of increasing knowledge of HIV/AIDS, altering attitudes, improving negotiation and communication skills, or in influencing positive behavior evidenced through consistent condom use, abstinence, or reducing the number of partners. Considering the importance of HIV/AIDS prevention among adolescents

Peer group intervention for HIV prevention among health workers in Chile.

PubMed

Norr, Kathleen F; Ferrer, Lilian; Cianelli, Rosina; Crittenden, Kathleen S; Irarrázabal, Lisette; Cabieses, Báltica; Araya, Alejandra; Bernales, Margarita

2012-01-01

We tested the impacts of a professionally assisted peer-group intervention on Chilean health workers' HIV-related knowledge, attitudes, and behaviors using a quasi-experimental design with a pretest and 3-month posttest. Two Santiago suburbs were randomly assigned to the intervention or delayed intervention control condition. Five community clinics per suburb participated. Interested workers at the intervention (n = 262) and control (n = 293) clinics participated and completed both evaluations. At posttest, intervention clinic workers had higher knowledge and more positive attitudes regarding HIV, condoms, stigmatization, and self-efficacy for prevention. They reported more partner discussion about safer sex, less unprotected sex, and more involvement in HIV prevention activities in the clinic and the community, but they did not report fewer sexual partners or more standard precautions behaviors. Because of these positive impacts, the program will become a regular continuing education unit that can be used to meet health-worker licensing requirements. Copyright © 2012 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Providers’ Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions

PubMed Central

Owczarzak, Jill; Dickson-Gomez, Julia

2014-01-01

Since 1999, the Centers for Disease Control have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions (DEBI) program. Based on in-depth, semi-structured interviews with a convenience sample of 22 HIV prevention service providers from 8 agencies in Wisconsin who participated in DEBI training, this article explores providers’ motivations for attending DEBI training, perceptions of the utility and value of the DEBI program, and criticisms of the program. Providers indicated that they attended training as part of general skill-building efforts, as a way to improve services through the adoption of evidence-based interventions, and to better meet client needs. DEBI training participants were critical of the program's “top down” approach, perceived lack of fit between the DEBI and their target populations, and what they perceived as a lack of evidence that the interventions would work with their particular populations. These results suggest that in order for the DEBI program to be more widely accepted, the experiences and expertise of providers need to be more fully integrated into the processes of developing, disseminating, and adapting evidence-based HIV prevention interventions. PMID:21517660

Providers' Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions

ERIC Educational Resources Information Center

Owczarzak, Jill; Dickson-Gomez, Julia

2011-01-01

Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV…

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

PubMed Central

El-Bassel, Nabila

2015-01-01

We conducted a systematic review of couple-based HIV biobehavioral (skills-building, VCT, and adherence) and biomedical (ART, circumcision) prevention and intervention studies designed to reduce sexual-and drug-risk behaviors and HIV transmission and acquisition. Of the 11,162 papers identified in the search, 93 peer-reviewed papers met the inclusion criteria and yielded a total of 33 studies conducted globally. Biobehavioral couple-based prevention and intervention studies have been efficacious in reducing sexual- and drug-risk behaviors, increasing access to HIV testing and care, and improving adherence. Biomedical couple-based studies were found to reduce HIV incidence among HIV-negative sex partners and viral load among HIV-positive partners. Despite much progress, couple-based HIV prevention and intervention studies remain limited; a number of methodological gaps exist and studies focusing on MSM, people who inject drugs, and sex workers are scarce. PMID:24980246

Straight Talk: HIV Prevention for African-American Heterosexual Men: Theoretical Bases and Intervention Design

PubMed Central

Frye, Victoria; Bonner, Sebastian; Williams, Kim; Henny, Kirk; Bond, Keosha; Lucy, Debbie; Cupid, Malik; Smith, Stephen; Koblin, Beryl A.

2016-01-01

In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. PMID:23016501

Cost and threshold analysis of an HIV/STI/hepatitis prevention intervention for young men leaving prison: Project START.

PubMed

Johnson, A P; Macgowan, R J; Eldridge, G D; Morrow, K M; Sosman, J; Zack, B; Margolis, A

2013-10-01

The objectives of this study were to: (a) estimate the costs of providing a single-session HIV prevention intervention and a multi-session intervention, and (b) estimate the number of HIV transmissions that would need to be prevented for the intervention to be cost-saving or cost-effective (threshold analysis). Project START was evaluated with 522 young men aged 18-29 years released from eight prisons located in California, Mississippi, Rhode Island, and Wisconsin. Cost data were collected prospectively. Costs per participant were $689 for the single-session comparison intervention, and ranged from $1,823 to 1,836 for the Project START multi-session intervention. From the incremental threshold analysis, the multi-session intervention would be cost-effective if it prevented one HIV transmission for every 753 participants compared to the single-session intervention. Costs are comparable with other HIV prevention programs. Program managers can use these data to gauge costs of initiating these HIV prevention programs in correctional facilities.

Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: initial data on an enrollment meta-intervention.

PubMed

Wilson, Kristina; Durantini, Marta R; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

2013-01-01

Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N=41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention.

Reducing cultural and psychological barriers to Latino enrollment in HIV-prevention counseling: Initial data on an enrollment meta-intervention

PubMed Central

Wilson, Kristina; Durantini, Marta R.; Albarracín, Julia; Crause, Candi; Albarracín, Dolores

2013-01-01

Aspects of Latino culture (e.g., machismo, marianism) can act as barriers to enrollment in HIV-prevention programs. To lift these barriers, a culturally appropriate meta-intervention was designed to increase intentions to enroll in HIV-prevention counseling by Latinos. Latino participants (N = 41) were recruited from the community and randomly assigned to either an experimental or control meta-intervention condition that varied the introduction to a HIV-prevention counseling program. Following the meta-intervention, participants were issued an invitation to take part in HIV-prevention counseling. The outcome measure was the intention to enroll in a HIV-prevention counseling session. Findings indicated that enrollment intentions were higher in the experimental meta-intervention condition (96%) than in the control meta-intervention condition (53%). In addition, the effects of the meta-intervention were comparable across genders and participant ages. Findings suggest that the use of a culturally appropriate meta-intervention may be an effective strategy for increasing Latino enrollment in HIV-prevention programs. These promising findings warrant further investigation into the efficacy and effectiveness of this meta-intervention. PMID:23398305

Structural interventions to prevent HIV/sexually transmitted disease: are they cost-effective for women in the southern United States?

PubMed

Cohen, Deborah A; Wu, Shin-Yi; Farley, Thomas A

2006-07-01

Structural interventions are theoretically promising for populations with a low prevalence of HIV, because they can reach large numbers of people to influence their social norms and collective risky behaviors for a relatively low cost per person. Because HIV transmission is continuing to increase among women in the southern United States, interventions to stem this epidemic are particularly warranted. This study explores whether structural interventions may be a cost-effective way to prevent HIV in this population. We used the cost-effectiveness estimator, "Maximizing the Benefit" to determine the relative cost-effectiveness of 6 structural HIV prevention interventions. "Maximizing the Benefit" is a spreadsheet tool using mathematical models to estimate the cost per HIV infection prevented taking into account the epidemiologic contexts, behavioral change as a result of an intervention, and the costs of intervention. We applied estimates of HIV prevalence related to blacks in the southern United States. All the structural interventions were cost-effective compared with average lifetime treatment costs of HIV, but mass media, condom availability, and alcohol taxes theoretically prevented the largest numbers of HIV infections. Although the assumptions used in cost-effectiveness estimates have many limitations, they do allow for a relative comparison of different interventions and help to inform policy decisions related to the allocation of HIV prevention resources. Structural interventions hold the greatest promise in reducing HIV transmission among low-prevalence populations.

A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions

ERIC Educational Resources Information Center

Owczarzak, Jill; Phillips, Sarah D.; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna

2016-01-01

The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to…

Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention.

PubMed

Kegeles, Susan M; Rebchook, Gregory; Tebbetts, Scott; Arnold, Emily

2015-04-17

Since the scale-up of HIV/AIDS prevention evidence-based interventions (EBIs) has not been simple, it is important to examine processes that occur in the translation of the EBIs into practice that affect successful implementation. The goal of this paper is to examine facilitators and barriers to effective implementation that arose among 72 community-based organizations as they moved into practice a multilevel HIV prevention intervention EBI, the Mpowerment Project, for young gay and bisexual men. CBOs that were implementing the Mpowerment Project participated in this study and were assessed at baseline, and 6-months, 1 year, and 2 years post-baseline. Semi-structured telephone interviews were conducted separately with individuals at each CBO. Study data came from 647 semi-structured interviews and extensive notes and commentaries from technical assistance providers. Framework Analysis guided the analytic process. Barriers and facilitators to implementation was the overarching thematic framework used across all the cases in our analysis. Thirteen themes emerged regarding factors that influence the successful implementation of the MP. These were organized into three overarching themes: HIV Prevention System Factors, Community Factors, and Intervention Factors. The entire HIV Prevention System, including coordinators, supervisors, executive directors, funders, and national HIV prevention policies, all influenced implementation success. Other Prevention System Factors that affected the effective translation of the EBI into practice include Knowledge About Intervention, Belief in the Efficacy of the Intervention, Desire to Change Existing Prevention Approach, Planning for Intervention Before Implementation, Accountability, Appropriateness of Individuals for Coordinator Positions, Evaluation of Intervention, and Organizational Stability. Community Factors included Geography and Sociopolitical Climate. Intervention Factors included Intervention Characteristics and

Web and Mobile Based HIV Prevention and Intervention Programs Pros and Cons - A Review.

PubMed

Niakan, Sharareh; Mehraeen, Esmaeil; Noori, Tayebeh; Gozali, Elahe

2017-01-01

With the increasing growth of HIV positive people the use of information and communication technologies (ICT) can play an important role in controlling the spread of the AIDS. Web and Mobile are the new technologies that young people take advantage from them. In this study a review to investigate the web and mobile based HIV prevention and intervention programs was carried out. A scoping review was conducted including PubMed, Science direct, Web of Science and Proquest to find relevant sources that published in 2009 to 2016. To identify published, original research that reported the web and mobile-based HIV prevention and intervention programs, an organized search was conducted with the following search keywords in combination: HIV, AIDS, m-Health, Mobile phone, Cell phone, Smartphone, Mobile health, internet, and web. Using the employed strategies, 173 references retrieved. Searched articles were compared based on their titles and abstracts. To identify duplicated articles, the title and abstracts were considered and 101 duplicated references were excluded. By going through the full text of related papers, 35 articles were found to be more related to the questions of this paper from which 72 final included. The advantages of web and mobile-based interventions include the possibility to provide constancy in the delivery of an intervention, impending low cost, and the ability to spread the intervention to an extensive community. Online programs such as Chat room-based Education program, Web-based therapeutic education system, and Online seek information can use for HIV/AIDS prevention. To use of mobile for HIV/AIDS prevention and intervention, programs including in: Health system focused applications, Population health focused applications, and Health messaging can be used.

HIV Prevention for Adults With Criminal Justice Involvement: A Systematic Review of HIV Risk-Reduction Interventions in Incarceration and Community Settings

PubMed Central

Dumont, Dora; Operario, Don

2014-01-01

We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32 271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12 629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches. PMID:25211725

Contextual Mediators influencing the Effectiveness of Behavioural Change Interventions: A Case of HIV/AIDS Prevention Behaviours

PubMed Central

Musiimenta, Angella

2012-01-01

Background: Although Uganda had recorded declines in HIV infection rates around 1990’s, it is argued that HIV/AIDS risk sexual behaviour, especially among the youth, started increasing again from early 2000. School-based computer-assisted HIV interventions can provide interactive ways of improving the youth’s HIV knowledge, attitudes and skills. However, these interventions have long been reported to have limited success in improving the youth’s sexual behaviours, which is always the major aim of implementing such interventions. This could be because the commonly used health promotion theories employed by these interventions have limited application in HIV prevention. These theories tend to lack sufficient attention to contextual mediators that influence ones sexual behaviours. Moreover, literature increasingly expresses dissatisfaction with the dominant prevailing descriptive survey-type HIV/AIDS-related research. Objective and Methods: The objective of this research was to identify contextual mediators that influence the youth’s decision to adopt and maintain the HIV/AIDS preventive behaviour advocated by a computer-assisted intervention. To achieve this objective, this research employed qualitative method, which provided in-depth understanding of how different contexts interact to influence the effectiveness of HIV/AIDS interventions. The research question was: What contextual mediators are influencing the youth’s decision to adopt and maintain the HIV/AIDS preventive behaviour advocated by a computer-assisted intervention? To answer this research question, 20 youth who had previously completed the WSWM intervention when they were still in secondary schools were telephone interviewed between Sept.08 and Dec.08. The collected data was then analysed, based on grounded theory’s coding scheme. Results: Findings demonstrate that although often ignored by HIV interventionists and researchers, variety of contextual mediators influence individual uptake of

Implementation of a "County-Township-Village" Allied HIV Prevention and Control Intervention in Rural China.

PubMed

Yu, Jun; Zhang, Yi; Jiang, Junjun; Lu, Qinglin; Liang, Bingyu; Liu, Deping; Fang, Keyong; Huang, Jiegang; He, Yang; Ning, Chuanyi; Liao, Yanyan; Lai, Jingzhen; Wei, Wudi; Qin, Fengxiang; Ye, Li; Geng, Wenkui; Liang, Hao

2017-09-01

In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention. Compared to traditional intervention, the innovative intervention achieved positive effects in decreasing risky behaviors. Among female sex workers, condom use rate in the last month increased from 72.06% to 96.82% (p < 0.01). Among drug users, having commercial sex rate in the last year reduced from 17.20% to 5.94% and condom use rate increased from 14.06% to 76.09% (p < 0.01). The risk ratio of HIV infection during innovative intervention was 0.631 (95% confidence interval 0.549-0.726) compared with traditional one. Cost-effectiveness analysis indicates that innovative intervention restores each disability-adjusted life year costing an average of $124.26. Taken together, Longzhou's innovative intervention has achieved good effects on HIV/AIDS prevention and control and provides a good reference for rural China.

The development, feasibility and acceptability of an Internet-based STI–HIV prevention intervention for young Chilean women

PubMed Central

Villegas, N.; Santisteban, D.; Cianelli, R.; Ferrer, L.; Ambrosia, T.; Peragallo, N.; Lara, L.

2014-01-01

Background Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI–HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI–HIV prevention interventions and avoiding barriers to services. Aims The study aimed to develop a culturally informed Internet-based STI–HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. Methods The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. Results The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. Discussion and conclusion This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI–HIV prevention and sex-related content. Implications for nursing and health policy The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI–HIV prevention strategies

Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs

ERIC Educational Resources Information Center

Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

2009-01-01

The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

Recent progress in immune-based interventions to prevent HIV-1 transmission to children.

PubMed

Voronin, Yegor; Jani, Ilesh; Graham, Barney S; Cunningham, Coleen K; Mofenson, Lynne M; Musoke, Philippa M; Permar, Sallie R; Scarlatti, Gabriella

2017-12-01

Globally, 150,000 new paediatric human immunodeficiency virus type 1 (HIV-1) infections occurred in 2015. There remain complex challenges to the global elimination of paediatric HIV-1 infection. Thus, for the global community to achieve elimination of new paediatric HIV-1 infections, innovative approaches need to be explored. Immune-based approaches to prevention of mother-to-child transmission (MTCT) may help fill some of the remaining gaps and provide new opportunities to achieve an AIDS-free generation. Immune-based interventions to prevent MTCT of HIV-1 may include paediatric HIV vaccines and passive immunization approaches. Recent discoveries providing evidence of robust immune responses to HIV in infants open new and exciting prospects for paediatric HIV vaccines. Moreover, successful vaccination of infants has a different set of requirements than vaccination of adults and may be easier to achieve. Proof-of-concept has been established over the last two decades that passively administered HIV-1 Env-specific monoclonal antibody (mAbs) can prevent chimeric simian human immunodeficiency virus (SHIV) transmission to newborn nonhuman primates. There has been tremendous progress in isolating and characterizing broadly neutralizing antibodies to HIV, and clinical testing of these antibodies for treatment and prevention in both infants and adults is a major effort in the field. Immune-based interventions need to be actively explored as they can provide critically important tools to address persistent challenges in MTCT prevention. It is a pivotal time for the field with active discussions on the best strategy to further reduce HIV infection of infants and accomplish the World Health Organization Fast-Track 2030 goals to eliminate new paediatric HIV infections. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours.

PubMed

Gibbs, Andrew; Jacobson, Jessica; Kerr Wilson, Alice

Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV. We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours. Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes. The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps.

Trauma-Informed HIV Prevention and Treatment.

PubMed

Sales, Jessica M; Swartzendruber, Andrea; Phillips, Ashley L

2016-12-01

The high prevalence of trauma and its negative impact on health and health-promoting behaviors underscore the need for multi-level interventions to address trauma and its associated sequelae to improve physical and mental well-being in both HIV-infected and HIV-uninfected populations. Growing global awareness of the intersection of trauma and HIV has resulted in development and testing of interventions to address trauma in the context of HIV treatment and HIV prevention in the USA and globally. Despite increasing recognition of the widespread nature of trauma and the importance of trauma to HIV transmission around the globe, several gaps remain. Through a survey of the literature, we identified eight studies (published in the past 5 years) describing interventions to address the effects of trauma on HIV-related outcomes. In particular, this study focused on the levels of intervention, populations the interventions were designed to benefit, and types of trauma addressed in the interventions in the context of both HIV prevention and treatment. Remarkably absent from the HIV prevention, interventions reviewed were interventions designed to address violence experienced by men or transgender individuals, in the USA or globally. Given the pervasive nature of trauma experienced generally, but especially among individuals at heightened risk for HIV, future HIV prevention interventions universally should consider becoming trauma-informed. Widespread acknowledgement of the pervasive impact of gender-based violence on HIV outcomes among women has led to multiple calls for trauma-informed care (TIC) approaches to improve the effectiveness of HIV services for HIV-infected women. TIC approaches may be relevant for and should also be tested among men and all groups with high co-occurring epidemics of HIV and trauma (e.g., men who have sex with men (MSM), transgendered populations, injection drug users, sex workers), regardless of type of trauma experience.

Trauma-Informed HIV Prevention and Treatment

PubMed Central

Sales, Jessica M.; Swartzendruber, Andrea; Phillips, Ashley L.

2016-01-01

The high prevalence of trauma and its negative impact on health and health-promoting behaviors underscore the need for multi-level interventions to address trauma and its associated sequelae to improve physical and mental well-being in both HIV-infected and HIV-uninfected populations. Growing global awareness of the intersection of trauma and HIV has resulted in development and testing of interventions to address trauma in the context of HIV treatment and HIV prevention in the U.S. and globally. Despite increasing recognition of the widespread nature of trauma and the importance of trauma to HIV transmission around the globe, several gaps remain. Through a survey of the literature, we identified 8 studies (published in the past 5 years) describing interventions to address the effects of trauma on HIV-related outcomes. In particular, this study focused on the levels of intervention, populations the interventions were designed to benefit, and types of trauma addressed in the interventions in the context of both HIV prevention and treatment. Remarkably absent from the HIV prevention interventions reviewed were interventions designed to address violence experienced by men or transgender individuals, in the U.S. or globally. Given the pervasive nature of trauma experienced generally, but especially among individuals at heightened risk for HIV, future HIV prevention interventions universally should consider becoming trauma-informed. Widespread acknowledgement of the pervasive impact of gender-based violence on HIV outcomes among women has led to multiple calls for trauma-informed care (TIC) approaches to improve the effectiveness of HIV services for HIV infected women. TIC approaches may be relevant for and should also be tested among men and all groups with high co-occurring epidemics of HIV and trauma (e.g., men who have sex with men (MSM), transgendered populations, injection drug users, sex workers), regardless of type of trauma experience. PMID:27704251

Participation and Diffusion Effects of a Peer-Intervention for HIV Prevention among Adults in Rural Malawi

PubMed Central

Crittenden, Kathleen S.; Kaponda, Chrissie P. N.; Jere, Diana L.; McCreary, Linda L.; Norr, Kathleen F.

2015-01-01

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n=415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more cost

Effects of friendship closeness in an adolescent group HIV prevention intervention.

PubMed

Morrison, Diane M; Casey, Erin A; Beadnell, Blair A; Hoppe, Marilyn J; Gillmore, Mary Rogers; Wilsdon, Anthony; Higa, Darrel; Carlisle, Shauna; Wells, Elizabeth A

2007-12-01

Although many interventions for youth rely, explicitly or implicitly, on group effects, sparse theoretical or empirical attention has been paid to the rationale for choosing a small-group design. The present study assesses the role of friendship closeness among youth in prevention intervention groups in shaping their HIV risk-related attitudes, intentions, perceived self-efficacy and perceived norms. Data from an experimental test of a group HIV prevention intervention are used to assess the relationship of friendship on cognitive outcomes at posttest and 6-month follow-up, in a multilevel regression design. Friendship among group members was assessed at baseline and post-intervention, for youth in the experimental intervention and in a control, career exploration, condition. Level of friendship within the group was positively related to attendance and enjoyment of the intervention in the control group only. Most cognitive outcomes were unaffected by individual or group levels of friendship closeness, but those effects observed were opposite to those desired. Friendly groups were no more likely to converge in their cognitions over time than were less-friendly groups. The need for more research on the effects of friendship on intervention outcomes, and for multilevel analyses of group effects, are discussed.

Librarian-initiated HIV/AIDS prevention intervention program outcome in rural communities in Oyo State, Nigeria.

PubMed

Ajuwon, G A; Komolafe-Opadeji, H O; Ikhizama, B

2013-01-01

The objective of this study was to meet the HIV/AIDS information and service needs of citizens living in selected rural, underserved communities in Oyo State, Nigeria. This was a librarian-initiated intervention program (pre-post) study of heads of rural households in Oyo State. A questionnaire was used for pre- and post-intervention assessment. The education covered knowledge about HIV/AIDS, routes of transmission, prevention strategies, and attitude toward persons living with HIV. It increased participants' knowledge about AIDS and improved attitude toward those living with HIV. Provision and dissemination of information on HIV/AIDS through librarians to rural settlers is an important prevention strategy and librarians can make major contributions.

Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients.

PubMed

Ibañez, Gladys E; Whitt, Elaine; Rosa, Mario de la; Martin, Steve; O'Connell, Daniel; Castro, Jose

2016-07-01

The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo. © The Author(s) 2016.

SOMOS: Evaluation of an HIV Prevention Intervention for Latino Gay Men

ERIC Educational Resources Information Center

Vega, Miriam Y.; Spieldenner, Andrew R.; DeLeon, Dennis; Nieto, Bolivar X.; Stroman, Carolyn A.

2011-01-01

Latino gay men face multiple barriers to human immunodeficiency virus (HIV) prevention, in particular a lack of intervention programs that integrate prevention messages with cultural norms and address issues of social marginalization from multiple communities (gay community and Latino community), homophobia and racism. In order to address these…

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

PubMed Central

Gibbs, Andrew; Jacobson, Jessica; Kerr Wilson, Alice

2017-01-01

ABSTRACT Background: Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV.Objective/Methods: We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours.Results: Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes.Conclusions: The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps. PMID:28467193

Adapting HIV prevention evidence-based interventions in practice settings: an interview study

PubMed Central

2009-01-01

Background Evidence-based interventions that are being delivered in real-world settings are adapted to enhance the external validity of these interventions. The purpose of this study was to examine multiple intervention adaptations made during pre-implementation, implementation, maintenance, and evolution phases of human immunodeficiency virus HIV prevention technology transfer. We examined two important categories of adaptations -- modifications to key characteristics, such as activities or delivery methods of interventions and reinvention of the interventions including addition and deletion of core elements. Methods Study participants were thirty-four community-based organization staff who were implementing evidence-based interventions in Los Angeles, California. Participants were interviewed twice and interviews were professionally transcribed. Transcriptions were coded by two coders with good inter-rater reliability (kappa coefficient = 0.73). Sixty-two open-ended codes for adaptation activities, which were linked to 229 transcript segments, were categorized as modifications of key characteristics or reinvention. Results Participants described activities considered modifications to key characteristics and reinvention of evidence-based interventions during pre-implementation, implementation, and maintenance phases. None of the participants reported accessing technical assistance or guidance when reinventing their interventions. Staff executed many of the recommended steps for sound adaptation of these interventions for new populations and settings. Conclusion Staff reported modifying and reinventing interventions when translating HIV prevention programs into practice. Targeted technical assistance for formative evaluation should be focused on the pre-implementation phase during which frequent modifications occur. Continuous or repeated measurements of fidelity are recommended. Increased technical assistance and guidance are needed to ensure that reinventions are

Controlling HIV Epidemics among Injection Drug Users: Eight Years of Cross-Border HIV Prevention Interventions in Vietnam and China

PubMed Central

Hammett, Theodore M.; Des Jarlais, Don C.; Kling, Ryan; Kieu, Binh Thanh; McNicholl, Janet M.; Wasinrapee, Punneeporn; McDougal, J. Stephen; Liu, Wei; Chen, Yi; Meng, Donghua; Huu Nguyen, Tho; Ngoc Hoang, Quyen; Van Hoang, Tren

2012-01-01

Introduction HIV in Vietnam and Southern China is driven by injection drug use. We have implemented HIV prevention interventions for IDUs since 2002–2003 in Lang Son and Ha Giang Provinces, Vietnam and Ning Ming County (Guangxi), China. Methods Interventions provide peer education and needle/syringe distribution. Evaluation employed serial cross-sectional surveys of IDUs 26 waves from 2002 to 2011, including interviews and HIV testing. Outcomes were HIV risk behaviors, HIV prevalence and incidence. HIV incidence estimation used two methods: 1) among new injectors from prevalence data; and 2) a capture enzyme immunoassay (BED testing) on all HIV+ samples. Results We found significant declines in drug-related risk behaviors and sharp reductions in HIV prevalence among IDUs (Lang Son from 46% to 23% [p<0.001], Ning Ming: from 17% to 11% [p = 0.003], and Ha Giang: from 51% to 18% [p<0.001]), reductions not experienced in other provinces without such interventions. There were significant declines in HIV incidence to low levels among new injectors through 36–48 months, then some rebound, particularly in Ning Ming, but BED-based estimates revealed significant reductions in incidence through 96 months. Discussion This is one of the longest studies of HIV prevention among IDUs in Asia. The rebound in incidence among new injectors may reflect sexual transmission. BED-based estimates may overstate incidence (because of false-recent results in patients with long-term infection or on ARV treatment) but adjustment for false-recent results and survey responses on duration of infection generally confirm BED-based incidence trends. Combined trends from the two estimation methods show sharp declines in incidence to low levels. The significant downward trends in all primary outcome measures indicate that the Cross-Border interventions played an important role in bringing HIV epidemics among IDUs under control. The Cross-Border project offers a model of HIV prevention for IDUs

Impact of Mano a Mano Mujer, an HIV Prevention Intervention, on Depressive Symptoms among Chilean Women

PubMed Central

Cianelli, Rosina; Lara, Loreto; Villegas, Natalia; Bernales, Margarita; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda

2012-01-01

Background Worldwide, an in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low income Chilean women. Depressed people are less willing to participate in behaviors that protect them against HIV. Objectives To analyze the impact of Mano a Mano-Mujer (MM-M) on depressive symptoms among Chilean women. Methods A quasi-experimental design was used to test the impact of MM-M, an HIV prevention intervention. The research was conducted in Santiago- Chile, a total of 400 women participated in the study (intervention group, n = 182; control group, n = 218). The intervention was guided by the social-cognitive model and the primary health model. The intervention consists of six two-hour sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face to face interviews were conducted at baseline and at 3 months follow-up Results At 3 months post-intervention, Chilean women who participated in MM-M significantly decreased their reported depressive symptoms. Conclusions MM-M provided significant benefits for women's depression symptoms. This study offers a model that address depression, a risk factor for HIV. It uses nurses as leaders for the screening of depressive symptoms and as facilitators of community interventions. PMID:22452388

Faith and HIV prevention: the conceptual framing of HIV prevention among Pentecostal Batswana teenagers

PubMed Central

2014-01-01

Background There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana; - a country with one of the highest HIV prevalence in the world. Method Participants were 213 Pentecostal church members (67% female; age range 12 to 23 years; median age = 19 years). We engaged the participants in a mixed-method inductive process to collect data on their implicit framing of HIV prevention concepts, taking into account the centrality of religion concepts to them and the moderating influences of age, gender and sexual experience. After, we analysed the data using multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) to map the ways the church youths framed HIV prevention. Results The findings suggest the church youth to conceptually frame their HIV prevention from both faith-oriented and secular-oriented perspectives, while prioritizing the faith-oriented concepts based on biblical teachings and future focus. In their secular-oriented framing of HIV prevention, the church youths endorsed the importance to learn the facts about HIV and AIDS, understanding of community norms that increased risk for HIV and prevention education. However, components of secular-oriented framing of HIV prevention concepts were comparatively less was well differentiated among the youths than with faith-oriented framing, suggesting latent influences of the church knowledge environment to undervalue secular oriented concepts. Older and sexually experienced church youths in their framing

Faith and HIV prevention: the conceptual framing of HIV prevention among Pentecostal Batswana teenagers.

PubMed

Mpofu, Elias; Nkomazana, Fidelis; Muchado, Jabulani A; Togarasei, Lovemore; Bingenheimer, Jeffrey Bart

2014-03-05

There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana;--a country with one of the highest HIV prevalence in the world. Participants were 213 Pentecostal church members (67% female; age range 12 to 23 years; median age=19 years). We engaged the participants in a mixed-method inductive process to collect data on their implicit framing of HIV prevention concepts, taking into account the centrality of religion concepts to them and the moderating influences of age, gender and sexual experience. After, we analysed the data using multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) to map the ways the church youths framed HIV prevention. The findings suggest the church youth to conceptually frame their HIV prevention from both faith-oriented and secular-oriented perspectives, while prioritizing the faith-oriented concepts based on biblical teachings and future focus. In their secular-oriented framing of HIV prevention, the church youths endorsed the importance to learn the facts about HIV and AIDS, understanding of community norms that increased risk for HIV and prevention education. However, components of secular-oriented framing of HIV prevention concepts were comparatively less was well differentiated among the youths than with faith-oriented framing, suggesting latent influences of the church knowledge environment to undervalue secular oriented concepts. Older and sexually experienced church youths in their framing of HIV prevention valued future

Outcomes of a Family-Based HIV Prevention Intervention for Substance Using Juvenile Offenders

PubMed Central

Tolou-Shams, Marina; Dauria, Emily; Conrad, Selby M.; Kemp, Kathleen; Johnson, Sarah; Brown, Larry K.

2017-01-01

Approximately 80% of all arrested youth are diverted from detention and supervised in the community through probation, specialty courts and other community-based diversion efforts. Justice-involved youth have greater psychiatric impairment, substance use and sexual risk behaviors than their non-justice-involved peers. Family-based interventions to address mental health, substance use and recidivism have been successful in improving these youth outcomes; but the lack of integration of HIV/STI prevention is notable given the co-occurrence of substance use, delinquency and sexual risk-taking behaviors among justice-involved youth. Moreover, emotion dysregulation may be an important and understudied underlying construct of these co-occurring risk behaviors for justice-involved youth. Study participants were 47 caregiver-youth dyads enrolled in a juvenile drug court program. As part of a pilot efficacy trial, dyads were randomized to a 5-session family-based integrated substance use and HIV/STI prevention intervention that relied on affect management strategies for risk reduction or an adolescent-only psychoeducation condition matched for time and attention. Data collected at baseline and 3 months post-intervention suggest that a family-based integrated affect management substance use and HIV prevention pilot intervention may lead to justice-involved youths’ enhanced motivation to change their marijuana use, decreased marijuana use and decreased risky sexual behavior over time. Future research is required to replicate these pilot trial findings and should also examine family-level mediators and moderators of treatment response, particularly with respect to HIV prevention efforts for these youth. PMID:28476263

A Model Human Sexuality--HIV/AIDS Prevention and Intervention Service-Learning Program

ERIC Educational Resources Information Center

Stewart, Clarence, M., Jr.

2005-01-01

This article deals with a service-learning program focused on human sexuality and HIV/AIDS prevention and intervention at the Howard University Department of Health, Human Performance and Leisure Studies. Topics discussed include how this program was created, an overview of peer education, HIV/AIDS peer education training, and services provided to…

Randomized community-level HIV prevention intervention trial for men who drink in South African alcohol-serving venues.

PubMed

Kalichman, Seth C; Simbayi, Leickness C; Cain, Demetria; Carey, Kate B; Carey, Michael P; Eaton, Lisa; Harel, Ofer; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

2014-10-01

South African alcohol-serving establishments (i.e., shebeens) offer unique opportunities to reduce HIV risks among men who drink. To test an individual- and a social structural-level HIV prevention intervention for men who drink in shebeens. Twelve matched pairs of township neighbourhoods were randomized to receive either (i) an HIV prevention intervention (guided by Social Action Theory) to reduce sexual risk and increase risk reduction communication in social networks, or (ii) an attention-matched control intervention that focused on the prevention of relationship violence. At the individual level, the interventions delivered skills building workshops focused on sexual risk reduction. At the social structural level, the intervention aimed to increase conversations about safer sex among men in the shebeens, distributed small media and implemented community educational events. Individual-level outcomes were assessed by following the workshop cohorts for 1 year (N = 984), and community-level outcomes were examined through cross-sectional community surveys conducted for 1 year in the shebeens (N = 9,678). Men in the HIV prevention workshops demonstrated greater condom use, more HIV prevention-oriented conversations and greater perceptions of safer sex norms than men in the comparison workshops. Changes at the community level demonstrated significant differences in condom use, although the pattern was not consistent over time. Multi-level interventions that target men who drink in South African shebeens may help reduce risks for HIV and other sexually transmitted infections. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Examining racial and ethnic minority differences among YMSM during recruitment for an online HIV prevention intervention study.

PubMed

Du Bois, Steve N; Johnson, Sarah E; Mustanski, Brian

2012-08-01

HIV disproportionately affects racial and ethnic minority young men who have sex with men (YMSM). HIV prevention research does not include these YMSM commensurate to their HIV burden. We examined racial and ethnic differences during a unique three-step recruitment process for an online, YMSM HIV prevention intervention study (N = 660). Step one was completed in-person; steps two and three online. Fewer Black and Latino YMSM completed step two-initiating online participation-than White YMSM. Internet use frequency accounted for the Latino versus White difference in initiating online participation, but not the Black versus White difference. Future online HIV prevention interventions recruiting diverse YMSM should focus on initiating online engagement among Black participants.

Examining Racial and Ethnic Minority Differences among YMSM during Recruitment for an Online HIV Prevention Intervention Study

PubMed Central

Du Bois, Steve N.; Johnson, Sarah E.; Mustanski, Brian

2011-01-01

HIV disproportionately affects racial and ethnic minority young men who have sex with men (YMSM). HIV prevention research does not include these YMSM commensurate to their HIV burden. We examined racial and ethnic differences during a unique three-step recruitment process for an online, YMSM HIV prevention intervention study (N=660). Step one was completed in-person; steps two and three online. Fewer Black and Latino YMSM completed step two – initiating online participation – than White YMSM. Internet use frequency accounted for the Latino vs. White difference in initiating online participation, but not the Black vs. White difference. Future online HIV prevention interventions recruiting diverse YMSM should focus on initiating online engagement among Black participants. PMID:21986869

Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence.

PubMed

Daniel-Ulloa, Jason; Ulibarri, M; Baquero, B; Sleeth, C; Harig, H; Rhodes, S D

2016-12-01

Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).

Evolving Strategies, Opportunistic Implementation: HIV Risk Reduction in Tanzania in the Context of an Incentive-Based HIV Prevention Intervention

PubMed Central

Packel, Laura; Keller, Ann; Dow, William H.; de Walque, Damien; Nathan, Rose; Mtenga, Sally

2012-01-01

Background Behavior change communication (BCC) interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection. Methods In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction. Results We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence. Conclusions Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting

Participation and diffusion effects of a peer-intervention for HIV prevention among adults in rural Malawi.

PubMed

Crittenden, Kathleen S; Kaponda, Chrissie P N; Jere, Diana L; McCreary, Linda L; Norr, Kathleen F

2015-05-01

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003-2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more

Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

PubMed

Cianelli, R; Lara, L; Villegas, N; Bernales, M; Ferrer, L; Kaelber, L; Peragallo, N

2013-04-01

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions. © 2012 Blackwell Publishing.

Project power: Adapting an evidence-based HIV/STI prevention intervention for incarcerated women.

PubMed

Fasula, Amy M; Fogel, Catherine I; Gelaude, Deborah; Carry, Monique; Gaiter, Juarlyn; Parker, Sharon

2013-06-01

Incarcerated women are a critical population for targeted HIV/STI prevention programming; however, there is a dearth of evidence-based, genderspecific behavioral interventions for this population. Systematically adapting existing evidence-based interventions (EBIs) can help fill this gap. We illustrate the adaptation of the HIV/STI prevention EBI, Project Safe, for use among incarcerated women and delivery in prisons. Project POWER, the final adapted intervention, was developed using formative research with prison staff and administration, incarcerated and previously incarcerated women, and input of community advisory boards. Intervention delivery adaptations included: shorter, more frequent intervention sessions; booster sessions prior to and just after release; facilitator experience in prisons and counseling; and new videos. Intervention content adaptations addressed issues of empowerment, substance use, gender and power inequity in relationships, interpersonal violence, mental health, reentry, and social support. This illustration of the adaption process provides information to inform additional efforts to adapt EBIs for this underserved population.

Proposal for the Development of a Standardized Protocol for Assessing the Economic Costs of HIV Prevention Interventions

PubMed Central

Pinkerton, Steven D.; Pearson, Cynthia R.; Eachus, Susan R.; Berg, Karina M.; Grimes, Richard M.

2008-01-01

Summary Maximizing our economic investment in HIV prevention requires balancing the costs of candidate interventions against their effects and selecting the most cost-effective interventions for implementation. However, many HIV prevention intervention trials do not collect cost information, and those that do use a variety of cost data collection methods and analysis techniques. Standardized cost data collection procedures, instrumentation, and analysis techniques are needed to facilitate the task of assessing intervention costs and to ensure comparability across intervention trials. This article describes the basic elements of a standardized cost data collection and analysis protocol and outlines a computer-based approach to implementing this protocol. Ultimately, the development of such a protocol would require contributions and “buy-in” from a diverse range of stakeholders, including HIV prevention researchers, cost-effectiveness analysts, community collaborators, public health decision makers, and funding agencies. PMID:18301128

HIV Prevention Counseling Intervention Delivered During Routine Clinical Care Reduces HIV Risk Behavior in HIV-Infected South Africans Receiving Antiretroviral Therapy: The Izindlela Zokuphila/Options for Health Randomized Trial

PubMed Central

Fisher, Jeffrey D.; Cornman, Deborah H.; Shuper, Paul A.; Christie, Sarah; Pillay, Sandy; Macdonald, Susan; Ngcobo, Ntombenhle; Amico, K. Rivet; Lalloo, Umesh; Friedland, Gerald; Fisher, William A.

2014-01-01

Context Sustainable interventions are needed to minimize HIV risk behavior among people living with HIV (PLWH) in South Africa on antiretroviral therapy (ART), a significant proportion of whom do not achieve viral suppression. Objective To determine whether a brief lay counselor delivered intervention implemented during routine care can reduce risky sex among PLWH on ART. Design Cluster randomized 16 HIV clinical care sites in KwaZulu Natal, South Africa, to intervention or standard-of-care. Setting Publicly funded HIV clinical care sites. Patients 1891 PLWH on ART received the HIV prevention counseling intervention (n = 967) or standard-of-care counseling (n = 924). Intervention Lay counselors delivered a brief intervention using motivational interviewing strategies based on the Information—Motivation—Behavioral Skills (IMB) model during routine clinical care. Main Outcome Measures Number of sexual events without a condom in the past four weeks with partners of any HIV status, and with partners perceived to be HIV-negative or HIV-status unknown, assessed at baseline, 6, 12, and 18 months. Results Intervention participants reported significantly greater reductions in HIV risk behavior on both primary outcomes, compared to standard-of-care participants. Differences in STI incidence between arms were not observed. Conclusion Effective behavioral interventions, delivered by lay counselors within the clinical care setting, are consistent with the strategy of linking HIV care and HIV prevention and integrating biomedical and behavioral approaches to stemming the HIV epidemic. PMID:25230288

Cost effectiveness of targeted HIV prevention interventions for female sex workers in India.

PubMed

Prinja, Shankar; Bahuguna, Pankaj; Rudra, Shalini; Gupta, Indrani; Kaur, Manmeet; Mehendale, S M; Chatterjee, Susmita; Panda, Samiran; Kumar, Rajesh

2011-06-01

To ascertain the cost effectiveness of targeted interventions for female sex workers (FSW) under the National AIDS Control Programme in India. A compartmental mathematical Markov state model was used over a 20-year time horizon (1995-2015) to estimate the cost effectiveness of FSW targeted interventions, with a health system perspective. The incremental costs and effects of FSW targeted interventions were compared against a baseline scenario of mass media for the general population alone. The incremental cost-effectiveness ratio was computed at a 3% discount rate using HIV infections averted and disability-adjusted life-years (DALY) as benefit measures. It was assumed that the transmission of the HIV virus moves from a high-risk group (FSW) to the client population and finally to the general population (partners of clients). Targeted interventions for FSW result in a reduction of 47% (1.6 million) prevalent and 36% (2.7 million) cumulative HIV cases, respectively, in 2015. Adult HIV prevalence in India, with and without (mass media only) FSW interventions, would be 0.25% and 0.48% in 2015. Indian government and development partners spend an average US $104 (INR4680) per HIV infection averted and US $10.7 (INR483) per DALY averted. Discounting at 3%, FSW targeted interventions cost US $105.5 (INR4748) and US $10.9 (INR490) per HIV case and DALY averted, respectively. At the current gross domestic product in India, targeted intervention is a cost-effective strategy for HIV prevention in India.

HIV prevention in primary care: impact of a clinical intervention.

PubMed

Bluespruce, J; Dodge, W T; Grothaus, L; Wheeler, K; Rebolledo, V; Carey, J W; McAfee, T A; Thompson, R S

2001-05-01

Discomfort, lack of confidence in skills, and environmental constraints may cause primary care providers to miss opportunities to discuss human immunodeficiency virus (HIV) risk with patients. We used a systems approach to address both intrapersonal and environmental barriers to HIV risk assessment and prevention counseling in a managed care clinical setting. The design was one-group pretest/posttest. The study took place in two primary care clinics of a large Pacific Northwest managed care organization. Participants (n = 49) included physicians, physician assistants, nurse practitioners, registered nurses, and social workers. The intervention included training, clarification of provider/staff roles, assess to tools and materials, and reminders/reinforcers. Outcome measures were provider attitudes, beliefs, outcome expectations, knowledge, confidence in skills, and perceived supports and barriers, measured by written pretest/posttest surveys administered 12 months apart. Seven months after the most intensive part of the intervention, providers' attitudes and beliefs were more favorable to HIV risk assessment and prevention counseling. They were less likely to express frustration with high-risk patients (decrease from 100% to 79% agreement, p = 0.001) and more confident that their advice would be effective with gay men and single adult heterosexuals (p = 0.002 and 0.005, respectively). They reported more confidence in their training in sexual history taking (p = 0.0003) and their skills assessing readiness for change (p = 0.007), and more support in practice environments. This study demonstrated that it is possible to affect important personal and environmental factors that influence primary care providers' HIV prevention behavior using an interactive, real-world systems approach. Further research is needed on providers' impact on patient behavior.

Mediation Analysis of an Adolescent HIV/STI/Pregnancy Prevention Intervention

ERIC Educational Resources Information Center

Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.

2014-01-01

Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…

eHealth Interventions for HIV Prevention in High-Risk Men Who Have Sex With Men: A Systematic Review

PubMed Central

Travers, Jasmine; Rojas, Marlene; Carballo-Diéguez, Alex

2014-01-01

Background While the human immunodeficiency virus (HIV) incidence rate has remained steady in most groups, the overall incidence of HIV among men who have sex with men (MSM) has been steadily increasing in the United States. eHealth is a platform for health behavior change interventions and provides new opportunities for the delivery of HIV prevention messages. Objective The purpose of this systematic review was to examine the use of eHealth interventions for HIV prevention in high-risk MSM. Methods We systematically searched PubMed, OVID, ISI Web of Knowledge, Google Scholar, and Google for articles and grey literature reporting the original results of any studies related to HIV prevention in MSM and developed a standard data collection form to extract information on study characteristics and outcome data. Results In total, 13 articles met the inclusion criteria, of which five articles targeted HIV testing behaviors and eight focused on decreasing HIV risk behaviors. Interventions included Web-based education modules, text messaging (SMS, short message service), chat rooms, and social networking. The methodological quality of articles ranged from 49.4-94.6%. Wide variation in the interventions meant synthesis of the results using meta-analysis would not be appropriate. Conclusions This review shows evidence that eHealth for HIV prevention in high-risk MSM has the potential to be effective in the short term for reducing HIV risk behaviors and increasing testing rates. Given that many of these studies were short term and had other limitations, but showed strong preliminary evidence of improving outcomes, additional work needs to rigorously assess the use of eHealth strategies for HIV prevention in high-risk MSM. PMID:24862459

A complex systems approach to evaluate HIV prevention in metropolitan areas: preliminary implications for combination intervention strategies.

PubMed

Marshall, Brandon D L; Paczkowski, Magdalena M; Seemann, Lars; Tempalski, Barbara; Pouget, Enrique R; Galea, Sandro; Friedman, Samuel R

2012-01-01

HIV transmission among injecting and non-injecting drug users (IDU, NIDU) is a significant public health problem. Continuing propagation in endemic settings and emerging regional outbreaks have indicated the need for comprehensive and coordinated HIV prevention. We describe the development of a conceptual framework and calibration of an agent-based model (ABM) to examine how combinations of interventions may reduce and potentially eliminate HIV transmission among drug-using populations. A multidisciplinary team of researchers from epidemiology, sociology, geography, and mathematics developed a conceptual framework based on prior ethnographic and epidemiologic research. An ABM was constructed and calibrated through an iterative design and verification process. In the model, "agents" represent IDU, NIDU, and non-drug users who interact with each other and within risk networks, engaging in sexual and, for IDUs, injection-related risk behavior over time. Agents also interact with simulated HIV prevention interventions (e.g., syringe exchange programs, substance abuse treatment, HIV testing) and initiate antiretroviral treatment (ART) in a stochastic manner. The model was constructed to represent the New York metropolitan statistical area (MSA) population, and calibrated by comparing output trajectories for various outcomes (e.g., IDU/NIDU prevalence, HIV prevalence and incidence) against previously validated MSA-level data. The model closely approximated HIV trajectories in IDU and NIDU observed in New York City between 1992 and 2002, including a linear decrease in HIV prevalence among IDUs. Exploratory results are consistent with empirical studies demonstrating that the effectiveness of a combination of interventions, including syringe exchange expansion and ART provision, dramatically reduced HIV prevalence among IDUs during this time period. Complex systems models of adaptive HIV transmission dynamics can be used to identify potential collective benefits of

Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

PubMed

Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

2015-12-01

Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. © 2013 John Wiley & Sons Ltd.

Enhancement of a Locally Developed HIV Prevention Intervention for Hispanic/Latino MSM: A Partnership of Community-Based Organizations, a University, and the Centers for Disease Control and Prevention.

PubMed

Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J; Garcia, Manuel; Painter, Thomas M

2015-08-01

Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral HIV/STD prevention interventions are currently available for use with this vulnerable population. We describe the enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated in North Carolina with support from the Centers of Disease Control and Prevention (CDC). Our intervention enhancement process included incorporating local data on risks and context; identifying community needs and priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If the CDC-sponsored evaluation determines that HOLA en Grupos is efficacious, it will be the first such behavioral HIV/STD prevention intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners.

Project Roadmap: Reeducating Older Adults in Maintaining AIDS Prevention--A Secondary Intervention for Older HIV-Positive Adults

ERIC Educational Resources Information Center

Illa, Lourdes; Echenique, Marisa; Saint Jean, Gilbert; Bustamante-Avellaneda, Victoria; Metsch, Lisa; Mendez-Mulet, Luis; Eisdorfer, Carl; Sanchez-Martinez, Mario

2010-01-01

The number of older adults living with HIV/AIDS is larger than ever. Little is known about their sexual behaviors, although contrary to stereotypes, older adults desire and engage in sexual activity. Despite increased recognition of the need for prevention interventions targeting HIV-positive individuals, no secondary HIV prevention interventions…

Developing community networks to deliver HIV prevention interventions.

PubMed Central

Guenther-Grey, C; Noroian, D; Fonseka, J; Higgins, D

1996-01-01

Outreach has a long history in health and social service programs as an important method for reaching at-risk persons within their communities. One method of "outreach" is based on the recruitment of networks of community members (or "networkers") to deliver HIV prevention messages and materials in the context of their social networks and everyday lives. This paper documents the experiences of the AIDS Community Demonstration Projects in recruiting networkers to deliver HIV prevention interventions to high-risk populations, including injecting drug users not in treatment; female sex partners of injecting drug users; female sex traders; men who have sex with men but do not self-identify as gay; and youth in high-risk situations. The authors interviewed project staff and reviewed project records of the implementation of community networks in five cities. Across cities, the projects successfully recruited persons into one or more community networks to distribute small media materials, condoms, and bleach kits, and encourage risk-reduction behaviors among community members. Networkers' continuing participation was enlisted through a variety of monetary and nonmonetary incentives. While continuous recruitment of networkers was necessary due to attrition, most interventions reported maintaining a core group of networkers. In addition, the projects appeared to serve as a starting point for some networkers to become more active in other community events and issues. PMID:8862156

Epidemic Impacts of a Community Empowerment Intervention for HIV Prevention among Female Sex Workers in Generalized and Concentrated Epidemics

PubMed Central

Wirtz, Andrea L.; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R.; Sherman, Susan G.; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

2014-01-01

Introduction Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. Methods We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5–65% in Kenya and Ukraine; 10–70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012–2016 and, compared to status quo when all interventions are held constant. Results Optimistic but feasible coverage (65%–70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. Discussion A community empowerment approach to HIV prevention and

Epidemic impacts of a community empowerment intervention for HIV prevention among female sex workers in generalized and concentrated epidemics.

PubMed

Wirtz, Andrea L; Pretorius, Carel; Beyrer, Chris; Baral, Stefan; Decker, Michele R; Sherman, Susan G; Sweat, Michael; Poteat, Tonia; Butler, Jennifer; Oelrichs, Robert; Semini, Iris; Kerrigan, Deanna

2014-01-01

Sex workers have endured a high burden of HIV infection in and across HIV epidemics. A comprehensive, community empowerment-based HIV prevention intervention emphasizes sex worker organization and mobilization to address HIV risk and often includes community-led peer education, condom distribution, and other activities. Meta-analysis of such interventions suggests a potential 51% reduction in inconsistent condom use. Mathematical modeling exercises provide theoretical insight into potential impacts of the intervention on HIV incidence and burden in settings where interventions have not yet been implemented. We used a deterministic model, Goals, to project the impact on HIV infections when the community empowerment interventions were scaled up among female sex workers in Kenya, Thailand, Brazil, and Ukraine. Modeling scenarios included expansion of the comprehensive community empowerment-based HIV prevention intervention from baseline coverage over a 5-year period (5-65% in Kenya and Ukraine; 10-70% in Thailand and Brazil), while other interventions were held at baseline levels. A second exercise increased the intervention coverage simultaneously with equitable access to ART for sex workers. Impacts on HIV outcomes among sex workers and adults are observed from 2012-2016 and, compared to status quo when all interventions are held constant. Optimistic but feasible coverage (65%-70%) of the intervention demonstrated a range of impacts on HIV: 220 infections averted over 5 yrs. among sex workers in Thailand, 1,830 in Brazil, 2,220 in Ukraine, and 10,800 infections in Kenya. Impacts of the intervention for female sex workers extend to the adult population, cumulatively averting 730 infections in Thailand to 20,700 adult infections in Kenya. Impacts vary by country, influenced by HIV prevalence in risk groups, risk behaviors, intervention use, and population size. A community empowerment approach to HIV prevention and access to universal ART for female sex workers is a

Added benefits: Reduced depressive symptom levels among African-American female adolescents participating in an HIV prevention intervention

PubMed Central

Brown, Jennifer L.; Sales, Jessica M.; Swartzendruber, Andrea L.; Eriksen, Michael D.; DiClemente, Ralph J.; Rose, Eve S.

2014-01-01

Background Adolescents experience elevated depressive symptoms which health promotion interventions may reduce. Purpose This study investigated whether HIV prevention trial participation decreased depressive symptoms among African-American female adolescents. Methods Adolescents (N=701; M age = 17.6) first received a group-delivered HIV prevention intervention and then either 12 sexual health (intervention condition) or 12 general health (comparison condition) phone counseling contacts over 24 months. ACASI assessments were conducted at baseline, and at 6-, 12-, 18-, and 24-months post-baseline. Linear generalized estimating equations were used to detect percent relative change in depressive symptoms. Results Participants reported a 2.7% decrease in depressive symptoms (p = 0.001) at each assessment. Intervention participants endorsed an additional 3.6% decrease in depressive symptoms (p = 0.058). Conclusions Trial participation was associated with reduced depressive symptomatology, particularly among those receiving personalized sexual health counseling. HIV prevention interventions may benefit from incorporating additional content to address adolescents’ mental health needs. PMID:24366521

The HOPE social media intervention for global HIV prevention in Peru: a cluster randomised controlled trial.

PubMed

Young, Sean D; Cumberland, William G; Nianogo, Roch; Menacho, Luis A; Galea, Jerome T; Coates, Thomas

2015-01-01

Social media technologies offer new approaches to HIV prevention and promotion of testing. We examined the efficacy of the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. In this cluster randomised controlled trial, Peruvian MSM from Greater Lima (including Callao) who had sex with a man in the past 12 months, were 18 years of age or older, were HIV negative or serostatus unknown, and had a Facebook account or were willing to create one (N=556) were randomly assigned (1:1) by concealed allocation to join intervention or control groups on Facebook for 12 weeks. For the intervention, Peruvian MSM were trained and assigned to be HIV prevention mentors (peer-leaders) to participants in Facebook groups. The interventions period lasted 12 weeks. Participants in control groups received an enhanced standard of care, including standard offline HIV prevention available in Peru and participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants also completed questionnaires on HIV risk behaviours and social media use at baseline and 12 week follow-up. The primary outcome was the number of participants who received a free HIV test at a local community clinic. The facebook groups were analysed as clusters to account for intracluster correlations. This trial is registered with ClinicalTrials.gov, number NCT01701206. Of 49 peer-leaders recruited, 34 completed training and were assigned at random to the intervention Facebook groups. Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted

HIV/AIDS interventions in an aging U.S. population.

PubMed

Jacobson, Stephanie A

2011-05-01

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the population of people over age 50, but few interventions have been established. The ecological perspective, which integrates intrapersonal, interpersonal, organizational, community, and policy factors, was used to review the current interventions and propose possible new HIV/AIDS prevention efforts for older adults. Intrapersonal interventions are often based on the health belief model. The precaution adoption process model was explored as an alternative intrapersonal theory for modeling prevention efforts. Community interventions using diffusion of innovations theory are fully explored, and new interventions are proposed as an option for preventing HIV/AIDS in older adults. An agenda for future research and interventions is proposed. Social workers will be at the forefront of the effort to prevent HIV/AIDS in older adults. They must accept this responsibility, propose interventions, and evaluate their effectiveness.

Recruiting and Retaining High-Risk Adolescents into Family-Based HIV Prevention Intervention Research

ERIC Educational Resources Information Center

Kapungu, Chisina T.; Nappi, Carla N.; Thakral, Charu; Miller, Steven A.; Devlin, Catharine; McBride, Cami; Hasselquist, Emily; Coleman, Gloria; Drozd, Derek; Barve, Chinmayee; Donenberg, Geri; DiClemente, Ralph; Brown, Larry

2012-01-01

The purpose of this study was to examine the effectiveness of evidence-based recruitment and retention strategies for a longitudinal, family-based HIV prevention intervention study targeting adolescents in psychiatric care by (1) determining consent rate (recruitment), rate of participation at the first intervention session (retention), and…

Sex role segregation and mixing among men who have sex with men: implications for biomedical HIV prevention interventions.

PubMed

Armbruster, Benjamin; Roy, Sourya; Kapur, Abhinav; Schneider, John A

2013-01-01

Men who have sex with men (MSM) practice role segregation - insertive or receptive only sex positions instead of a versatile role - in several international settings where candidate biomedical HIV prevention interventions (e.g., circumcision, anal microbicide) will be tested. The effects of these position-specific interventions on HIV incidence are modeled. We developed a deterministic compartmental model to predict HIV incidence among Indian MSM using data from 2003-2010. The model's sex mixing matrix was derived from network data of Indian MSM (n=4604). Our model captures changing distribution of sex roles over time. We modeled microbicide and circumcision efficacy on trials with heterosexuals. Increasing numbers of versatile MSM resulted in little change in HIV incidence over 20 years. Anal microbicides and circumcision would decrease the HIV prevalence at 10 years from 15.6% to 12.9% and 12.7% respectively. Anal microbicides would provide similar protection to circumcision at the population level despite lower modeled efficacy (54% and 60% risk reduction, respectively). Combination of the interventions were additive: in 5 years, the reduction in HIV prevalence of the combination (-3.2%) is almost the sum of their individual reductions in HIV prevalence (-1.8% and -1.7%). MSM sex role segregation and mixing, unlike changes in the sex role distribution, may be important for evaluating HIV prevention interventions in international settings. Synergies between some position-specific prevention interventions such as circumcision and anal microbicides warrant further study.

Outcomes of an HIV Prevention Peer Group Intervention for Rural Adults in Malawi

ERIC Educational Resources Information Center

Kaponda, Chrissie P. N.; Norr, Kathleen F.; Crittenden, Kathleen S.; Norr, James L.; McCreary, Linda L.; Kachingwe, Sitingawawo I.; Mbeba, Mary M.; Jere, Diana L. N.; Dancy, Barbara L.

2011-01-01

This study used a quasi-experimental design to evaluate a six-session peer group intervention for HIV prevention among rural adults in Malawi. Two rural districts were randomly assigned to intervention and control conditions. Independent random samples of community adults compared the districts at baseline and at 6 and 18 months postintervention.…

HIV prevention cost-effectiveness: a systematic review

PubMed Central

2009-01-01

Background After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion criteria included: HIV prevention intervention, year for publication (2005-2008), setting (low- and middle-income countries), and CE estimation (empirical or modeling) using outcomes in terms of cost per HIV infection averted and/or cost per disability-adjusted life year (DALY) or quality-adjusted life year (QALY). Results We found 21 distinct studies analyzing the CE of HIV-prevention interventions published in the past four years (2005-2008). Seventeen CE studies analyzed biomedical interventions; only a few dealt with behavioral and environmental/structural interventions. Sixteen studies focused on sub-Saharan Africa, and only a handful on Asia, Latin America and Eastern Europe. Many HIV-prevention interventions are very cost effective in absolute terms (using costs per DALY averted), and also in country-specific relative terms (in cost per DALY measured as percentage of GDP per capita). Conclusion There are several types of interventions for which CE studies are still not available or insufficient, including surveillance, abstinence, school-based education, universal precautions, prevention for positives and most structural interventions. The sparse CE evidence available is not easily comparable; thus, not very useful for decision

Efficacy of HIV Prevention Interventions in Latin American and Caribbean Nations, 1995–2008: A Meta-Analysis

PubMed Central

Huedo-Medina, Tania B.; Boynton, Marcella H.; Warren, Michelle R.; LaCroix, Jessica M.; Carey, Michael P.; Johnson, Blair T.

2014-01-01

This meta-analysis synthesized 34 HIV prevention interventions (from 27 studies) that were evaluated in Latin American and Caribbean nations. These studies were obtained through systematic searches of English, Spanish, and Portuguese-language databases available as of January 2009. Overall, interventions significantly increased knowledge (d = 0.51) and condom use (d = 0.28) but the effects varied widely. Interventions produced more condom use when they focused on high-risk individuals, distributed condoms, and explicitly addressed socio-cultural components. The best-fitting models utilized factors related to geography, especially indices of a nations’ human development index (HDI) and income inequality (i.e., Gini index). Interventions that provided at least three hours of content succeeded better when HDI and income inequality were lower, suggesting that intensive HIV prevention activities succeed best where the need is greatest. Implications for HIV intervention development in Latin America and the Caribbean are discussed. PMID:20661768

Peer outreach work as economic activity: implications for HIV prevention interventions among female sex workers.

PubMed

George, Annie; Blankenship, Kim M

2015-01-01

Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers' economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers' relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers.

Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers

PubMed Central

George, Annie; Blankenship, Kim M.

2015-01-01

Female sex workers (FSWs) who work as peer outreach workers in HIV prevention programs are drawn from poor socio-economic groups and consider outreach work, among other things, as an economic activity. Yet, while successful HIV prevention outcomes by such programs are attributed in part to the work of peers who have dense relations with FSW communities, there is scant discussion of the economic implications for FSWs of their work as peers. Using observational data obtained from an HIV prevention intervention for FSWs in south India, we examined the economic benefits and costs to peers of doing outreach work and their implications for sex workers’ economic security. We found that peers considered their payment incommensurate with their workload, experienced long delays receiving compensation, and at times had to advance money from their pockets to do their assigned peer outreach work. For the intervention these conditions resulted in peer attrition and difficulties in recruitment of new peer workers. We discuss the implications of these findings for uptake of services, and the possibility of reaching desired HIV outcomes. Inadequate and irregular compensation to peers and inadequate budgetary outlays to perform their community-based outreach work could weaken peers’ relationships with FSW community members, undermine the effectiveness of peer-mediated HIV prevention programs and invalidate arguments for the use of peers. PMID:25775122

Couples-Focused Prevention Program to Reduce HIV Risk Among Transgender Women and Their Primary Male Partners: Feasibility and Promise of the Couples HIV Intervention Program.

PubMed

Operario, Don; Gamarel, Kristi E; Iwamoto, Mariko; Suzuki, Sachico; Suico, Sabrina; Darbes, Lynae; Nemoto, Tooru

2017-08-01

HIV risk among transgender women has been attributed to condomless sex with primary male partners. This study pilot tested a couples-focused HIV intervention program for transgender women and their primary male partners. We analyzed data from 56 transgender women and their male partners (n = 112 participants) who were randomized as a couple to one of two groups. Participants in the intervention group (27 couples) received 3 counseling sessions: 2 couples-focused sessions, which discussed relationship dynamics, communication, and HIV risk, and 1 individual-focused session on HIV prevention concerns. Participants in the control group (29 couples) received 1 session on general HIV prevention information delivered to both partners together. At 3-month follow-up, participants in the intervention reported lower odds of condomless sex with primary partners (OR 0.5, 95 % CI 0.3-1.0), reduced odds of engaging in sex with a casual partner (OR 0.3, 95 % CI 0.1-1.0), and reduction in the number of casual partners (B = -1.45, SE = 0.4) compared with the control group. Findings provide support for the feasibility and promise of a couples-focused HIV prevention intervention for transgender women and their primary male partners.

Religious communities and HIV prevention: an intervention-study using a human rights-based approach

PubMed Central

Paiva, V.; Garcia, J.; Rios, L.F.; Santos, A.O.; Terto, V.; Munõz-Laboy, M.

2011-01-01

Religious communities have been a challenge to HIV prevention globally. Focusing on the acceptability component of the right to health, this intervention study examined how local Catholic, Evangelical and Afro-Brazilian religious communities can collaborate to foster young people’s sexual health and ensure their access to comprehensive HIV prevention in their communities in Brazil. This article describes the process of a three-stage sexual health promotion and HIV prevention initiative that used a multicultural human rights approach to intervention. Methods included 27 in-depth interviews with religious authorities on sexuality, AIDS prevention and human rights, and training 18 young people as research-agents, who surveyed 177 youth on the same issues using self-administered questionnaires. The results, analysed using a rights-based perspective on health and the vulnerability framework, were discussed in daylong interfaith workshops. Emblematic of the collaborative process, workshops are the focus of the analysis. Our findings suggest that this human rights framework is effective in increasing inter-religious tolerance and in providing a collective understanding of the sexuality and prevention needs of youth from different religious communities, and also serves as a platform for the expansion of state AIDS programmes based on laical principles. PMID:20373192

Theory-based interventions in STIs/HIV Prevention: A systematic review of the literature in Iran

PubMed Central

Latifi, Arman; Merghati-Khoei, Effat; Shojaeizadeh, Davood; Nedjat, Saharnaz; Mehri, Ali; Garmaroudi, Gholamreza

2017-01-01

Background: Various theory-based interventions (TBIs) have been done to prevent STI/HIV. The current study aimed at reviewing the TBIs for STI/HIV prevention in Iran. Methods: We systematically searched 6 English and Persian electronic databases to identify TBIs conducted for STI/HIV prevention in Iran. General searches were conducted using PubMed MeSH terms. Articles were included if they were interventional and conducted using models and theories, aimed at reducing the risk of STIs, were quasi-experimental or experimental, and if their full text was available. Results: Overall, 1042 studies were found. Finally, 13 original studies met our inclusion criteria. The findings indicated that HBM and TPB were the most frequently used theory/models. High school students and drug abusers were the most common target groups in the included studies. Conclusion: The results revealed that the majority of the conducted TBIs contained a methodological weakness. Conducting randomized controlled trials is needed to evaluate the effectiveness of the TBIs.

A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention

PubMed Central

Kennedy, Caitlin E.; Fonner, Virginia A.; O'Reilly, Kevin R.; Sweat, Michael D.

2013-01-01

Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. We conducted a systematic review by searching electronic databases from 1990-2012, examining secondary references, and hand searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of 5,218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with 6 conducted in sub-Saharan Africa, 3 in South or Southeast Asia, and 3 in Latin America and the Caribbean. Target populations included adult women (N=6), female sex workers/bar workers (N=3), and youth/orphans (N=3). All studies targeted females except 2 among youth/orphans. Study rigor was moderate, with 2 group-randomized trials and 2 individual-randomized trials. All interventions except 3 included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these interventions may have important effects

A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention.

PubMed

Kennedy, Caitlin E; Fonner, Virginia A; O'Reilly, Kevin R; Sweat, Michael D

2014-01-01

Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. The authors conducted a systematic review by searching electronic databases from 1990 to 2012, examining secondary references, and hand-searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care, or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of the 5218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with six conducted in sub-Saharan Africa, three in South or Southeast Asia, and three in Latin America and the Caribbean. Target populations included adult women (N = 6), female sex workers/bar workers (N = 3), and youth/orphans (N = 3). All studies targeted females except two among youth/orphans. Study rigor was moderate, with two group-randomized trials and two individual-randomized trials. All interventions except three included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners, or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these

The Effectiveness of HIV Prevention Interventions in Socioeconomically Disadvantaged Ethnic Minority Women: A Systematic Review and Meta-Analysis.

PubMed

Ruiz-Perez, Isabel; Murphy, Matthew; Pastor-Moreno, Guadalupe; Rojas-García, Antonio; Rodríguez-Barranco, Miguel

2017-12-01

Surveys in the United States and Europe have shown a plateau of new HIV cases, with certain regions and populations disproportionately affected by the disease. Ethnic minority women and socioeconomically disadvantaged groups are disproportionately affected by HIV. Previous reviews have focused on prevention interventions targeting ethnic minority men who have sex with men, have not accounted for socioeconomic status, or have included only interventions carried out in clinical settings. To review and assess the effectiveness of HIV prevention interventions targeting socioeconomically disadvantaged ethnic minority women in member states of the Organisation for Economic Co-operation and Development (OECD). On March 31, 2014, we executed a search using a strategy designed for the MEDLINE (Ovid), CINAHL, Embase, Scopus, and Web of Knowledge databases. Additional searches were conducted through the Cochrane Library, CRD Databases, metaRegister of Controlled Trials, EURONHEED, CEA Registry, and the European Action Program for Health Inequities as well as in gray literature sources. No language or date restrictions were applied. We selected studies assessing the effectiveness of interventions to prevent HIV among ethnic minority women of low socioeconomic status in which at least 80% of participants were reported to belong to an ethnic minority group and to have a low income or be unemployed. We included only studies that were conducted in OECD member states and were randomized controlled trials or quasi-experimental investigations with a comparison group. A data extraction form was developed for the review and used to collect relevant information from each study. We summarized results both qualitatively and quantitatively. The main outcomes were categorized into 3 groups: improved knowledge regarding transmission of HIV, behavior changes related to HIV transmission, and reductions in the incidence of sexually transmitted infections (STIs). We then performed meta

HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action.

PubMed

Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana

2017-08-01

The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.

Lessons Learned From Dissemination of Evidence-Based Interventions for HIV Prevention.

PubMed

Collins, Charles B; Sapiano, Tobey N

2016-10-01

In 1999, IOM issued a report that recommended that the Centers for Disease Control and Prevention should disseminate evidence-based HIV prevention interventions (EBIs) to be implemented by health departments, community-based organizations, drug treatment centers, and clinics. Based on these recommendations, the Diffusion of Effective Behavioral Interventions Project was initiated in 2000 and began disseminating interventions into public health practice. For 15 years, the Centers for Disease Control and Prevention has disseminated 29 EBIs to more than 11,300 agencies. Lessons were identified during the 15 years of implementation regarding successful methods of dissemination of EBIs. Lessons around selecting interventions for dissemination, developing a dissemination infrastructure including a resource website (https://effectiveinterventions.cdc.gov), and engagement with stakeholders are discussed. A continuous development approach ensured that intervention implementation materials, instructions, and technical assistance were all tailored to the needs of end users, focus populations, and agency capacities. Six follow-up studies demonstrated that adopters of EBIs were able to obtain comparable outcomes to those of the original efficacy research. The Diffusion of Effective Behavioral Interventions Project may offer guidance for other large, national, evidence-based public health dissemination projects. Published by Elsevier Inc.

Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness.

PubMed

Wainberg, Milton L; Alfredo González, M; McKinnon, Karen; Elkington, Katherine S; Pinto, Diana; Gruber Mann, Claudio; Mattos, Paulo E

2007-07-01

As in other countries worldwide, adults with severe mental illness (SMI) in Brazil are disproportionately infected with HIV relative to the general population. Brazilian psychiatric facilities lack tested HIV prevention interventions. To adapt existing interventions, developed only in the US, we conducted targeted ethnography with adults with SMI and staff from two psychiatric institutions in Brazil. We sought to characterize individual, institutional, and interpersonal factors that may affect HIV risk behavior in this population. We conducted 350 hours of ethnographic field observations in two mental health service settings in Rio de Janeiro, and 9 focus groups (n=72) and 16 key-informant interviews with patients and staff in these settings. Data comprised field notes and audiotapes of all exchanges, which were transcribed, coded, and systematically analyzed. The ethnography identified and/or characterized the institutional culture: (1) patients' risk behaviors; (2) the institutional setting; (3) intervention content; and (4) intervention format and delivery strategies. Targeted ethnography also illuminated broader contextual issues for development and implementation of HIV prevention interventions for adults with SMI in Brazil, including an institutional culture that did not systematically address patients' sexual behavior, sexual health, or HIV sexual risk, yet strongly impacted the structure of patients' sexual networks. Further, ethnography identified the Brazilian concept of "social responsibility" as important to prevention work with psychiatric patients. Targeted ethnography with adults with SMI and institutional staff provided information critical to the adaptation of tested US HIV prevention interventions for Brazilians with SMI.

Comprehensive HIV Prevention for Transgender Persons.

PubMed

Neumann, Mary Spink; Finlayson, Teresa J; Pitts, Nicole L; Keatley, JoAnne

2017-02-01

Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons' HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels-socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration.

Comprehensive HIV Prevention for Transgender Persons

PubMed Central

Neumann, Mary Spink; Finlayson, Teresa J.; Pitts, Nicole L.; Keatley, JoAnne

2017-01-01

Transgender persons are at high risk for HIV infection, but prevention efforts specifically targeting these people have been minimal. Part of the challenge of HIV prevention for transgender populations is that numerous individual, interpersonal, social, and structural factors contribute to their risk. By combining HIV prevention services with complementary medical, legal, and psychosocial services, transgender persons’ HIV risk behaviors, risk determinants, and overall health can be affected simultaneously. For maximum health impact, comprehensive HIV prevention for transgender persons warrants efforts targeted to various impact levels—socioeconomic factors, decision-making contexts, long-lasting protections, clinical interventions, and counseling and education. We present current HIV prevention efforts that reach transgender persons and present others for future consideration. PMID:27997228

Patterns of HIV Prevalence and HIV Risk Behaviors among Injection Drug Users Prior to and 24 Months following Implementation of Cross-Border HIV Prevention Interventions in Northern Vietnam and Southern China

ERIC Educational Resources Information Center

Hammett, Theodore M.; Kling, Ryan; Johnston, Patrick; Liu, Wei; Ngu, Doan; Friedmann, Patricia; Binh, Kieu Thanh; Dong, Ha Viet; Van, Ly Kieu; Donghua, Meng; Chen, Yi; Des Jarlais, Don C.

2006-01-01

In 2002, we implemented a 4-year HIV prevention intervention for injection drug users (IDUs) in Lang Son Province, Vietnam, and Ning Ming County, Guangxi Province, China, a cross-border region seriously affected by inter-twined epidemics of heroin injection and HIV infection. The interventions involve peer education on HIV risk reduction and…

Evaluations of Structural Interventions for HIV Prevention: A Review of Approaches and Methods.

PubMed

Iskarpatyoti, Brittany S; Lebov, Jill; Hart, Lauren; Thomas, Jim; Mandal, Mahua

2018-04-01

Structural interventions alter the social, economic, legal, political, and built environments that underlie processes affecting population health. We conducted a systematic review of evaluations of structural interventions for HIV prevention in low- and middle-income countries (LMICs) to better understand methodological and other challenges and identify effective evaluation strategies. We included 27 peer-reviewed articles on interventions related to economic empowerment, education, and substance abuse in LMICs. Twenty-one evaluations included clearly articulated theories of change (TOCs); 14 of these assessed the TOC by measuring intermediary variables in the causal pathway between the intervention and HIV outcomes. Although structural interventions address complex interactions, no evaluation included methods designed to evaluate complex systems. To strengthen evaluations of structural interventions, we recommend clearly articulating a TOC and measuring intermediate variables between the predictor and outcome. We additionally recommend adapting study designs and analytic methods outside traditional epidemiology to better capture complex results, influences external to the intervention, and unintended consequences.

Digital gaming for HIV prevention with young adolescents.

PubMed

Enah, Comfort; Moneyham, Linda; Vance, David E; Childs, Gwendolyn

2013-01-01

The search for intervention strategies appropriate for young adolescents has recently led to the use of digital games. Digital gaming interventions are promising because they may be developmentally appropriate for adolescent populations. The gaming approach also capitalizes on an inherent interest to adolescents and circumvents traditional barriers to access to prevention interventions faced in some geographical areas. Notwithstanding, research on gaming in HIV prevention is quite limited. In this review article, we examine the need for contextually relevant HIV prevention interventions among young adolescents. From this, we provide a theoretical framework for exploring contextually relevant HIV risk factors and a foundation for gathering and using input from the target population to adapt an existing game or to create a developmentally appropriate and contextually relevant HIV prevention game. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Empowering peer group leaders for HIV prevention in Malawi.

PubMed

McCreary, Linda L; Kaponda, Chrissie P N; Davis, Kristina; Kalengamaliro, Mary; Norr, Kathleen F

2013-09-01

Behavioral change interventions using peer group leaders are effective and widely used, but few studies have examined how being a peer group leader affects the leaders. This study describes how participants felt being a peer group leader affected their lives. This descriptive qualitative study interviewed 18 experienced peer group leaders who had conducted a multisession human immunodeficiency virus (HIV) prevention peer group intervention in rural Malawi. We used inductive content analysis and comparisons within and between cases. Three major themes were identified. All leaders said they experienced personal changes in their knowledge, attitudes, or HIV prevention behaviors. They described interacting with family, neighbors, and friends, and speaking at church or community meetings, to discuss HIV prevention issues. They increased their self-efficacy to engage others in sensitive HIV prevention issues, developed a self-identity as a change agent, and came to be recognized in their community as trustworthy advisors about HIV and acquired immunodeficiency syndrome. These three themes, taken together, form the meta-theme of psychological empowerment. Being a peer group leader empowered the leaders as change agents for HIV prevention and had impacts in the community after the intervention ended, potentially increasing the long-term effectiveness and cost effectiveness of peer group interventions. Healthcare workers and community volunteers who led HIV prevention sessions continued HIV prevention activities in the community and workplace after the program ended. Training health workers as volunteer HIV prevention leaders offers a strategy to bring HIV prevention to limited-resource settings, despite health worker shortages. © 2013 Sigma Theta Tau International.

Project ORE: A Friendship-Based Intervention to Prevent HIV/STI in Urban African American Adolescent Females

ERIC Educational Resources Information Center

Dolcini, M. Margaret; Harper, Gary W.; Boyer, Cherrie B.; Pollack, Lance M.

2010-01-01

There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship-based HIV/STI prevention…

Optimal allocation of HIV prevention funds for state health departments.

PubMed

Yaylali, Emine; Farnham, Paul G; Cohen, Stacy; Purcell, David W; Hauck, Heather; Sansom, Stephanie L

2018-01-01

To estimate the optimal allocation of Centers for Disease Control and Prevention (CDC) HIV prevention funds for health departments in 52 jurisdictions, incorporating Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program funds, to improve outcomes along the HIV care continuum and prevent infections. Using surveillance data from 2010 to 2012 and budgetary data from 2012, we divided the 52 health departments into 5 groups varying by number of persons living with diagnosed HIV (PLWDH), median annual CDC HIV prevention budget, and median annual HRSA expenditures supporting linkage to care, retention in care, and adherence to antiretroviral therapy. Using an optimization and a Bernoulli process model, we solved for the optimal CDC prevention budget allocation for each health department group. The optimal allocation distributed the funds across prevention interventions and populations at risk for HIV to prevent the greatest number of new HIV cases annually. Both the HIV prevention interventions funded by the optimal allocation of CDC HIV prevention funds and the proportions of the budget allocated were similar across health department groups, particularly those representing the large majority of PLWDH. Consistently funded interventions included testing, partner services and linkage to care and interventions for men who have sex with men (MSM). Sensitivity analyses showed that the optimal allocation shifted when there were differences in transmission category proportions and progress along the HIV care continuum. The robustness of the results suggests that most health departments can use these analyses to guide the investment of CDC HIV prevention funds into strategies to prevent the most new cases of HIV.

A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting.

PubMed

Chen, H T; Grimley, D M; Waithaka, Y; Aban, I B; Hu, J; Bachmann, L H

2008-01-01

There is increasing interest in using healthcare providers to deliver HIV-prevention services to their patients. Unfortunately, lack of counselling skills and time constraints within busy clinics serve as barriers to such efforts. The Providers Advocating for Sexual Health Initiative (PASHIN) study used state-of-the-art computer technology to assess each participant's risk behaviours and to determine the patient's readiness for changing each behaviour. The computer synthesized the participant-entered data, determined the targeted risk behaviour and printed a behavioural theory-based provider advice sheet and a 3-point patient prescription for the targeted risk behaviour. Since the intervention does not require providers to spend time performing a detailed sexual-risk assessment and it does not require providers to have received extensive counselling training, it has the potential to minimize some of the barriers associated with provider-delivered interventions. Thus, the purpose of this process evaluation was to assess how the PASHIN intervention was implemented in the field, including issues such as the fidelity of implementation and health providers' views on and experience with implementing the intervention. Overall, the results demonstrated that the computer-based, provider-delivered intervention was successfully delivered by providers within the context of regularly scheduled treatment sessions with HIV-positive men who have sex with men (MSM) patients. The majority of providers (79.4%) and patients (83.5%) reported that the quality of HIV-prevention services delivered during these sessions was 'good'. The majority of the providers also reported that they had received adequate training, felt more confident in communicating HIV-prevention issues with their patients and provided more HIV-prevention counselling to their patients, due to the project. However, the experience of delivering HIV-prevention counselling during an 18-month period did not appear to change

Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy.

PubMed

Wagman, Jennifer A; King, Elizabeth J; Namatovu, Fredinah; Kiwanuka, Deus; Kairania, Robert; Semanda, John Baptist; Nalugoda, Fred; Serwadda, David; Wawer, Maria J; Gray, Ronald; Brahmbhatt, Heena

2016-01-01

Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from the Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes and Respect for Everyone (SHARE) Project between 2005 and 2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence, and its model could be adopted as a promising practice in other settings. In this article we describe how SHARE's IPV-prevention strategies were integrated into RHSP's existing HIV programming and provide recommendations for replication of the approach.

A quasi-experimental evaluation of a community-based HIV prevention intervention for Mexican American female adolescents: the SHERO's program.

PubMed

Harper, Gary W; Bangi, Audrey K; Sanchez, Bernadette; Doll, Mimi; Pedraza, Ana

2009-10-01

This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a female-gendered version of the word hero) intervention or a single session information-only HIV prevention intervention. Assessment data were collected at pretest, posttest, and 2-month follow up. Significant improvements across all time points were revealed on measures of self-esteem, condom attitudes, beliefs regarding a woman's control of her sexuality, beliefs regarding sexual assault, perceived peer norms, and HIV/AIDS and STI knowledge. At posttest SHERO's participants were more likely to carry condoms and to report abstaining from vaginal sex in the previous 2 months; and at 2-month follow up they reported using condoms more often in the preceding 2 months and planned on using them more frequently in the coming 2 months. Findings support the development of community-based adolescent HIV prevention interventions that address culturally specific ecological factors.

Developing a Family-Based HIV Prevention Intervention in Rural Kenya: Challenges in Conducting Community-Based Participatory Research

PubMed Central

Puffer, Eve S.; Pian, Jessica; Sikkema, Kathleen J.; Ogwang-Odhiambo, Rose A.; Broverman, Sherryl A.

2013-01-01

Community-based participatory research (CBPR) introduces new ethical challenges for HIV prevention studies in low-resource international settings. We describe a CBPR study in rural Kenya to develop and pilot a family-based HIV prevention and mental health promotion intervention. Academic partners (APs) worked with a community advisory committee (CAC) during formative research, intervention development, and a pilot trial. Ethical challenges emerged related to: negotiating power imbalances between APs and the CAC; CAC members’ shifting roles as part of the CAC and wider community; and anticipated challenges in decision making about sustainability. Factors contributing to ethical dilemmas included low access to education, scarcity of financial resources, and the shortage of HIV-related services despite high prevalence. PMID:23651936

Resources and obstacles to developing and implementing a structural intervention to prevent HIV in San Salvador, El Salvador

PubMed Central

Corbett, A. Michelle; Bodnar, Gloria; Rodriguez, Karla; Guevara, Carmen E

2009-01-01

HIV prevention researchers have increasingly advocated structural interventions that address factors in the social, political and economic context to reduce disparities of HIV/AIDS among disadvantaged populations. This paper draws on data collected in three different types of low-income communities (n=6) in the San Salvador metropolitan area in El Salvador. Nine focus group discussions were conducted between January 2006 - July 2007, six with community leaders, and three with crack cocaine users, as well as in-depth interviews with 20 crack users and crack dealers. We explore opportunities and barriers to the implementation of a community-level, structural intervention. We first analyze the different forms of leadership, and other community resources including existing HIV prevention activities that could potentially be used to address the related problems of crack use and HIV in the communities, and the structural factors that may act as barriers to capitalizing on communities’ strengths in interventions. Each of the communities studied demonstrated different resources that stem from each community's unique history and geographic location. HIV testing and prevention resources varied widely among the communities, with resources concentrated in one Older Central community despite a strong need in all communities. In many communities, fear of gang violence and non-responsiveness by government agencies to communities’ needs have discouraged community organizing. In the discussion, we offer concrete suggestions for developing and implementing structural interventions to reduce HIV risks that use communities’ different but complementary resources. PMID:19910099

Context and group dynamics in a CBPR-developed HIV prevention intervention

PubMed Central

Dickson-Gomez, Julia; Corbett, A. Michelle; Bodnar, Gloria; Zuniga, Maria Ofelia; Guevara, Carmen Eugenia; Rodriguez, Karla; Navas, Verónica

2016-01-01

This paper will explore in detail the effects of context and group dynamics on the development of a multi-level community-based HIV prevention intervention for crack cocaine users in the San Salvador Metropolitan Area, El Salvador. Community partners included residents from marginal communities, service providers from the historic center of San Salvador and research staff from a non-profit organization. The community contexts from which partners came varied considerably and affected structural group dynamics, i.e. who was identified as community partners, their research and organizational capacity, and their ability to represent their communities, with participants from marginal communities most likely to hold community leadership positions and be residents, and those from the center of San Salvador most likely to work in religious organizations dedicated to HIV prevention or feeding indigent drug users. These differences also affected the intervention priorities of different partners. The context of communities changed over time, particularly levels of violence, and affected group dynamics and the intervention developed. Finally, strategies were needed to elicit input from stakeholders under-represented in the community advisory board, in particular active crack users, in order to check the feasibility of the proposed intervention and revise it as necessary. Because El Salvador is a very different context than that in which most CBPR studies have been conducted, our results reveal important contextual factors and their effects on partnerships not often considered in the literature. PMID:25070835

[EFFECTIVE EDUCATIONAL INTERVENTIONS IN HIV FOR WOMEN].

PubMed

Miner, Sarah; Poupin, Lauren; Bernales, Margarita; Ferrer, Lilian; Cianelli, Rosina

In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women. the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women. a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision. all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV. prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.

Optimal allocation of HIV prevention funds for state health departments

PubMed Central

Farnham, Paul G.; Cohen, Stacy; Purcell, David W.; Hauck, Heather; Sansom, Stephanie L.

2018-01-01

Objective To estimate the optimal allocation of Centers for Disease Control and Prevention (CDC) HIV prevention funds for health departments in 52 jurisdictions, incorporating Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program funds, to improve outcomes along the HIV care continuum and prevent infections. Methods Using surveillance data from 2010 to 2012 and budgetary data from 2012, we divided the 52 health departments into 5 groups varying by number of persons living with diagnosed HIV (PLWDH), median annual CDC HIV prevention budget, and median annual HRSA expenditures supporting linkage to care, retention in care, and adherence to antiretroviral therapy. Using an optimization and a Bernoulli process model, we solved for the optimal CDC prevention budget allocation for each health department group. The optimal allocation distributed the funds across prevention interventions and populations at risk for HIV to prevent the greatest number of new HIV cases annually. Results Both the HIV prevention interventions funded by the optimal allocation of CDC HIV prevention funds and the proportions of the budget allocated were similar across health department groups, particularly those representing the large majority of PLWDH. Consistently funded interventions included testing, partner services and linkage to care and interventions for men who have sex with men (MSM). Sensitivity analyses showed that the optimal allocation shifted when there were differences in transmission category proportions and progress along the HIV care continuum. Conclusion The robustness of the results suggests that most health departments can use these analyses to guide the investment of CDC HIV prevention funds into strategies to prevent the most new cases of HIV. PMID:29768489

Exploring Implementation and Fidelity of Evidence-Based Behavioral Interventions for HIV Prevention: Lessons Learned From the Focus on Kids Diffusion Case Study

PubMed Central

Galbraith, Jennifer S.; Stanton, Bonita; Boekeloo, Bradley; King, Winifred; Desmond, Sharon; Howard, Donna; Black, Maureen M.; Carey, James W.

2014-01-01

Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity to the intervention’s eight core elements. A cross-sectional telephone survey was administered to 34 staff members from organizations that had previously implemented FOK. Questions assessed how the organization adhered to, adapted, dropped, or altered the intervention. None of the organizations implemented all eight core elements. This study underscores the importance for HIV intervention researchers to clearly identify and describe core elements. More effort is needed to reflect the constraints practitioners face in nonresearch settings. To ensure intervention effectiveness, additional research and technical assistance are needed to help organizations implement HIV prevention EBIs with fidelity. PMID:18445739

Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy

PubMed Central

Wagman, Jennifer A.; King, Elizabeth J.; Namatovu, Fredinah; Kiwanuka, Deus; Kairania, Robert; Ssemanda, John Baptist; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.; Gray, Ronald; Brahmbhatt, Heena

2016-01-01

Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes And Respect for Everyone (SHARE) Project between 2005–2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence and its model could be adopted as a promising practice in other settings. In this paper we describe how SHARE’s IPV-prevention strategies were integrated into RHSP’s existing HIV programming and provide recommendations for replication of the approach. PMID:26086189

Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

PubMed

Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

Strategies used by community-based organizations to evaluate their locally developed HIV prevention interventions: Lessons learned from the CDC's innovative interventions project.

PubMed

Painter, Thomas M; Ngalame, Paulyne M; Lucas, Basil; Lauby, Jennifer L; Herbst, Jeffrey H

2010-10-01

Community-based organizations (CBOs) play an important role in health promotion efforts and the delivery of HIV prevention interventions for at-risk minority populations. CBOs may also develop their own interventions but often lack the capacity or funds to rigorously evaluate them. The Innovative Interventions project of the Centers for Disease Control and Prevention (CDC) funded three CBOs to rigorously evaluate the efficacy of interventions they had developed and were delivering to Black women, Black men who have sex with men (MSM), and adolescent males in juvenile justice settings, respectively. The evaluation results have been reported elsewhere. This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions.

Exposure to a community-level HIV prevention intervention: who gets the message.

PubMed

Walls, C T; Lauby, J; Lavelle, K; Derby, T; Bond, L

1998-08-01

As part of the evaluation of a community-level HIV prevention program for women, this study examined predictors of exposure to print media and community outreach and assessed the relationship between exposure to the intervention and condom use behavior. Data from interviews with 479 women randomly selected from the intervention community in 1995 and 1996 were examined. Analysis of demographic and risk characteristics were conducted to identify predictors of exposure to the project's HIV prevention messages. Additionally, logistic regression analyses were conducted to examine the effects of intervention exposure on condom use, controlling for factors related to exposure. The results revealed that the print media campaign reached the largest number of women. However, women at highest risk did not have high rates of exposure to print media, but had greater exposure to outreach. Exposure to print media had an effect on increased communication with a main partner about condom use, but was not significantly related to condom use last time had sex. There were no significant main effects for exposure to outreach on condom use behavior. An important finding of this analysis was that each intervention strategy was successful in reaching a different portion of the target population and that exposure had differential effects on the condom use behavior of particular segments of the target population.

Structural factors in HIV prevention: concepts, examples, and implications for research.

PubMed

Sumartojo, E

2000-06-01

HIV-prevention behavior is affected by the environment as well as by characteristics of individuals at risk. HIV-related structural factors are defined as barriers to, or facilitators of, an individual's HIV prevention behaviors; they may relate to economic, social, policy, organizational or other aspects of the environment. A relatively small number of intervention studies demonstrates the potential of structural interventions to increase HIV prevention in the United States and internationally. The promise of structural interventions has also been shown in studies of interventions to prevent disease or promote public health in areas other than HIV. Frameworks help define and exemplify structural barriers and facilitators for HIV prevention. One framework developed at Centers for Disease Control and Prevention gives examples of structural facilitators in terms of the economic resources, policy supports, societal attitudes, and organizational structures and functions associated with governments, service organizations, businesses, workforce organizations, faith communities, justice systems, media organizations, educational systems, and healthcare systems. Frameworks should assist researchers and health officials to identify important areas for structural research and programming. A structural approach is timely and innovative. Despite limitations, including the challenge of a new perspective on prevention and the difficulty of evaluating their effects, researchers and public health officials are urged to pursue structural interventions to prevent HIV.

Efficacy of a Group-Based Multimedia HIV Prevention Intervention for Drug-Involved Women under Community Supervision: Project WORTH

PubMed Central

El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A.; Rowe, Jessica; Almonte, Maria; Witte, Susan

2014-01-01

Importance This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. Objective We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. Design, Setting, Participants, and Intervention We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Main Outcomes and Measures Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Results Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02–0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57–0.90). Conclusion and Relevance The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

An Overview of HIV Prevention Interventions for People Who Inject Drugs in Tanzania

PubMed Central

Ratliff, Eric A.; McCurdy, Sheryl A.; Mbwambo, Jessie K. K.; Lambdin, Barrot H.; Voets, Ancella; Pont, Sandrine; Maruyama, Haruka; Kilonzo, Gad P.

2013-01-01

In the past decade, Tanzania has seen a rapid rise in the number of people who inject drugs (PWID), specifically heroin. While the overall HIV prevalence in Tanzania has declined recently to 5.6%, in 2009, the HIV prevalence among PWID remains alarmingly high at 35%. In this paper, we describe how the Tanzania AIDS Prevention Program (TAPP), Médecins du Monde France (MdM-F), and other organisations have been at the forefront of addressing this public health issue in Africa, implementing a wide array of harm reduction interventions including medication-assisted treatment (MAT), needle and syringe programs (NSP), and “sober houses” for residential treatment in the capital, Dar es Salaam, and in Zanzibar. Looking toward the future, we discuss the need to (1) extend existing services and programs to reach more PWID and others at risk for HIV, (2) develop additional programs to strengthen existing programs, and (3) expand activities to include structural interventions to address vulnerabilities that increase HIV risk for all Tanzanians. PMID:23346410

Exploring Implementation and Fidelity of Evidence-Based Behavioral Interventions for HIV Prevention: Lessons Learned from the Focus on Kids Diffusion Case Study

ERIC Educational Resources Information Center

Galbraith, Jennifer S.; Stanton, Bonita; Boekeloo, Bradley; King, Winifred; Desmond, Sharon; Howard, Donna; Black, Maureen M.; Carey, James W.

2009-01-01

Evidence-based interventions (EBIs) are used in public health to prevent HIV infection among youth and other groups. EBIs include core elements, features that are thought to be responsible for the efficacy of interventions. The authors evaluate experiences of organizations that adopted an HIV-prevention EBI, Focus on Kids (FOK), and their fidelity…

A review of HIV/AIDS system-level interventions

PubMed Central

Bauermeister, José A.; Tross, Susan; Ehrhardt, Anke A.

2010-01-01

The escalating HIV/AIDS epidemic worldwide demands that on-going prevention efforts be strengthened, disseminated, and scaled-up. System-level interventions refer to programs aiming to improve the functioning of an agency as well as the delivery of its services to the community. System-level interventions are a promising approach to HIV/AIDS prevention because they focus on (a) improving the agency’s ability to adopt evidence-based HIV prevention and care programs; (b) develop and establish policies and procedures that maximize the sustainability of on-going prevention and care efforts; and (c) improve decision-making processes such as incorporating the needs of communities into their tailored services. We reviewed studies focusing on system-level interventions by searching multiple electronic abstracting indices, including PsycInfo, PubMed, and ProQuest. Twenty-three studies out of 624 peer-reviewed studies (published from January 1985 to February 2007) met study criteria. Most of the studies focused on strengthening agency infrastructure, while other studies included collaborative partnerships and technical assistance programs. Our findings suggest that system-level interventions are promising in strengthening HIV/AIDS prevention and treatment efforts. Based on our findings, we propose recommendations for future work in developing and evaluating system-level interventions. PMID:18369722

The Impact of Perceived Group Support on the Effectiveness of an HIV Prevention Intervention for African American Women

ERIC Educational Resources Information Center

Belgrave, Faye Z.; Corneille, Maya; Hood, Kristina; Foster-Woodson, Julia; Fitzgerald, Angela

2010-01-01

The enormous HIV/AIDS disparity among African American women and women in other ethnic groups dictates the need to implement the most effective HIV prevention interventions. This study examined the impact of perceived group support on HIV protective behaviors (i.e., attitudes and behaviors related to condom use, alcohol, and drugs) of African…

Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

PubMed

Mizuno, Yuko; Zhu, Julia; Crepaz, Nicole; Beer, Linda; Purcell, David W; Johnson, Christopher H; Valverde, Eduardo E; Skarbinski, Jacek

2014-01-28

Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions. Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States. Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable. About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions. HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.

Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH.

PubMed

El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A; Rowe, Jessica; Almonte, Maria; Witte, Susan

2014-01-01

This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90). The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. Clinical

Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review

PubMed Central

Mendoza Lua, Frania; Ovadje, Lauretta; Hong, Ethan; Castillo, Berenice; Salas-Wright, Christopher P

2017-01-01

Background HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth. Objective The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth. Methods We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included. Results Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts. Conclusions Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed. PMID:29237577

HIV prevention and care services for female sex workers: efficacy of a targeted community-based intervention in Burkina Faso.

PubMed

Traore, Isidore T; Meda, Nicolas; Hema, Noelie M; Ouedraogo, Djeneba; Some, Felicien; Some, Roselyne; Niessougou, Josiane; Sanon, Anselme; Konate, Issouf; Van De Perre, Philippe; Mayaud, Philippe; Nagot, Nicolas

2015-01-01

Although interventions to control HIV among high-risk groups such as female sex workers (FSW) are highly recommended in Africa, the contents and efficacy of these interventions are unclear. We therefore designed a comprehensive dedicated intervention targeting young FSW and assessed its impact on HIV incidence in Burkina Faso. Between September 2009 and September 2011 we conducted a prospective, interventional cohort study of FSW aged 18 to 25 years in Ouagadougou, with quarterly follow-up for a maximum of 21 months. The intervention combined prevention and care within the same setting, consisting of peer-led education sessions, psychological support, sexually transmitted infections and HIV care, general routine health care and reproductive health services. At each visit, behavioural characteristics were collected and HIV, HSV-2 and pregnancy were tested. We compared the cohort HIV incidence with a modelled expected incidence in the study population in the absence of intervention, using data collected at the same time from FSW clients. The 321 HIV-uninfected FSW enrolled in the cohort completed 409 person-years of follow-up. No participant seroconverted for HIV during the study (0/409 person-years), whereas the expected modelled number of HIV infections were 5.05/409 person-years (95% CI, 5.01-5.08) or 1.23 infections per 100 person-years (p=0.005). This null incidence was related to a reduction in the number of regular partners and regular clients, and by an increase in consistent condom use with casual clients (adjusted odds ratio (aOR)=2.19; 95% CI, 1.16-4.14, p=0.01) and with regular clients (aOR=2.18; 95% CI, 1.26-3.76, p=0.005). Combining peer-based prevention and care within the same setting markedly reduced the HIV incidence among young FSW in Burkina Faso, through reduced risky behaviours.

Mobilising indigenous resources for anthropologically designed HIV-prevention and behaviour-change interventions in southern Africa.

PubMed

Green, Edward C; Dlamini, Cedza; D'Errico, Nicole C; Ruark, Allison; Duby, Zoe

2009-12-01

HIV prevention is often implemented as if African culture were either nonexistent or a series of obstacles to overcome in order to achieve an effective, gender-equitable, human rights-based set of interventions. Similarly, traditional or indigenous leaders, such as chiefs and members of royal families, have been largely excluded from HIV/AIDS responses in Africa. This qualitative study used focus group discussions and in-depth interviews with traditional leaders and 'ritual specialists' to better understand cultural patterns and ways of working with, rather than against, culture and traditional leaders in HIV-prevention efforts. The research was carried out in four southern African countries (Botswana, Lesotho, South Africa and Swaziland). The purpose was to discover what aspects of indigenous leadership and cultural resources might be accessed and developed to influence individual behaviour as well as the prevailing community norms, values, sanctions and social controls that are related to sexual behaviour. The indigenous leaders participating in the research largely felt bypassed and marginalised by organised efforts to prevent HIV infections and also believed that HIV-prevention programmes typically confronted, circumvented, criticised or condemned traditional culture. However, indigenous leaders may possess innovative ideas about ways to change individuals' sexual behaviour in general. The participants discussed ways to revive traditional social structures and cultural mechanisms as a means to incorporate HIV-prevention and gender-sensitivity training into existing cultural platforms, such as rites of passage, chiefs' councils and traditional courts.

Sibanye Methods for Prevention Packages Program Project Protocol: Pilot Study of HIV Prevention Interventions for Men Who Have Sex With Men in South Africa.

PubMed

McNaghten, Ad; Kearns, Rachel; Siegler, Aaron J; Phaswana-Mafuya, Nancy; Bekker, Linda-Gail; Stephenson, Rob; Baral, Stefan D; Brookmeyer, Ron; Yah, Clarence S; Lambert, Andrew J; Brown, Benjamin; Rosenberg, Eli; Blalock Tharp, Mondie; de Voux, Alex; Beyrer, Chris; Sullivan, Patrick S

2014-10-16

Human immunodeficiency virus (HIV) prevention intervention programs and related research for men who have sex with men (MSM) in the southern African region remain limited, despite the emergence of a severe epidemic among this group. With a lack of understanding of their social and sexual lives and HIV risks, and with MSM being a hidden and stigmatized group in the region, optimized HIV prevention packages for southern African MSM are an urgent public health and research priority. The objective of the Sibanye Health Project is to develop and evaluate a combination package of biomedical, behavioral, and community-level HIV prevention interventions and services for MSM in South Africa. The project consists of three phases: (1) a comprehensive literature review and summary of current HIV prevention interventions (Phase I), (2) agent-based mathematical modeling of HIV transmission in southern African MSM (Phase II), and (3) formative and stigma-related qualitative research, community engagement, training on providing health care to MSM, and the pilot study (Phase III). The pilot study is a prospective one-year study of 200 men in Cape Town and Port Elizabeth, South Africa. The study will assess a package of HIV prevention services, including condom and condom-compatible lubricant choices, risk-reduction counseling, couples HIV testing and counseling, pre-exposure prophylaxis (PrEP) for eligible men, and non-occupational post-exposure prophylaxis for men with a high risk exposure. The pilot study will begin in October 2014. Preliminary results from all components but the pilot study are available. We developed a literature review database with meta-data extracted from 3800 documents from 67 countries. Modeling results indicate that regular HIV testing and promotion of condom use can significantly impact new HIV infections among South African MSM, even in the context of high coverage of early treatment of HIV-positive men and high coverage of PrEP for at-risk HIV

Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples.

PubMed

Martinez, Omar; Wu, Elwin; Levine, Ethan C; Muñoz-Laboy, Miguel; Fernandez, M Isabel; Bass, Sarah Bauerle; Moya, Eva M; Frasca, Timothy; Chavez-Baray, Silvia; Icard, Larry D; Ovejero, Hugo; Carballo-Diéguez, Alex; Rhodes, Scott D

2016-01-01

Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. We collaborated with Latino male couples and providers to adapt Connect 'n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that biomedical strategies should be offered after

Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention

PubMed Central

Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.

2012-01-01

Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females’ lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18–23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many ‘non-changers’ were engaged in non-stable ‘on and off’ relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. ‘Non-changers’ also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child’s father, as well as elaborating on the intersection of substance use and risky sexual decision-making. PMID:22641793

Limited effectiveness of HIV prevention for young people in sub-Saharan Africa: studying the role of intervention and evaluation

PubMed Central

Michielsen, K.

2013-01-01

On average, 2,500 young people (15-24 years) get infected with HIV every day; 80% of which live in sub-Saharan Africa. Since no cure or vaccine is available, reducing sexual risk behaviour in this group is crucial in tackling the epidemic. The general objective of this doctoral study was to improve the effectiveness of HIV prevention interventions for young people in sub-Saharan Africa. First, we assessed the overall effectiveness of such interventions (systematic literature review, meta-analysis). Secondly, we evaluated a school-based peer-led HIV prevention interventions in Rwanda (longitudinal, non-randomized controlled trial), to get insight into how interventions are developed, implemented and evaluated. While the first two objectives demonstrated limited effectiveness, the third objective aimed to identify reasons for this limited effectiveness: a) baseline characteristics of respondents that predict participation were identified (using data from objective 2); b) we studied determinants of young people’s sexual behavior using a qualitative ‘mailbox study’ that assessed the spontaneous thoughts of Rwandan adolescents on sexuality; c) we assessed the role of one specific structural factor: education (literature review and analysis of existing datasets); d) we assessed the theoretical underpinnings of existing HIV prevention interventions for young people in sub-Saharan Africa (literature review). Based on these studies, we discuss two main reasons for the observed limited effectiveness: factors associated with the intervention (strong focus on cognitions and moral, and implementation issues), and with evaluation (design, power, indicators). Recommendations for improving interventions, evaluations and for further research are provided. PMID:24753945

The network approach and interventions to prevent HIV among injection drug users.

PubMed Central

Neaigus, A

1998-01-01

OBJECTIVE: To review human immunodeficiency virus (HIV) risk reduction interventions among injecting drug users (IDUs) that have adopted a network approach. METHODS: The design and outcomes of selected network-based interventions among IDUs are reviewed using the network concepts of the dyad (two-person relationship), the personal risk network (an index person and all of his or her relationship), and the "sociometric" network (the complete set of relations between people in a population) and community. RESULTS: In a dyad intervention among HIV-serodiscordant couples, many of which included IDUs, there were no HIV seroconversions. Participants in personal risk network interventions were more likely to reduce drug risks and in some of these interventions, sexual risks, than were participants in individual-based interventions. Sociometric network interventions reached more IDUs and may be more cost-effective than individual-based interventions. CONCLUSION: Network-based HIV risk reduction interventions among IDUs, and others at risk for HIV, hold promise and should be encouraged. PMID:9722819

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS

PubMed Central

Collins, Linda M.; Kugler, Kari C.; Gwadz, Marya Viorst

2015-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally. PMID:26238037

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.

PubMed

Collins, Linda M; Kugler, Kari C; Gwadz, Marya Viorst

2016-01-01

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally.

A novel, bottom-up approach to promote evidence-based HIV prevention for people who inject drugs in Ukraine: protocol for the MICT (‘Bridge’) HIV prevention exchange project

PubMed Central

2014-01-01

Background Ukraine has one of the most severe HIV epidemics in Eastern Europe, with an estimated 1.6% of the adult population living with the virus. Injection drug use accounts for 36% of new HIV cases. Nongovernmental organizations in Ukraine have little experience with effective, theory-based behavioral risk reduction interventions necessary to reduce the scope of the HIV epidemic among Ukrainians who inject drugs. This study seeks to promote the use of evidence-based HIV prevention strategies among Ukrainian organizations working with drug users. Methods/design This study combines qualitative and quantitative methods to explore a model of HIV prevention intervention development and implementation that disseminates common factors of effective behavioral risk reduction interventions and enables service providers to develop programs that reflect their specific organizational contexts. Eight agencies, located in regions of Ukraine with the highest HIV and drug use rates and selected to represent key organizational context criteria (e.g., agency size, target population, experience with HIV prevention), will be taught common factors as the basis for intervention development. We will use qualitative methods, including interviews and observations, to document the process of intervention development and implementation at each agency. Using risk assessments with intervention participants, we will also assess intervention effectiveness. The primary outcome analyses will determine the extent to which agencies develop and implement an intervention for drug users that incorporates common factors of effective behavioral interventions. Effectiveness analyses will be conducted, and effect size of each intervention will be compared to that of published HIV prevention interventions for drug users with demonstrated effectiveness. This study will explore the role of organizational context on intervention development and implementation, including resource allocation decisions

Adaptation of a Couple-Based HIV/STI Prevention Intervention for Latino Men Who Have Sex With Men in New York City

PubMed Central

Martinez, Omar; Wu, Elwin; Frasca, Timothy; Shultz, Andrew Zach; Fernandez, M. Isabel; López Rios, Javier; Ovejero, Hugo; Moya, Eva; Chavez Baray, Silvia; Capote, Jonathan; Manusov, Justin; Anyamele, Chukwuemeka O.; López Matos, Jonathan; Page, John Satchel Horatio; Carballo-Diéguez, Alex; Sandfort, Theo G. M.

2016-01-01

Predominantly Spanish-speaking Latino men who have sex with men (MSM) and their same-sex partners continue to be at high risk for HIV and STIs. Behavioral research has identified how relationship dynamics for male couples are associated with sexual risk behavior. Connect ‘n Unite (CNU), an evidence-based HIV/STI prevention intervention originally created for Black MSM and their same-sex partners, was adapted for predominantly Spanish-speaking Latino MSM and their same-sex partners on the assumption that its key elements would be translatable while its efficacy would be retained. A systematic adaptation process utilizing qualitative methods was used, including intervention adaptation sessions with 20 predominantly Spanish-speaking Latino gay couples and 10 health service providers. The process included five steps: (1) engaging community stakeholders, (2) capturing the lived experiences of Latino gay couples, (3) identifying intervention priorities, (4) integrating the original intervention’s social cognitive theory into a relationship-oriented, ecological framework for Latino gay couples, and (5) adapting intervention activities and materials. The adapted intervention, which we called Latinos en Pareja or Latinos in a Relationship, incorporates elements that effective HIV prevention interventions share, including: a solid theoretical foundation; emphasis on increasing risk reduction norms, sexual communication skills and social support for protection; and guidance on how to utilize available, culturally and linguistically appropriate services. The systematic adaptation approach used for a couples-based HIV prevention intervention also can be employed by other researchers and community stakeholders to adapt evidence-based interventions that promote wellness, linkage to care, and disease prevention for populations not originally targeted. PMID:25846772

Enhancement of a locally developed HIV prevention intervention for Hispanic/Latino MSM: A partnership of community-based organizations, a university, and the Centers for Disease Control and Prevention

PubMed Central

Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J.; Garcia, Manuel; Painter, Thomas M.

2015-01-01

Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral interventions are currently available for use with this vulnerable population. We describe the development and enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated. Our enhancement process included incorporating local data on risks and context; identifying community priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If efficacious, HOLA en Grupos will be the first behavioral intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners. PMID:26241382

Moving Beyond of The Alphabet Soup of HIV Prevention

PubMed Central

Collins, Chris; Coates, Thomas J.; Curran, James

2010-01-01

It is time to scrap the “ABCs” and elevate the debate on HIV prevention beyond the incessant controversies over individual interventions. The ABCs are a woefully incomplete list of necessary prevention interventions, but the goal should not be to just add more letters to the prevention alphabet. Instead, advancing global HIV prevention means holding national gover nments, donors and global agencies accountable for prevention efforts that are tailored to national epidemics, bring quality interventions to a scale, and address environmental factors in vulnerability. The debate is not so much about one intervention or another, but whether countries have a comprehensive prevention effort in place that responds to their own unique situations. PMID:18641471

Interventions to modify sexual risk behaviours for preventing HIV in homeless youth.

PubMed

Naranbhai, Vivek; Abdool Karim, Quarraisha; Meyer-Weitz, Anna

2011-01-19

Homeless youth are at high risk for HIV infection as a consequence of risky sexual behaviour. Interventions for homeless youth are challenging. Assessment of the effectiveness of interventions to modify sexual risk behaviours for preventing HIV in homeless youth is needed. To evaluate and summarize the effectiveness of interventions for modifying sexual risk behaviours and preventing transmission of HIV among homeless youth. We searched electronic databases (CENTRAL, MEDLINE, EMBASE, AIDSearch, Gateway, PsycInfo, LILACS), reference lists of eligible articles, international health agency publication lists, and clinical trial registries. The search was updated January 2010. We contacted authors of published reports and other key role players. Randomised studies of interventions to modify sexual risk behaviour (biological, self-reporting of sexual-risk behaviour or health-seeking behaviour) in homeless youth (12-24 years). Data from eligible studies were extracted by two reviewers. We assessed risk of bias per the Cochrane Collaborations tool. None of the eligible studies reported any primary biological outcomes for this review. Reports of self-reporting sexual risk behaviour outcomes varied across studies precluding calculation of summary measures of effect; we present the outcomes descriptively for each study. We contacted authors for missing or ambiguous data. We identified three eligible studies after screening a total of 255 unique records. All three were performed in the United States of America and recruited substance-abusing male and female adolescents (total N=615) through homeless shelters into randomised controlled trials of independent and non-overlapping behavioural interventions. The three trials differed in theoretical background, delivery method, dosage (number of sessions,) content and outcome assessments. Overall, the variability in delivery and outcomes precluded estimation of summary of effect measures. We assessed the risk of bias to be high for

Exploring Factors Associated with Nonchange in Condom Use Behavior following Participation in an STI/HIV Prevention Intervention for African-American Adolescent Females

PubMed Central

Sales, Jessica M.; Brown, Jennifer L.; DiClemente, Ralph J.; Rose, Eve

2012-01-01

To enhance future STI/HIV prevention efforts, this study examined factors associated with adolescents' failure to improve their condom use behaviors after participating in an STI/HIV prevention intervention. African-American adolescent females (N = 205; M age = 17.9) in an STI/HIV prevention intervention trial completed ACASI interviews and provided self-collected vaginal swabs to assess two prevalent STIs at baseline and 6 months after intervention. Analyses compared those who increased condom use after intervention (change group) to those whose condom use did not increase (nonchange group). 43.4% did not increase their condom use after the intervention and were more likely to have an STI at followup (χ 2 = 4.64, P = .03). In a multivariate logistic regression model, the nonchange group was more likely to have (a) higher sensation seeking (AOR = .91, P = .023), (b) a boyfriend (AOR = .32, P = .046), and/or (c) a physical abuse history (AOR = .56, P = .057). There were also differences in the extent to which psychosocial mediators changed between the two groups. Findings highlight the need to tailor STI/HIV interventions to adolescents with a greater degree of sensation seeking and address key relationship characteristics and trauma histories to bolster intervention efficacy. PMID:22690331

Behavioral and psychosocial interventions for HIV prevention in floating populations in China over the past decade: a systematic literature review and meta-analysis.

PubMed

Liu, Xiaona; Erasmus, Vicki; Wu, Qing; Richardus, Jan Hendrik

2014-01-01

Floating populations have been repeatedly characterized as "the tipping point" for the HIV epidemic in China. This study aims to systematically summarize and assess the effectiveness of HIV prevention interventions in floating populations in China over the past decade. We conducted a systematic search in three international databases for literature published between 2005 and 2012 with condom use as the primary outcome, and knowledge about HIV transmission and prevention and stigma towards HIV-infected individuals as secondary outcomes. The impact of interventions on changing the primary and secondary outcomes was calculated by risk difference (RD). We also performed subgroup analyses and meta-regression based on different study characteristics, using Stata 12.0, for the primary outcome. Sixteen studies (out of 149) involved 19 different programs and a total of 10,864 participants at entry from 11 provinces in China. The pooled effect estimate of all studies indicated that people participating in HIV-related interventions were 13% more likely to use condoms (95%CI: 0.07, 0.18), however, the effects on increasing condom use exhibited significant heterogeneity across programs (P<0.01, I2 = 0.93). The meta-regression results suggest that interventions have been significantly less successful in changing condom use in more recent studies (β, 0.14; 95%CI: 0.01, 0.27), adjusted for sexual relationship, study design and follow-up period. Regarding the secondary outcomes, HIV-related interventions were successful at improving knowledge about HIV transmission and prevention (RD, -0.26; 95%CI: -0.36, -0.16 and RD, -0.25; 95%CI: -0.33, -0.16, respectively), and decreasing stigma (RD, 0.18; 95%CI: 0.09, 0.27). The included studies between 2005 and 2012 indicate that HIV prevention interventions among Chinese floating populations in the past decade were only marginally effective at increasing condom use, but relatively successful at increasing HIV knowledge and decreasing

'Proyecto Orgullo', an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru.

PubMed

Maiorana, Andres; Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santisteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative, and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: (1) Self-reflection Small Group sessions; (2) Supporting peers in HIV prevention; (3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; (4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; (5) A Project Space; (6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socialising/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW.

Interaction between 5-HTTLPR Polymorphism and Abuse History on Adolescent African-American Females’ Condom Use Behavior Following Participation in an HIV Prevention Intervention

PubMed Central

Sales, Jessica M.; DiClemente, Ralph J.; Brody, Gene H.; Philibert, Robert A.; Rose, Eve

2013-01-01

Not everyone exposed to an efficacious HIV intervention will reduce sexual risk behaviors, yet little is known about factors associated with “failure to change” high risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene (5-HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents’ failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females (N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. 44.1% did not increase their condom use from baseline levels 6 months after participating in the STI/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime. PMID:23479192

Gender-based violence and HIV: relevance for HIV prevention in hyperendemic countries of southern Africa.

PubMed

Andersson, Neil; Cockcroft, Anne; Shea, Bev

2008-12-01

Gender-based violence (GBV) is common in southern Africa. Here we use GBV to include sexual and non-sexual physical violence, emotional abuse, and forms of child sexual abuse. A sizeable literature now links GBV and HIV infection.Sexual violence can lead to HIV infection directly, as trauma increases the risk of transmission. More importantly, GBV increases HIV risk indirectly. Victims of childhood sexual abuse are more likely to be HIV positive, and to have high risk behaviours.GBV perpetrators are at risk of HIV infection, as their victims have often been victimised before and have a high risk of infection. Including perpetrators and victims, perhaps one third of the southern African population is involved in the GBV-HIV dynamic.A randomised controlled trial of income enhancement and gender training reduced GBV and HIV risk behaviours, and a trial of a learning programme reported a non-significant reduction in HIV incidence and reduction of male risk behaviours (primary prevention). Interventions among survivors of GBV can reduce their HIV risk (secondary prevention). Various strategies can reduce spread of HIV from infected GBV survivors (tertiary prevention). Dealing with GBV could have an important effect on the HIV epidemic.A policy shift is necessary. HIV prevention policy should recognise the direct and indirect implications of GBV for HIV prevention, the importance of perpetrator dynamics, and that reduction of GBV should be part of HIV prevention programmes. Effective interventions are likely to include a structural component, and a GBV awareness component.

Integrating HIV Prevention and Relationship Education for Young Same-Sex Male Couples: A Pilot Trial of the 2GETHER Intervention.

PubMed

Newcomb, Michael E; Macapagal, Kathryn R; Feinstein, Brian A; Bettin, Emily; Swann, Gregory; Whitton, Sarah W

2017-08-01

Young men who have sex with men are at high risk for HIV, and most new HIV infections occur in serious relationships. This pilot study assessed the feasibility, acceptability and preliminary efficacy of the 2GETHER couples-based HIV prevention and relationship education intervention for young same-sex male couples. We enrolled 57 young male couples (N = 114) into a four-session hybrid group and individual intervention. We assessed acceptability via post-session surveys and exit interviews, and we examined preliminary efficacy at a two week posttest. The vast majority of participants (93%) reported exclusively positive impressions of 2GETHER, and all components received high mean ratings. We observed decreases in HIV risk behavior, increases in information, motivation and behavioral skills related to HIV prevention, and improvement in relationship investment between pretest and posttest. Integrating relationship education and sexual health programming may be an effective way to reduce HIV transmissions in young male couples.

Insight into Jordanian thinking about HIV: knowledge of Jordanian men and women about HIV prevention.

PubMed

Alkhasawneh, Esra; McFarland, Willi; Mandel, Jeffery; Seshan, Vidya

2014-01-01

Research on HIV prevention programs for countries with large Muslim populations is scarce. HIV knowledge, attitudes, and beliefs were assessed in a convenience sample of 128 women and 88 men at two universities in Jordan with the goal of gaining insight into how to approach HIV risk behaviors. In general terms, 97% of participants had heard of AIDS and the majority understood the common methods of transmission. Misconceptions were common; most participants did not recognize condoms as an HIV prevention method. A sense of fatalism regarding the acquisition of HIV was common. In Jordan, challenges to HIV-prevention interventions includes misconceptions about HIV transmission, gender-related differences in the willingness to discuss sexual issues, and fatalism regarding the acquisition of HIV. Silence about sexual activity, particularly among women, was pervasive. Culturally tailored interventions are needed to decrease stigma and address gender inequalities that may contribute to increased risks of HIV in Jordan. Copyright © 2014 Association of Nurses in AIDS Care. All rights reserved.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples

PubMed Central

Martinez, Omar; Wu, Elwin; Levine, Ethan C.; Muñoz-Laboy, Miguel; Fernandez, M. Isabel; Bass, Sarah Bauerle; Moya, Eva M.; Frasca, Timothy; Chavez-Baray, Silvia; Icard, Larry D.; Ovejero, Hugo; Carballo-Diéguez, Alex; Rhodes, Scott D.

2016-01-01

Introduction Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition. Materials and Methods We collaborated with Latino male couples and providers to adapt Connect ‘n Unite, an evidence-based intervention for Black male couples, for Latino male couples. We conducted a series of three focus groups, each with two cohorts of couples, and one focus group with providers. A purposive stratified sample of 20 couples (N = 40, divided into two cohorts) and 10 providers provided insights into how to adapt and integrate social, cultural, and biomedical approaches in a couples-based HIV/AIDS behavioral intervention. Results The majority (N = 37) of the couple participants had no prior knowledge of the following new biomedical strategies: non-occupational post-exposure prophylaxis (nPEP); pre-exposure prophylaxis (PrEP); and HIV self-testing kits. After they were introduced to these biomedical interventions, all participants expressed a need for information and empowerment through knowledge and awareness of these interventions. In particular, participants suggested that we provide PrEP and HIV self-testing kits by the middle or end of the intervention. Providers suggested a need to address behavioral, social and structural issues, such as language barriers; and the promotion of client-centered approaches to increase access to, adaptation of, and adherence to biomedical strategies. Corroborating what couple participants suggested, providers agreed that

Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review.

PubMed

Córdova, David; Mendoza Lua, Frania; Ovadje, Lauretta; Hong, Ethan; Castillo, Berenice; Salas-Wright, Christopher P

2017-12-13

HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth. The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth. We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included. Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts. Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed. ©David Córdova, Frania Mendoza Lua, Lauretta Ovadje, Ethan Hong, Berenice Castillo, Christopher P Salas-Wright. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 13.12.2017.

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention.

PubMed

Berkley-Patton, Jannette Y; Moore, Erin; Berman, Marcie; Simon, Stephen D; Thompson, Carole Bowe; Schleicher, Thomas; Hawes, Starlyn M

2013-11-13

The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters, brochures/church bulletins

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention

PubMed Central

Berkley-Patton, Jannette Y; Moore, Erin; Berman, Marcie; Simon, Stephen D; Thompson, Carole Bowe; Schleicher, Thomas; Hawes, Starlyn M

2013-01-01

Introduction The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. Methods Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g., sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g., food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. Results At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g., age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters

Social network approaches to recruitment, HIV prevention, medical care, and medication adherence.

PubMed

Latkin, Carl A; Davey-Rothwell, Melissa A; Knowlton, Amy R; Alexander, Kamila A; Williams, Chyvette T; Boodram, Basmattee

2013-06-01

This article reviews the current issues and advancements in social network approaches to HIV prevention and care. Social network analysis can provide a method to understand health disparities in HIV rates, treatment access, and outcomes. Social network analysis is a valuable tool to link social structural factors to individual behaviors. Social networks provide an avenue for low-cost and sustainable HIV prevention interventions that can be adapted and translated into diverse populations. Social networks can be utilized as a viable approach to recruitment for HIV testing and counseling, HIV prevention interventions, optimizing HIV medical care, and medication adherence. Social network interventions may be face-to-face or through social media. Key issues in designing social network interventions are contamination due to social diffusion, network stability, density, and the choice and training of network members. There are also ethical issues involved in the development and implementation of social network interventions. Social network analyses can also be used to understand HIV transmission dynamics.

The Benefits of a Friendship-Based HIV/STI Prevention Intervention for African American Youth

ERIC Educational Resources Information Center

Harper, Gary W.; Dolcini, M. Margaret; Benhorin, Shira; Watson, Susan E.; Boyer, Cherrie B.

2014-01-01

This article presents findings from a qualitative evaluation of an HIV/STI (sexually transmitted infection) prevention intervention for urban African American youth (Project ÒRÉ), which was delivered to groups of 3 to 8 adolescents who were members of the same friendship network. Sixteen focus groups (N = 63) were conducted with youth following…

A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.

PubMed

Cordova, David; Bauermeister, Jose A; Fessler, Kathryn; Delva, Jorge; Nelson, Annabelle; Nurenberg, Rachel; Mendoza Lua, Frania; Alers-Rojas, Francheska; Salas-Wright, Christopher P

2015-12-18

Despite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care. The purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as "S4E"). A total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis. A total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician-adolescent HIV/STI and drug use communication

A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study

PubMed Central

Bauermeister, Jose A; Fessler, Kathryn; Delva, Jorge; Nelson, Annabelle; Nurenberg, Rachel; Mendoza Lua, Frania; Alers-Rojas, Francheska; Salas-Wright, Christopher P

2015-01-01

Background Despite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care. Objectives The purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as “S4E”). Methods A total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis. Results A total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician

HIV prevention and low-income Chilean women

PubMed Central

CIANELLI, ROSINA; FERRER, LILIAN; MCELMURRY, BEVERLY J.

2008-01-01

Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV. PMID:18432428

HIV prevention and low-income Chilean women: machismo, marianismo and HIV misconceptions.

PubMed

Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J

2008-04-01

Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.

PROJECT SALUD: EFFICACY OF A COMMUNITY-BASED HIV PREVENTION INTERVENTION FOR HISPANIC MIGRANT WORKERS IN SOUTH FLORIDA

PubMed Central

Sánchez, Jesús; De La Rosa, Mario; Serna, Claudia A.

2014-01-01

Project Salud evaluates the efficacy of a community-based intervention to reduce risk behaviors and enhance factors for HIV-preventative behaviors. A randomized controlled trial of 278 high risk Latino migrant workers was conducted between 2008 and 2010. Participants completed an audio computer-assisted self-interview questionnaire at baseline and 3- and 9-month post-intervention follow-ups. Participants were randomly assigned to the community-based intervention (A-SEMI) or the health promotion condition (HPC). Both interventions consisted of four 2.5–hour interactive sessions and were structurally equivalent in administration and format. Relative to the comparison condition, A-SEMI participants reported more consistent condom use, were less likely to report never having used condoms, and were more likely to have used condoms at last sexual encounter during the past 90 and 30 days. A-SEMI participants also experienced a positive change in regard to factors for HIV-preventive behaviors over the entire 9-month period. Our results support the implementation of community-based, culturally tailored interventions among Latino migrant workers. PMID:24059875

From Brochures to Videos to Counseling: Exposure to HIV-Prevention Programs

PubMed Central

Albarracín, Dolores; Leeper, Joshua; Earl, Allison; Durantini, Marta R.

2013-01-01

This research tested the prediction that reading a preventive brochure leads people to watch a preventive video, and that watching this video in turn leads to an increase in the likelihood of participating in a preventive counseling session. A sample of men and women from a southeastern community in the United States was recruited for a general health survey with the objective of examining participation in HIV-prevention interventions. Unobtrusive measures of exposure to HIV-prevention brochures, an HIV-prevention video, and an HIV-prevention counseling session were obtained. Findings indicated that reading the brochures increased watching the video and that watching the video increased participation in the counseling session. The association between exposure to the video and exposure to the counseling was mediated by expectations that the counseling would be useful. Findings are discussed in terms of the need to ensure exposure to interventions to achieve intervention effectiveness. PMID:17985230

Problematics of empowerment: sex worker HIV prevention in the Pacific.

PubMed

McMillan, Karen E; Worth, Heather

2016-12-01

A recent overview of HIV/STI prevention programmes for sex workers in the Pacific region indicates that, despite a regional policy shift from universal to targeted interventions, Pacific Island countries currently lack core HIV/STI prevention services for sex workers. Across the region, condom distribution, peer outreach and support services for sex workers have ceased even in countries where such programmes had previously existed. This article cautions that the endorsement of empowerment projects does not negate the important role of condom access in HIV and STI prevention efforts for Pacific sex workers. While community empowerment underpins, and is essential to the sustainability of, effective interventions, it does not constitute an adequate form of HIV and STI prevention in and of itself. We contend that in the context of the Pacific Islands, timely and effective HIV prevention measures must specifically attend to the implementation of, and sustained support for, behavioural interventions such as sex-worker-specific peer education, condom and lubricant distribution, and access to appropriate sexual health services. Further, the responsibility for delivery of these should not be borne solely by fledgling sex worker organizations and communities. The evolution of targeted interventions in the Pacific and the current lack of funded condom distribution programmes highlight a more generalizable imperative within HIV prevention to ensure that behaviour change efforts are not considered to be extraneous to, or rendered redundant by, empowerment-based interventions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

HIV Prevention Among Diverse Young MSM: Research Needs, Priorities, and Opportunities.

PubMed

Rhodes, Scott D; Wong, Frank Y

2016-06-01

There remains a profound need for innovative and effective interventions designed for young men who have sex with men (YMSM) generally, and racial and ethnic minority YMSM, YMSM living in rural communities, and low-income YMSM, particularly, to prevent HIV and improve health outcomes in the United States. This introduction to this theme issue, "Behavioral HIV Prevention Interventions for Diverse YMSM," of AIDS Education and Prevention identifies some of the research needs, priorities, and opportunities that emerged during a seminal NIMHD-sponsored workshop on HIV prevention behavioral interventions for diverse YMSM. It provides researchers, practitioners, and federal partners guidance in next steps to reduce the impact of the HIV epidemic among YMSM. The needs, priorities, and opportunities identified serve as a foundation to push both the science and the practice of HIV prevention forward. We recognize that considerably more research is needed, and this issue highlights intervention research-where we have been and where we should go. With the disparities faced by YMSM, we must act rapidly to do the work it will take to meet their prevention needs, reduce infections, and save lives.

A reanalysis of a behavioral intervention to prevent incident HIV infections: Including indirect effects in modeling outcomes of Project EXPLORE

PubMed Central

Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer

2013-01-01

Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226

Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies.

PubMed

Tolli, M V

2012-10-01

Peer education remains a popular strategy for health promotion and prevention, but evidence of its effectiveness is still limited. This article presents a systematic review of peer education interventions in the European Union that were published between January 1999 and May 2010. The objective of the review is to determine the effectiveness of peer education programs for human immunodeficiency virus (HIV) prevention, adolescent pregnancy prevention and promotion of sexual health among young people. Standardized methods of searching and data extraction were utilized and five studies were identified. Although a few statistically significant and non-significant changes were observed in the studies, it is concluded that, overall, when compared to standard practice or no intervention, there is no clear evidence of the effectiveness of peer education concerning HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people in the member countries of the European Union. Further research is needed to determine factors that contribute to program effectiveness.

Lessons Learned From the Field-Testing of Healthy Love: An HIV Prevention Intervention for Black Women.

PubMed

Galindo, Carla A; Few, Tai E; Daniels, Brandy; Parks, Carolyn P; Diallo, Dázon D; Moss, L Nyrobi N; Wilkes, Aisha L; Carraway, G Chezia

2017-05-01

Healthy Love is a brief, highly interactive, single-session, group-level HIV prevention intervention designed for African American women that is effective at reducing sex risk behaviors and increasing condom use and HIV testing among participants. The Centers for Disease Control and Prevention, through a contract, developed a user-friendly intervention package that would allow organizations to adopt and implement Healthy Love with fidelity. Training and implementation materials were developed to support original research protocols, and piloted and revised to conduct field-testing with case study agencies (CSAs). Three CSAs were selected to deliver the intervention over a 3-month period to test the utility of intervention materials and feasibility of implementation. All CSAs were able to successfully deliver 10 sessions with a total of 185 women ranging from 18 to 59 years of age. Successes and challenges encountered in training, preimplementation activities, and intervention delivery are described. Lessons learned from training, technical assistance, and process monitoring and evaluation informed final package revisions. Research to practice recommendations are shared as is guidance for future implementations of Healthy Love. The research to practice process used is a model approach for developing a comprehensive intervention package and will support the adoption of Healthy Love by other organizations.

Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand.

PubMed

Pattanaphesaj, Juntana; Teerawattananon, Yot

2010-07-07

Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria. The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.

Eban HIV/STD risk reduction intervention: conceptual basis and procedures.

PubMed

2008-09-01

To describe the Eban HIV/STD Risk Reduction Intervention being evaluated in the NIMH Multisite HIV/STD Prevention trial for heterosexual African American couples, including the integrated theoretical framework, the structure, core elements and procedures of the intervention, and how the content was shaped by culturally congruent concepts to address the needs of the study target population. The Eban HIV/STD Risk Reduction Intervention is designed to address multilevel individual-, interpersonal-, and community-level factors that contribute to HIV/STD transmission risk behaviors among heterosexual African American couples who are HIV serodiscordant. The Eban HIV/STD Risk Reduction Intervention employs a mixed modality, couple-based approach that is based on an integrated ecological framework incorporating social cognitive theory and uses an Afrocentric paradigm that is informed by previous evidence-based couples HIV prevention interventions. For this randomized controlled trial, African American serodiscordant couples were recruited from 4 urban sites (Atlanta, Los Angeles, New York, and Philadelphia) and were randomized to either the Eban HIV/STD Risk Reduction Intervention (treatment condition) or a Health Promotion Intervention that served as an attentional control condition. Both interventions had 4 individual couple sessions and 4 group sessions, but only the treatment condition was focused on reducing HIV/STD risk behaviors. Behavioral and biological data were collected at baseline, immediately after the intervention, and at 6 and 12 months. The theoretical framework, core elements, and content of each session are described and lessons learned from this intervention trial are discussed. An HIV prevention intervention combining couple and group sessions can be feasibly implemented with African American HIV-serodiscordant couples who remain at high risk of HIV/STD transmission. The lessons learned from the trial suggest that the participants responded very well

Combination HIV prevention among MSM in South Africa: results from agent-based modeling.

PubMed

Brookmeyer, Ron; Boren, David; Baral, Stefan D; Bekker, Linda-Gail; Phaswana-Mafuya, Nancy; Beyrer, Chris; Sullivan, Patrick S

2014-01-01

HIV prevention trials have demonstrated the effectiveness of a number of behavioral and biomedical interventions. HIV prevention packages are combinations of interventions and offer potential to significantly increase the effectiveness of any single intervention. Estimates of the effectiveness of prevention packages are important for guiding the development of prevention strategies and for characterizing effect sizes before embarking on large scale trials. Unfortunately, most research to date has focused on testing single interventions rather than HIV prevention packages. Here we report the results from agent-based modeling of the effectiveness of HIV prevention packages for men who have sex with men (MSM) in South Africa. We consider packages consisting of four components: antiretroviral therapy for HIV infected persons with CD4 count <350; PrEP for high risk uninfected persons; behavioral interventions to reduce rates of unprotected anal intercourse (UAI); and campaigns to increase HIV testing. We considered 163 HIV prevention packages corresponding to different intensity levels of the four components. We performed 2252 simulation runs of our agent-based model to evaluate those packages. We found that a four component package consisting of a 15% reduction in the rate of UAI, 50% PrEP coverage of high risk uninfected persons, 50% reduction in persons who never test for HIV, and 50% ART coverage over and above persons already receiving ART at baseline, could prevent 33.9% of infections over 5 years (95% confidence interval, 31.5, 36.3). The package components with the largest incremental prevention effects were UAI reduction and PrEP coverage. The impact of increased HIV testing was magnified in the presence of PrEP. We find that HIV prevention packages that include both behavioral and biomedical components can in combination prevent significant numbers of infections with levels of coverage, acceptance and adherence that are potentially achievable among MSM in

Laying the Groundwork for an HIV Prevention Intervention: A Descriptive Profile of the Los Angeles House and Ball Communities

PubMed Central

Kipke, Michele D.; Kubicek, Katrina; Supan, Jocelyn; Weiss, George; Schrager, Sheree

2012-01-01

African American young men who have sex with men (AAYMSM) represent the largest proportion of new HIV infections among MSM. While evidence-based interventions are lacking, all too often HIV interventions are implemented in a community without thoroughly understanding its needs, risks and assets. AAYMSM are not homogenous; subgroups exist that may require different approaches to be effective. The House and Ball communities represent one such subgroup. A community-engaged, mixed-methods approach was used. Participant observations, qualitative interviews (N=26), and a survey at House/Ball events (N=252) were completed. Survey data broadly describe the community. For example: 69% of survey respondents identify as gay; 25% as bisexual; 13% reported recent use of ecstasy and 11% recently participated in sex exchange. The depth of qualitative data is key for intervention development. For example, while the survey provides broad descriptions of respondents’ involvement in the House and Ball communities, leaders provided in-depth descriptions of the structure of the House and Ball scene –something vital to the development of HIV prevention programs within these communities. This kind of rigorous study is recommended prior to implementing an intervention. Findings are discussed in relation to leveraging the communities’ supportive aspects to design culturally relevant HIV prevention programs. PMID:22699855

Overcoming Barriers to HIV Treatment Adherence: A Brief Cognitive Behavioral Intervention for HIV-Positive Adults on Antiretroviral Treatment

PubMed Central

Olem, David; Sharp, Kelly M.; Taylor, Jonelle M.; Johnson, Mallory O.

2014-01-01

Maximizing HIV treatment adherence is critical in efforts to optimize health outcomes and to prevent further HIV transmission. The Balance Project intervention uses cognitive behavioral approaches to improve antiretroviral medication adherence through promoting adaptive coping with medication side effect and distress related to HIV. This 5-session intervention has been documented to prevent nonadherence among persons living with HIV who experience high levels of distress associated with their antiretroviral medication side effects. We describe the theoretical underpinnings of the intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications of the intervention in both research and clinical settings. PMID:24855332

Behavioral and Psychosocial Interventions for HIV Prevention in Floating Populations in China over the Past Decade: A Systematic Literature Review and Meta-Analysis

PubMed Central

Liu, Xiaona; Erasmus, Vicki; Wu, Qing; Richardus, Jan Hendrik

2014-01-01

Background Floating populations have been repeatedly characterized as “the tipping point” for the HIV epidemic in China. This study aims to systematically summarize and assess the effectiveness of HIV prevention interventions in floating populations in China over the past decade. Methods We conducted a systematic search in three international databases for literature published between 2005 and 2012 with condom use as the primary outcome, and knowledge about HIV transmission and prevention and stigma towards HIV-infected individuals as secondary outcomes. The impact of interventions on changing the primary and secondary outcomes was calculated by risk difference (RD). We also performed subgroup analyses and meta-regression based on different study characteristics, using Stata 12.0, for the primary outcome. Results Sixteen studies (out of 149) involved 19 different programs and a total of 10,864 participants at entry from 11 provinces in China. The pooled effect estimate of all studies indicated that people participating in HIV-related interventions were 13% more likely to use condoms (95%CI: 0.07, 0.18), however, the effects on increasing condom use exhibited significant heterogeneity across programs (P<0.01, I 2 = 0.93). The meta-regression results suggest that interventions have been significantly less successful in changing condom use in more recent studies (β, 0.14; 95%CI: 0.01, 0.27), adjusted for sexual relationship, study design and follow-up period. Regarding the secondary outcomes, HIV-related interventions were successful at improving knowledge about HIV transmission and prevention (RD, −0.26; 95%CI: −0.36, −0.16 and RD, −0.25; 95%CI: −0.33, −0.16, respectively), and decreasing stigma (RD, 0.18; 95%CI: 0.09, 0.27). Conclusions The included studies between 2005 and 2012 indicate that HIV prevention interventions among Chinese floating populations in the past decade were only marginally effective at increasing condom use, but relatively

‘Proyecto Orgullo’, an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru

PubMed Central

Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santiesteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: 1) Self-reflection Small Group sessions; 2) Supporting peers in HIV prevention; 3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; 4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; 5) A Project Space; 6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socializing/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW. PMID:27373578

Interventions to modify sexual risk behaviours for preventing HIV in homeless youth

PubMed Central

Naranbhai, Vivek; Karim, Quarraisha Abdool; Meyer-Weitz, Anna

2013-01-01

Background Homeless youth are at high risk for HIV infection as a consequence of risky sexual behavior. Interventions in homeless youth are challenging. Assessment of the effectiveness of interventions to modify sexual risk behaviours for preventing HIV in homeless youth is needed. Objectives To evaluate and summarize the effectiveness of interventions for modifying sexual risk behaviours and preventing transmission of HIV among homeless youth. Search methods We searched electronic databases (CENTRAL, Medline, EMBASE, AIDSearch, Gateway, PsycInfo, LILACS), reference lists of eligible articles, international health agency publication lists, and clinical trial registries. The search was updated January 2010. We contacted authors of published reports and other key role players. Selection criteria Randomized studies of interventions to modify sexual risk behavior (biological, self-report sexual-risk behavior or health seeking behavior) in homeless youth (12–24 years). Data collection and analysis Data from eligible studies were extracted by two reviewers. We assessed risk of bias per the Cochrane Collaborations tool. None of the eligible studies reported any primary biological outcomes for this review and the reporting of self-report sexual risk behavior outcomes was highly variable across studies precluding calculation of summary measures of effect; we present the outcomes descriptively for each study. We contacted authors for missing or ambiguous data. Results We identified three eligible studies after screening a total of 255 unique records. All three were performed in the United States of America and recruited substance-abusing male and female adolescents (total N=615) through homeless shelters into randomised controlled trials of independent and non-overlapping behavioural interventions. The three trials differed in theoretical background, delivery method, dosage (number of sessions,) content and outcome assessments. Overall, the variability in delivery and

Project Eban: An HIV/STD Intervention for African American Couples

PubMed Central

2010-01-01

Objective To describe the Eban HIV/STD Risk Reduction Intervention being evaluated in the NIMH Multisite HIV/STD Prevention trial for heterosexual African American couples, including the integrated theoretical framework, the structure, core elements and procedures of the intervention and how the content was shaped by culturally congruent concepts to address the needs of the study target population. Design The Eban HIV/STD Risk Reduction Intervention is designed to address multilevel individual, interpersonal and community level factors that contribute to HIV/STD transmission risk behaviors among heterosexual African American couples who are HIV serodiscordant. Methods The Eban HIV/STD Risk Reduction Intervention employs a mixed modality, couples-based approach that is based on an integrated ecological framework incorporating social cognitive theory and uses an Afro-centric paradigm that is informed by previous evidence-based couples HIV prevention interventions. For this randomized controlled trial, African American serodiscordant couples were recruited from four urban sites (Atlanta, Los Angeles, New York and Philadelphia) and were randomized to either the Eban HIV/STD Risk Reduction Intervention (treatment condition) or a Health Promotion Intervention that served as an attentional control condition. Both interventions had 4 individual couple sessions and 4 group sessions, but only the treatment condition was focused on reducing HIV/STD risk behaviors. Behavioral and biological data were collected at baseline, immediately after the intervention, and at 6 and 12 months. The theoretical framework, core elements and content of each session are described and lessons learned from this intervention trial are discussed. Results An HIV prevention intervention combining couple and group sessions can be feasibly implemented with African American HIV serodiscordant couples who remain at high risk of HIV/STD transmission. The lessons learned from the trial suggest that the

HIV/AIDS Interventions in an Aging U.S. Population

ERIC Educational Resources Information Center

Jacobson, Stephanie A.

2011-01-01

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the…

Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

PubMed

Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

2013-01-01

Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

The Efficacy of an HIV Risk Reduction Intervention for Hispanic Women

PubMed Central

Peragallo, Nilda; McCabe, Brian E.; Cianelli, Rosina

2012-01-01

Culturally-specific HIV risk reduction interventions for Hispanic women are needed. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/ and Autocuidado/Self-care) is a culturally-specific and theoretically-based group intervention for Hispanic women. The SEPA intervention consists of five sessions covering STI and HIV prevention; communication, condom negotiation and condom use; and violence prevention. A randomized trial tested the efficacy of SEPA with 548 adult U.S. Hispanic women (SEPA n = 274; delayed intervention control n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Intent-to-treat analyses indicated that SEPA decreased positive urine samples for Chlamydia; improved condom use, decreased substance abuse and IPV; improved communication with partner, improved HIV-related knowledge, improved intentions to use condoms, decreased barriers to condom use, and increased community prevention attitudes. Culturally-specific interventions have promise for preventing HIV for Hispanic women in the U.S. The effectiveness of SEPA should be tested in a translational community trial. PMID:21969175

The efficacy of an HIV risk reduction intervention for Hispanic women.

PubMed

Peragallo, Nilda; Gonzalez-Guarda, Rosa M; McCabe, Brian E; Cianelli, Rosina

2012-07-01

Culturally-specific HIV risk reduction interventions for Hispanic women are needed. SEPA (Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care) is a culturally-specific and theoretically-based group intervention for Hispanic women. The SEPA intervention consists of five sessions covering STI and HIV prevention; communication, condom negotiation and condom use; and violence prevention. A randomized trial tested the efficacy of SEPA with 548 adult U.S. Hispanic women (SEPA n = 274; delayed intervention control n = 274) who completed structured interviews at baseline and 3, 6, and 12 months post-baseline. Intent-to-treat analyses indicated that SEPA decreased positive urine samples for Chlamydia; improved condom use, decreased substance abuse and IPV; improved communication with partner, improved HIV-related knowledge, improved intentions to use condoms, decreased barriers to condom use, and increased community prevention attitudes. Culturally-specific interventions have promise for preventing HIV for Hispanic women in the U.S. The effectiveness of SEPA should be tested in a translational community trial.

Articulating a rights-based approach to HIV treatment and prevention interventions.

PubMed

Barr, David; Amon, Joseph J; Clayton, Michaela

2011-09-01

Since the beginning of the epidemic, the protection of human rights has been an integral component in the response to Human Immunodeficiency Virus (HIV). The high degree of stigma and discrimination associated with acquired immune deficiency syndrome (AIDS) has made human rights protection not only a priority to ensure the rights of people living with and at-risk for HIV, but to address public health goals as well. Advances in understanding the impact of antiretroviral treatment on HIV prevention provide exciting opportunities and even a paradigm shift in terms of AIDS prevention. However, this potential cannot be reached unless the advancement of human rights is a primary component of treatment and prevention programme and policy development. The use of antiretroviral treatment as prevention reinforces the value of basic principles related to the dignity and agency of people living with HIV to participate in the design and implementation of programmes, to be informed and to make informed decisions about their health and lives, to be protected from harm, and to have opportunities to seek redress and accountability for abuses. The possibility of using HIV treatment as a prevention tool means that now, more than ever, legal reform and community empowerment and mobilisation are necessary to realize the rights and health of people affected by HIV.

Reputationally Strong HIV Prevention Programs: Lessons from the Front Line

ERIC Educational Resources Information Center

Eke, Agatha N.; Mezoff, Jane S.; Duncan, Ted; Sogolow, Ellen D.

2006-01-01

Although HIV prevention researchers have conducted numerous controlled outcome studies to evaluate the effectiveness of theory-based interventions aimed at reducing HIV risk behaviors, many HIV risk reduction interventions are conducted not by researchers but by staff in local health departments or community-based organizations (CBOs). Despite…

Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort

PubMed Central

Wagman, Jennifer A; Gray, Ronald H; Campbell, Jacquelyn C; Thoma, Marie; Ndyanabo, Anthony; Ssekasanvu, Joseph; Nalugoda, Fred; Kagaayi, Joseph; Nakigozi, Gertrude; Serwadda, David; Brahmbhatt, Heena

2015-01-01

Summary Background Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda. Methods We used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from the previous trial were provided standard of care HIV services plus a community-level mobilisation intervention to change attitudes, social norms, and behaviours related to IPV, and a screening and brief intervention to promote safe HIV disclosure and risk reduction in women seeking HIV counselling and testing services (the Safe Homes and Respect for Everyone [SHARE] Project). Seven control group clusters (including two intervention groups from the original trial) received only standard of care HIV services. Investigators for the RCCS did a baseline survey between February, 2005, and June, 2006, and two follow-up surveys between August, 2006, and April, 2008, and June, 2008, and December, 2009. Our primary endpoints were self-reported experience and perpetration of past year IPV (emotional, physical, and sexual) and laboratory-based diagnosis of HIV incidence in the study population. We used Poisson multivariable regression to estimate adjusted prevalence risk ratios (aPRR) of IPV, and adjusted incidence rate ratios (aIRR) of HIV acquisition. This study was registered with ClinicalTrials.gov, number NCT02050763. Findings Between Feb 15, 2005, and June 30, 2006, we enrolled 11 448 individuals aged 15–49 years. 5337 individuals (in four intervention clusters) were allocated into the SHARE plus HIV services group and 6111 individuals (in seven control clusters) were allocated into the HIV services only group. Compared with control groups, individuals in the SHARE intervention groups had fewer self-reports of past

Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort.

PubMed

Wagman, Jennifer A; Gray, Ronald H; Campbell, Jacquelyn C; Thoma, Marie; Ndyanabo, Anthony; Ssekasanvu, Joseph; Nalugoda, Fred; Kagaayi, Joseph; Nakigozi, Gertrude; Serwadda, David; Brahmbhatt, Heena

2015-01-01

Intimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda. We used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from the previous trial were provided standard of care HIV services plus a community-level mobilisation intervention to change attitudes, social norms, and behaviours related to IPV, and a screening and brief intervention to promote safe HIV disclosure and risk reduction in women seeking HIV counselling and testing services (the Safe Homes and Respect for Everyone [SHARE] Project). Seven control group clusters (including two intervention groups from the original trial) received only standard of care HIV services. Investigators for the RCCS did a baseline survey between February, 2005, and June, 2006, and two follow-up surveys between August, 2006, and April, 2008, and June, 2008, and December, 2009. Our primary endpoints were self-reported experience and perpetration of past year IPV (emotional, physical, and sexual) and laboratory-based diagnosis of HIV incidence in the study population. We used Poisson multivariable regression to estimate adjusted prevalence risk ratios (aPRR) of IPV, and adjusted incidence rate ratios (aIRR) of HIV acquisition. This study was registered with ClinicalTrials.gov, number NCT02050763. Between Feb 15, 2005, and June 30, 2006, we enrolled 11 448 individuals aged 15-49 years. 5337 individuals (in four intervention clusters) were allocated into the SHARE plus HIV services group and 6111 individuals (in seven control clusters) were allocated into the HIV services only group. Compared with control groups, individuals in the SHARE intervention groups had fewer self-reports of past-year physical IPV (346 [16%] of 2127

Adolescent lives matter: preventing HIV in adolescents

PubMed Central

Pettifor, Audrey; Stoner, Marie; Pike, Carey; Bekker, Linda-Gail

2018-01-01

Purpose of review Many of the almost 2 million HIV infections that occurred globally in the last year occurred among adolescents and young people, particularly those from East and Southern Africa and within key populations. Global HIV epidemic control will require that new infections among these youth populations be curtailed. This review examines the most effective prevention approaches to reach these adolescent populations in the next 5 years. Recent findings Adolescents are in transition and are developmentally unique. They have specific needs and challenges, which if not addressed will result in less than successful interventions. Tailored, layered, combination prevention packages that take into account specific adolescent needs and involve biomedical, behavioural and structural components are recommended. These packages should be designed for and with the meaningful input of adolescents, and involve their peers in their implementation and execution. Where possible, age-appropriate health and social interventions that go beyond HIV should be bundled and offered in a variety of community-based venues that are already acceptable to and frequented by adolescents. Summary It is urgent that we reach adolescents globally with the most effective HIV prevention approaches. HIV prevention investment in this population has immediate and longer-term benefits. PMID:29528850

HIV prevention for migrants in transit: developing and testing TRAIN.

PubMed

Bahromov, Mahbat; Weine, Stevan

2011-06-01

This study was a pilot investigation of the feasibility, acceptability, and effects of TRAIN (Transit to Russia AIDS Intervention with Newcomers) a three-session HIV preventive intervention for Tajik male labor migrants performed in transit. Sixty adult Tajik male labor migrants on the 5-day train ride from Dushanbe to Moscow were randomly assigned to either the intervention or a control condition. Each initially completed an in-person survey then another 3 days later (immediately postintervention), and participated in a cell phone survey three months later. All participants came to all intervention sessions, were satisfied with the program, and completed all postassessments. In comparison with the controls, the TRAIN group reported significant increases in condom use with sex workers and non-sex workers, condom knowledge, worry about HIV/AIDS, talking with persons about HIV/AIDS, talking with wife about HIV/AIDS, community activities, and religious activities. HIV/AIDS prevention performed in transit is feasible, accceptable, and potentially efficacious in diminishing HIV risk behaviors in labor migrants.

Macro-Level Approaches to HIV Prevention Among Ethnic Minority Youth

PubMed Central

Prado, Guillermo; Lightfoot, Marguerita; Brown, C. Hendricks

2013-01-01

The HIV epidemic continues to disproportionately affect ethnic minority youth. These disconcerting health disparities indicate that although existing HIV preventive strategies for ethnic minority youth have been efficacious, they have not significantly reduced the impact of the epidemic in this population. Macro-level interventions, such as structural or policy interventions, have the potential to impact the HIV epidemic at a population level, and thus reduce the HIV health disparities that exist among ethnic minority youth and other segments of the U.S. population. This article calls for a paradigm shift to develop, evaluate, and disseminate interventions that target upstream/macro-level factors or that, at a minimum, integrate both a macro and individual level perspective. The article also discusses the challenges in developing and evaluating such interventions. Psychologists and other behavioral scientists can play a critical role in reducing the impact of HIV on ethnic minority youth by integrating macro-level approaches to future HIV prevention strategies. PMID:23688095

Three City Feasibility Study of a Body Empowerment and HIV Prevention Intervention Among Women with Drug Use Histories: Women FIT

PubMed Central

Morrow, Kathleen M.; Mayer, Kenneth H.; Koblin, Beryl A.; Peterside, Pamela Brown; Husnik, Marla J.; Metzger, David S.

2010-01-01

Abstract Background New intervention models are needed for HIV prevention among drug-using women. Methods The Women Fighting Infection Together (Women FIT) feasibility study enrolled 189 women in three U.S. cities (Providence, New York, Philadelphia) with drug-using histories, who also reported risky sexual behavior. Eligible women had participated previously in a yearlong study of HIV Counseling and Testing (HIV-CT) and limited case management. Two thirds of the sample were black, most were unemployed, and about two thirds reported prior or current crack use. Women were randomized into two groups. In one group, women participated in a manualized, four-session, peer-led, interactive group intervention that stressed body knowledge, woman-initiated HIV/sexually transmitted infection (HIV/STI) prevention, including a focus on women's health (reproductive health screening, sexual violence, self-breast examination, STI signs, symptoms), which aimed to increase comfort with and pride in their bodies. Control group women received HIV-CT enriched by female condom counseling. Outcomes included study retention, session attendance and ratings, changes in knowledge, and use of protection methods. Results The study successfully retained 95% of the participants for a 2-month follow-up. Positive assessments from participants and peer leaders exceeded preset thresholds for success. Pre-post changes in body knowledge (p < 0.0001) and protection methods knowledge (p < 0.01) was greater among the intervention women than the control women. Conclusions The body empowerment model deserves further elaboration in interventions focusing on women at high risk of HIV/STI acquisition. PMID:20662629

Biomedical Approaches to HIV Prevention in Women.

PubMed

Heumann, Christine L

2018-04-17

Effective HIV prevention techniques for women are of critical importance, as nearly half of all HIV infections globally are in women. This article reviews the recent literature on biomedical approaches to HIV prevention in women. In trials in which women were adherent to oral pre-exposure prophylaxis (PrEP), PrEP was equally efficacious in men and women. However, in studies of oral PrEP exclusively in women, adherence was low, and it was not efficacious. In trials of topical PrEP, including vaginal tenofovir gel and the monthly dapivirine ring, efficacy was also dependent upon adherence. Treatment as prevention (TasP) is a very effective HIV prevention strategy, though limited in that it is not controlled by the HIV-uninfected partner. Adherence is an important factor in the efficacy of biomedical interventions for HIV prevention in women; continued research is needed to identify the most efficacious and acceptable agents for women. Oral PrEP is currently recommended for the following groups of HIV-negative women: heterosexual women in ongoing sexual relationships with a partner infected with or at substantial risk of HIV infection and women who inject drugs and share injection or drug preparation equipment.

A systematic review of behavioral interventions to prevent HIV infection and transmission among heterosexual, adult men in low-and middle-income countries.

PubMed

Townsend, Loraine; Mathews, Catherine; Zembe, Yanga

2013-02-01

Prevention of new HIV infections needs to move to the forefront in the fight against HIV and AIDS. In the current economic crisis, low- and middle-income countries (LMICs) should invest limited resources to amass reliable evidence-based information about behavioral prevention efforts, and on behaviors that are driving the epidemic among people who are engaging in those behaviors. This paper aims to provide a systematic review and synthesis of behavioral interventions among a group of people in high HIV-burden countries: heterosexual men in LMICs. The review includes articles published between January 2001 and May 2010 that evaluated behavioral prevention interventions among heterosexual males aged 18+ years in LMICs. The studies were evaluated using the quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project. The review identified 19 articles that met the review's inclusion criteria. Most studies were conducted in South Africa (n=6); two each in Uganda and Thailand; and one in each of Angola, Brazil, Bulgaria, India, Nigeria, the Philippines, Russia, Ukraine and Zimbabwe. Eight of 19 interventions increased condom use among their respective populations. Those interventions that sought to reduce the number of sexual partners had little effect, and those that addressed alcohol consumption and intimate partner violence had mixed effects. There was no evidence for any specific format of intervention that impacted best on any of the targeted risk behaviors. The paucity of evaluated interventions for heterosexual men in LMICs suggests that adult men in these countries remain underrepresented in HIV prevention efforts.

Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment.

PubMed

Brown, Larry K; Hadley, Wendy; Donenberg, Geri R; DiClemente, Ralph J; Lescano, Celia; Lang, Delia M; Crosby, Richard; Barker, David; Oster, Danielle

2014-03-01

The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (p<.01) and self-efficacy (p<.05). The family-based intervention, compared with the other interventions, produced significant improvements in parent-teen sexual communication (p<.01), parental monitoring (p<.01), and parental permissiveness (p=.05). This RCT found that the HIV prevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.

Chieh Mei Ching Yi: A randomized controlled trial of a culturally tailored HIV prevention intervention for Chinese massage parlor women in Los Angeles.

PubMed

Takahashi, Lois M; Tobin, Karin E; To, Stacy; Ou, Samuel; Ma, Chui Hing Helen; Ao, Fiona Ka Wa; Candelario, Jury

2013-12-01

Asian heterosexual women in the U.S. have experienced relative rising HIV case rates, but there remain few studies and no evidence-based interventions that focus on this population. This study was a randomized controlled trial of a gender and ethnically tailored HIV prevention intervention for monolingual Chinese-speaking women who work as masseuses in Los Angeles. The intervention was two group-based sessions focused on HIV risk and prevention knowledge and condom skills. The control condition was a single-session HIV review. Participants were recruited using newspaper advertisements and referrals from agencies and massage schools. Two hundred women were randomly assigned to one of each condition. Retention in both conditions exceeded 90% at 3-month follow-up. Participants in both conditions demonstrated increases in knowledge on how to use male and female condoms. These effects were sustained at 3-month follow-up. The results highlight the possible efficacy of a one-workshop intervention in increasing HIV knowledge, but that more intensive participant interaction may be needed for improved condom use knowledge.

Update on the Epidemiology and Prevention of HIV/AIDS in the United States

PubMed Central

Castel, Amanda D.; Magnus, Manya; Greenberg, Alan E.

2015-01-01

This update on the epidemiology and prevention of HIV in the United States is intended to provide contextual background that will help inform an understanding of recent developments in the domestic HIV epidemic. We describe the epidemiology of HIV disease in the US and the HIV continuum of care based on data collected primarily through HIV surveillance systems led by the Centers for Disease Control and Prevention including HIV incidence, prevalence, comorbidities and death. Populations and geographic regions disparately impacted by HIV are also highlighted. The HIV prevention armamentarium is also described including behavioral approaches to prevention, the emerging availability of biomedical prevention interventions such as pre-exposure prophylaxis, and structural and population-level interventions including treatment as prevention. Finally gaps in our understanding of the epidemic are underscored and suggestions for future epidemiologic research are proposed. PMID:25960941

An Individually Tailored Intervention for HIV Prevention: Baseline Data From the EXPLORE Study

PubMed Central

Chesney, Margaret A.; Koblin, Beryl A.; Barresi, Patrick J.; Husnik, Marla J.; Celum, Connie L.; Colfax, Grant; Mayer, Kenneth; McKirnan, David; Judson, Franklyn N.; Huang, Yijian; Coates, Thomas J.

2003-01-01

Objectives. We describe the intervention tested in EXPLORE, an HIV prevention trial aimed at men who have sex with men (MSM), and test the empirical basis of the individually tailored intervention. Methods. Data on participants’ self-efficacy, communication skills, social norms, and enjoyment of unprotected anal intercourse were examined in relation to sexual risk. Combinations of these factors, together with alcohol use and noninjection drug use, were also examined. Results. The individual factors examined were associated with sexual risk behavior. The cohort was shown to be heterogeneous in regard to the presence of combinations of these risk-related factors. Conclusions. Baseline data from the EXPLORE study support the efficacy of the individually tailored intervention used. PMID:12773358

Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men

PubMed Central

Wolfers, Mireille EG; van den Hoek, Caty; Brug, Johannes; de Zwart, Onno

2007-01-01

Background There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS), the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds. Methods First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives") and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups. Results This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials. Conclusion This intervention development project indicates that careful well-informed intervention development using Intervention Mapping is feasible in

Primary Care Providers' HIV Prevention Practices Among Older Adults

PubMed Central

Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika

2016-01-01

Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425

National Institute of Mental Health Multisite Eban HIV/STD Prevention Intervention for African American HIV Serodiscordant Couples

PubMed Central

El-Bassel, Nabila; Jemmott, John B.; Landis, J. Richard; Pequegnat, Willo; Wingood, Gina M.; Wyatt, Gail E.; Bellamy, Scarlett L.

2014-01-01

Background Human immunodeficiency virus (HIV) has disproportionately affected African Americans. Couple-level interventions may be a promising intervention strategy. Methods To determine if a behavioral intervention can reduce HIV/sexually transmitted disease (STD) risk behaviors among African American HIV serodiscordant couples, a cluster randomized controlled trial (Eban) was conducted in Atlanta, Georgia; Los Angeles, California; New York, New York; and Philadelphia, Pennsylvania; with African American HIV serodiscordant heterosexual couples who were eligible if both partners were at least 18 years old and reported unprotected intercourse in the previous 90 days and awareness of each other's serostatus. One thousand seventy participants were enrolled (mean age, 43 years; 40% of male participants were HIV positive). Couples were randomized to 1 of 2 interventions: couple-focused Eban HIV/STD risk-reduction intervention or attention-matched individual-focused health promotion comparison. The primary outcomes were the proportion of condom-protected intercourse acts and cumulative incidence of STDs (chlamydia, gonorrhea, or trichomonas). Data were collected preintervention and postintervention, and at 6- and 12-month follow-ups. Results Data were analyzed for 535 randomized couples: 260 in the intervention group and 275 in the comparison group; 81.9% were retained at the 12-month follow-up. Generalized estimating equation analyses revealed that the proportion of condom-protected intercourse acts was larger among couples in the intervention group (0.77) than in the comparison group (0.47; risk ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41; P=.006) when adjusted for the baseline criterion measure. The adjusted percentage of couples using condoms consistently was higher in the intervention group (63%) than in the comparison group (48%; risk ratio, 1.45; 95% CI, 1.24 to 1.70; P<.001). The adjusted mean number of (log)unprotected intercourse acts was lower in

Collaborative research to prevent HIV among male prison inmates and their female partners.

PubMed

Grinstead, O A; Zack, B; Faigeles, B

1999-04-01

Despite the need for targeted HIV prevention interventions for prison inmates, institutional and access barriers have impeded development and evaluation of such programs. Over the past 6 years, the authors have developed a unique collaborative relationship to develop and evaluate HIV prevention interventions for prison inmates. The collaboration includes an academic research institution (the Center for AIDS Prevention Studies at the University of California, San Francisco), a community-based organization (Centerforce), and the staff and inmate peer educators inside a state prison. In this ongoing collaboration, the authors have developed and evaluated a series of HIV prevention interventions for prison inmates and for women who visit prison inmates. Results of these studies support the feasibility and effectiveness of HIV prevention programs for inmates and their partners both in prison and in the community. Access and institutional barriers to HIV intervention research in prisons can be overcome through the development of collaborative research partnerships.

Development of a Tailored HIV Prevention Intervention for Single Young Men Who Have Sex With Men Who Meet Partners Online: Protocol for the myDEx Project.

PubMed

Bauermeister, Jose Arturo; Tingler, Ryan C; Demers, Michele; Harper, Gary W

2017-07-19

New cases of human immunodeficiency virus (HIV) among young men who have sex with men (YMSM), aged 18 to 24, underscore the importance of developmentally-informed HIV programs for YMSM. We developed an online intervention focused on risk reduction strategies across different sexual partner types. Intervention activities focus on assisting YMSM reflect on their partner-seeking behaviors, develop sexual decision-making rules to reduce their HIV risks, and consider the adoption of HIV prevention behaviors. This pilot, randomized controlled trial (RCT) aims to examine the feasibility, acceptability, and preliminary efficacy of a tailored, Web-based HIV prevention intervention for single YMSM. We designed a prospective RCT of online-recruited cis-gender men (N=180) who reported recent unprotected anal intercourse, self-report as HIV negative or are unaware of their HIV status, and meet sexual partners through online dating apps. Individuals in the control arm receive an attention-control condition that includes HIV/sexually transmitted infection (STI) information currently available on sex education websites. Individuals in the intervention arm receive a 6-session Web-based program tailored on their demographic information, partner-seeking behaviors and relationship desires, and prior sexual attitudes and behaviors. This tailored content will match HIV prevention messages and safer sex skills with YMSM's outcome expectancies when meeting new partners and thereby help them consider how to integrate safer sex practices into different partner types. Study assessments are taken at baseline, 30-, 60-, and 90-day follow-ups. Intervention acceptability and preliminary efficacy will be explored in sexual risk behaviors and HIV/STI testing. The RCT launched in November 2016 and is ongoing. To date, 180 eligible individuals have been enrolled, consented, and randomized. Of the 120 individuals in the intervention arm, 51.7% (62/120) identify as non-Hispanic white and half of the

The Use of Technology to Advance HIV Prevention for Couples.

PubMed

Mitchell, Jason W

2015-12-01

The majority of HIV prevention studies and programs have targeted individuals or operated at the community level. This has also been the standard approach when incorporating technology (e.g., web-based, smartphones) to help improve HIV prevention efforts. The tides have turned for both approaches: greater attention is now focusing on couple-based HIV prevention and using technology to help improve these efforts for maximizing reach and potential impact. To assess the extent that technology has been used to help advance HIV prevention with couples, a literature review was conducted using four databases and included studies that collected data from 2000 to early 2015. Results from this review suggest that technology has primarily been used to help advance HIV prevention with couples as a tool for (1) recruitment and data collection and (2) intervention development. Challenges and limitations of conducting research (e.g., validity of dyadic data) along with future directions for how technology (e.g., mHealth, wearable sensors) can be used to advance HIV prevention with couples are then discussed. Given the growing and near ubiquitous use of the Internet and smartphones, further efforts in the realm of mHealth (e.g., applications or "apps") and eHealth are needed to develop novel couple-focused HIV-preventive interventions.

A discussion of HIV/AIDS family interventions: implications for family-focused nursing practice.

PubMed

Eustace, Rosemary W

2013-07-01

This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches. © 2012 Blackwell Publishing Ltd.

Blocking the benefit of group-based HIV-prevention efforts during adolescence: the problem of HIV-related stigma.

PubMed

Barker, David H; Swenson, Rebecca R; Brown, Larry K; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Diclemente, Ralph J; Salazar, Laura F; Romer, Daniel

2012-04-01

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

Articulating A Rights-Based Approach to HIV Treatment and Prevention Interventions

PubMed Central

Barr, David; Amon, Joseph J; Clayton, Michaela

2011-01-01

Since the beginning of the epidemic, the protection of human rights has been an integral component in the response to Human Immunodeficiency Virus (HIV). The high degree of stigma and discrimination associated with acquired immune deficiency syndrome (AIDS) has made human rights protection not only a priority to ensure the rights of people living with and at-risk for HIV, but to address public health goals as well. Advances in understanding the impact of antiretroviral treatment on HIV prevention provide exciting opportunities and even a paradigm shift in terms of AIDS prevention. However, this potential cannot be reached unless the advancement of human rights is a primary component of treatment and prevention programme and policy development. The use of antiretroviral treatment as prevention reinforces the value of basic principles related to the dignity and agency of people living with HIV to participate in the design and implementation of programmes, to be informed and to make informed decisions about their health and lives, to be protected from harm, and to have opportunities to seek redress and accountability for abuses. The possibility of using HIV treatment as a prevention tool means that now, more than ever, legal reform and community empowerment and mobilisation are necessary to realize the rights and health of people affected by HIV. PMID:21999775

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

PubMed Central

2012-01-01

Background Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention. Methods We undertook a realist review to answer the research question: ‘How are HIV prevention interventions in high-income countries adapted to suit immigrants’ needs?’ A key goal was to uncover underlying theories or mechanisms operating in behavioural HIV prevention interventions with immigrants, to uncover explanations as how and why they work (or not) for particular groups in particular contexts, and thus to refine the underlying theories. The realist review mapped seven initial mechanisms underlying culturally appropriate HIV prevention with immigrants. Evidence from intervention studies and qualitative studies found in systematic searches was then used to test and refine these seven mechanisms. Results Thirty-four intervention studies and 40 qualitative studies contributed to the analysis and synthesis of evidence. The strongest evidence supported the role of ‘consonance’ mechanisms, indicating the pivotal need to incorporate cultural values into the intervention content. Moderate evidence was found to support the role of three other mechanisms – ‘understanding’, ‘specificity’ and ‘embeddedness’ – which indicated that using the language of immigrants, usually the ‘mother tongue’, targeting (in terms of ethnicity) and the use of

The Usability and Acceptability of an Adolescent mHealth HIV/STI and Drug Abuse Preventive Intervention in Primary Care.

PubMed

Cordova, David; Alers-Rojas, Francheska; Lua, Frania Mendoza; Bauermeister, Jose; Nurenberg, Rachel; Ovadje, Lauretta; Fessler, Kathryn; Delva, Jorge; Salas-Wright, Christopher P; Council, Youth Leadership

2018-01-01

Human Immunodeficiency Virus (HIV)/sexually transmitted infection (STI) risk behaviors among adolescents remain significant public health concerns. Shifts in policy and advances in technology provide opportunities for researchers and clinicians to deliver and evaluate mobile-health (mHealth) prevention programs in primary care, however, research is limited. This study assessed the usability and acceptability of Storytelling 4 Empowerment-a mHealth HIV/STI and drug abuse preventive intervention app-among adolescents in primary care. Informed by principles of community-based participatory research, we recruited a purposive sample of 30 adolescents from a youth-centered community health care clinic in Southeast Michigan. The study sample is primarily African American and female. Adolescents who participated in the Storytelling 4 Empowerment intervention assessed its usability and acceptability, and self-reported their HIV/STI risk behaviors. We used a multiple-methods approach. Adolescents reported high acceptability of the content, process, and format of Storytelling 4 Empowerment, as evidenced by qualitative data and mean scores from the Session Evaluation Form for the HIV/STI and Alcohol/Drug content, overall Storytelling 4 Empowerment intervention, and Client Satisfaction Questionnaire-8. Findings indicate that Storytelling 4 Empowerment is acceptable among adolescents in primary care. A next step is to examine the effect of Storytelling 4 Empowerment on adolescent sexual risk and drug use behaviors and HIV/STI testing.

78 FR 10182 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program (Part C) Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive...

Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

PubMed

Amirkhanian, Yuri A; Kelly, Jeffrey A; Takacs, Judit; McAuliffe, Timothy L; Kuznetsova, Anna V; Toth, Tamas P; Mocsonaki, Laszlo; DiFranceisco, Wayne J; Meylakhs, Anastasia

2015-03-13

To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. St. Petersburg, Russia and Budapest, Hungary. Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size = 35 members, n = 626) were recruited. Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members. Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes. There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P = 0.04); UAI with a nonmain partner (P = 0.04); and UAI with multiple partners (P = 0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P = 0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P = 0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.

Trends in perinatal HIV prevention in New York City, 1994-2003.

PubMed

Peters, Vicki B; Liu, Kai-Lih; Robinson, Lisa-Gaye; Dominguez, Kenneth L; Abrams, Elaine J; Gill, Balwant S; Thomas, Pauline A

2008-10-01

We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003 to ascertain the success of the interventions in reducing perinatal transmission. We used data obtained from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 86% in 1994 to 1996 and 90% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates. Ongoing perinatal HIV surveillance allows for monitoring the implementation of guidelines to prevent mother-to-child transmission of HIV and determining factors that may contribute to perinatal HIV transmission.

What community-level strategies are needed to secure women's property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention.

PubMed

Dworkin, Shari L; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women's HIV risks, few science-based programs have focused on securing women's land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24-30%) and property rights violations were common. The program was designed to reduce women's HIV risk at the community level by protecting and enhancing women's access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women's property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention.

78 FR 78976 - Ryan White HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

... HIV/AIDS Program Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY...: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award To Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary care...

78 FR 31568 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary...

78 FR 10183 - Ryan White HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... HIV/AIDS Program, Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program.... ACTION: Notice of Ryan White HIV/AIDS Program Part C Early Intervention Services One-Time Noncompetitive Award to Ensure Continued HIV Primary Medical Care. SUMMARY: To prevent a lapse in comprehensive primary...

The Roles of Technology in Primary HIV Prevention for Men Who Have Sex with Men.

PubMed

Sullivan, Patrick S; Jones, Jeb; Kishore, Nishant; Stephenson, Rob

2015-12-01

Men who have sex with men (MSM) are at disproportionate risk for HIV infection globally. The past 5 years have seen considerable advances in biomedical interventions to reduce the risk of HIV infection. To be impactful in reducing HIV incidence requires the rapid and expansive scale-up of prevention. One mechanism for achieving this is technology-based tools to improve knowledge, acceptability, and coverage of interventions and services. This review provides a summary of the current gap in coverage of primary prevention services, how technology-based interventions and services can address gaps in coverage, and the current trends in the development and availability of technology-based primary prevention tools for use by MSM. Results from agent-based models of HIV epidemics of MSM suggest that 40-50 % coverage of multiple primary HIV prevention interventions and services, including biomedical interventions like preexposure prophylaxis, will be needed to reduce HIV incidence among MSM. In the USA, current levels of coverage for all interventions, except HIV testing and condom distribution, fall well short of this target. Recent findings illustrate how technology-based HIV prevention tools can be used to provide certain kinds of services at much larger scale, with marginal incremental costs. A review of mobile apps for primary HIV prevention revealed that most are designed by nonacademic, nonpublic health developers, and only a small proportion of available mobile apps specifically address MSM populations. We are unlikely to reach the required scale of HIV prevention intervention coverage for MSM unless we can leverage technologies to bring key services to broad coverage for MSM. Despite an exciting pipeline of technology-based prevention tools, there are broader challenges with funding structures and sustainability that need to be addressed to realize the full potential of this emerging public health field.

HIV prevention for Black women: structural barriers and opportunities.

PubMed

Newman, Peter A; Williams, Charmaine C; Massaquoi, Notisha; Brown, Marsha; Logie, Carmen

2008-08-01

Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.

HIV PREVENTION FOR MIGRANTS IN TRANSIT: DEVELOPING AND TESTING TRAIN

PubMed Central

Bahromov, Mahbat; Weine, Stevan

2013-01-01

This study was a pilot investigation of the feasibility, acceptability, and effects of TRAIN (Transit to Russia AIDS Intervention with Newcomers) a three-session HIV preventive intervention for Tajik male labor migrants performed in transit. Sixty adult Tajik male labor migrants on the 5-day train ride from Dushanbe to Moscow were randomly assigned to either the intervention or a control condition. Each initially completed an in-person survey then another 3 days later (immediately postintervention), and participated in a cell phone survey three months later. All participants came to all intervention sessions, were satisfied with the program, and completed all postassessments. In comparison with the controls, the TRAIN group reported significant increases in condom use with sex workers and non-sex workers, condom knowledge, worry about HIV/AIDS, talking with persons about HIV/AIDS, talking with wife about HIV/AIDS, community activities, and religious activities. HIV/AIDS prevention performed in transit is feasible, accceptable, and potentially efficacious in diminishing HIV risk behaviors in labor migrants. PMID:21696244

The community popular opinion leader HIV prevention programme: conceptual basis and intervention procedures.

PubMed

2007-04-01

To describe the community popular opinion leader (C-POL) intervention employed in the NIMH Collaborative HIV/STD Prevention Trial, including its theoretical, conceptual, and empirical basis, intervention procedures and methods, core elements, and how its content was culturally tailored to address the needs of varied populations. The programme is designed to identify, recruit, train, and intensively engage C-POLs of a target population to convey HIV risk reduction messages to people in their communities, with the intention of reducing high-risk behavior at a population level. Based on the diffusion of innovation theory, the intervention identified, trained, and engaged C-POL within a high-risk community population to advocate, recommend, and endorse the importance of safer behavior to other members of the same population. Nine core elements of the intervention are discussed. Data collected during rapid ethnography were used to adapt the content of the intervention for food market owners and workers in China, male patrons of wine shops and at-risk women congregating nearby in India, young people in social gathering venues in Peruvian barrios, dormitory students in Russia, and people congregating in commercial areas of growth points in Zimbabwe. The C-POL intervention model taps into community strengths, altruism, and people's desire to do something to help fight against AIDS. With few exceptions, C-POLs participated enthusiastically in the training sessions and reported having conversations in the community. Rapid ethnography can be used to tailor an intervention to diverse settings while maintaining fidelity to the core elements of the intervention.

Frequency of false positive rapid HIV serologic tests in African men and women receiving PrEP for HIV prevention: implications for programmatic roll-out of biomedical interventions.

PubMed

Ndase, Patrick; Celum, Connie; Kidoguchi, Lara; Ronald, Allan; Fife, Kenneth H; Bukusi, Elizabeth; Donnell, Deborah; Baeten, Jared M

2015-01-01

Rapid HIV assays are the mainstay of HIV testing globally. Delivery of effective biomedical HIV prevention strategies such as antiretroviral pre-exposure prophylaxis (PrEP) requires periodic HIV testing. Because rapid tests have high (>95%) but imperfect specificity, they are expected to generate some false positive results. We assessed the frequency of true and false positive rapid results in the Partners PrEP Study, a randomized, placebo-controlled trial of PrEP. HIV testing was performed monthly using 2 rapid tests done in parallel with HIV enzyme immunoassay (EIA) confirmation following all positive rapid tests. A total of 99,009 monthly HIV tests were performed; 98,743 (99.7%) were dual-rapid HIV negative. Of the 266 visits with ≥1 positive rapid result, 99 (37.2%) had confirmatory positive EIA results (true positives), 155 (58.3%) had negative EIA results (false positives), and 12 (4.5%) had discordant EIA results. In the active PrEP arms, over two-thirds of visits with positive rapid test results were false positive results (69.2%, 110 of 159), although false positive results occurred at <1% (110/65,945) of total visits. When HIV prevalence or incidence is low due to effective HIV prevention interventions, rapid HIV tests result in a high number of false relative to true positive results, although the absolute number of false results will be low. Program roll-out for effective interventions should plan for quality assurance of HIV testing, mechanisms for confirmatory HIV testing, and counseling strategies for persons with positive rapid test results.

A quarter-century of HIV prevention intervention efforts among children and adolescents across the globe

PubMed Central

Stanton, Bonita; Li, Xiaoming

2014-01-01

In 1988 a group of pediatricians, developmental, clinical, child and social psychologists, anthropologists and health educators began researching in Baltimore, Maryland, on an Human Immunodefiency Virus (HIV) prevention intervention, Focus on Youth (FOY). Over the next 25 years, the questions being addressed by FOY reflected those of the global HIV research experience. During the first phase, the questions being addressed by the broader research community included: Can HIV risk behaviors be purposefully impacted by behavioral interventions? If so, how do successful interventions differ from those that are not effective? Are theory-based interventions more likely to be effective than information-only-based interventions? Can theories be translated into culturally and developmentally appropriate interventions including those that are appropriate for children and adolescents? Should parents be involved – and if so, how? During its next phase, the FOY team increasingly became concerned with a disturbing reality. A large number of interventions had been developed and some had been shown to have evidence of impact. But virtually all of these interventions had been conducted in the USA or Europe. The questions facing researchers included: With the global burden of HIV disproportionately impacting low- and middle-income countries (LMIC), especially those in southern Africa, the Caribbean and parts of Asia, what is known about the effectiveness of western-based interventions in these culturally, racially and economically disparate settings? With the exciting proliferation of interventions, federal agencies in the USA and international agencies including Joint United Nations Programme on HIV/AIDS realized the importance of assessing the research portfolio and developing metrics of effectiveness. The questions during this phase included: What is an “effective” intervention? How are effective interventions implemented in a new setting? This phase merged with the next

Project Salud: Using community-based participatory research to culturally adapt an HIV prevention intervention in the Latino migrant worker community.

PubMed

Sánchez, Jesús; Serna, Claudia A; de La Rosa, Mario

2012-01-01

Despite the unique and challenging circumstances confronting Latino migrant worker communities in the U.S., debate still exists as to the need to culturally adapt evidence-based interventions for dissemination with this population. Project Salud adopted a community-based participatory research model and utilized focus group methodology with 83 Latino migrant workers to explore the relevance of culturally adapting an evidence-based HIV prevention intervention to be disseminated within this population. Findings from this study indicate that, despite early reservations, Latino migrant workers wanted to participate in the cultural adaptation that would result in an intervention that was culturally relevant, respectful, responsive to their life experiences, and aligned with their needs. This study contributes to the cultural adaptation/fidelity debate by highlighting the necessity of exploring ways to develop culturally adapted interventions characterized by high cultural relevance without sacrificing high fidelity to the core components that have established efficacy for evidence-based HIV prevention interventions.

Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

PubMed Central

Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

2013-01-01

Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

Gender-Focused HIV and Pregnancy Prevention for School-Going Adolescents: The Mpondombili Pilot Intervention in KwaZulu-Natal, South Africa

PubMed Central

Harrison, Abigail; Hoffman, Susie; Mantell, Joanne E.; Smit, Jennifer A.; Leu, Cheng-Shiun; Exner, Theresa M.; Stein, Zena A.

2016-01-01

This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (ages 14–17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. Main outcome: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex. At five months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal [OR=1.61; 95% CI=1.01, 2.57] and condom use [OR=1.76; 95% CI=1.07, 2.89], partner communication [OR=2.42; 95% CI=1.27, 4.23], and knowledge of HIV testing opportunities [OR=1.76; 95% CI=1.08, 2.87]. This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication, and has potential to improve preventive behaviors. PMID:27642267

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15-24, Part 2: Evaluation of a Pilot Intervention.

PubMed

Willis, Leigh A; Kachur, Rachel; Castellanos, Ted J; Nichols, Kristen; Mendoza, Maria C B; Gaul, Zaneta J; Spikes, Pilgrim; Gamayo, Ashley C; Durham, Marcus D; LaPlace, Lisa; Straw, Julie; Staatz, Colleen; Buge, Hadiza; Hogben, Matthew; Robinson, Susan; Brooks, John; Sutton, Madeline Y

2018-03-01

In the United States, young people (ages 15-24 years) are disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), due at least in part to inadequate or incorrect HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI). Comic book narratives are a proven method of HIV/STD prevention communication to strengthen KABI for HIV/STD prevention. Motion comics, a new type of comic media, are an engaging and low-cost means of narrative storytelling. The objective of this study was to quantitatively evaluate the effectiveness of a pilot six-episode HIV/STD-focused motion comic series to improve HIV/STD-related KABI among young people. We assessed change in HIV/STD knowledge, HIV stigma, condom attitudes, HIV/STD testing attitudes, and behavioral intentions among 138 participants in 15 focus groups immediately before and after viewing the motion comic series. We used paired t-tests and indicators of overall improvement to assess differences between surveys. We found a significant decrease in HIV stigma (p < .001) and increases in both HIV knowledge (p = .002) and behavioral intentions to engage in safe sex (p < .001). In summary, this motion comic intervention improved HIV/STD-related KABI of young adult viewers by reducing HIV stigma and increasing behavioral intentions to engage in safer sex. Our results demonstrate the promise of this novel intervention and support its use to deliver health messages to young people.

Unity in Diversity: Results of a Randomized Clinical Culturally Tailored Pilot HIV Prevention Intervention Trial in Baltimore, Maryland, for African American Men Who Have Sex with Men

ERIC Educational Resources Information Center

Tobin, Karin; Kuramoto, Satoko J.; German, Danielle; Fields, Errol; Spikes, Pilgrim S.; Patterson, Jocelyn; Latkin, Carl

2013-01-01

Unity in Diversity was a randomized controlled trial of a culturally tailored HIV prevention intervention for African American men who have sex with men. The intervention condition was six group-based sessions and one individual session. The control condition was a single-session HIV prevention review. Participants were aged 18 years or older,…

Prevention options for positives: the effects of a health communication intervention for men who have sex with men living with HIV/AIDS.

PubMed

Lapinski, Maria Knight; Randall, Liisa M; Peterson, Mark; Peterson, Amy; Klein, Katherine A

2009-09-01

This article reports the results of a small-scale quasi-experiment that tested the efficacy of the Prevention Options for Positives intervention. The experiment tested for the outcomes of group sessions combined with individual-level counseling (ILC) versus ILC-only for men who have sex with men who are HIV positive. Both arms of the intervention were based on behavior change theory and dealt specifically with communication outcomes. The results indicate that the group- and individual-level interventions combined have a greater impact on risk communication behaviors with main partners than did the ILC-only sessions. group-session/ILC participants were more likely to decide not to have sex if they were drunk or high, and more likely to tell their partner and ask their partner about HIV status than were participants in the ILC groups. Knowledge about HIV was relatively high, and there was little change across groups. The Prevention Options for Positives intervention influenced the relative importance of various referent groups, but normative beliefs were not affected. The implications of these findings for communication practice and research with HIV-positive men who have sex with men are addressed.

Mathematical modeling of HIV prevention measures including pre-exposure prophylaxis on HIV incidence in South Korea.

PubMed

Kim, Sun Bean; Yoon, Myoungho; Ku, Nam Su; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Kim, Changsoo; Kwon, Hee-Dae; Lee, Jeehyun; Smith, Davey M; Choi, Jun Yong

2014-01-01

Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM.

Mathematical Modeling of HIV Prevention Measures Including Pre-Exposure Prophylaxis on HIV Incidence in South Korea

PubMed Central

Kim, Sun Bean; Yoon, Myoungho; Ku, Nam Su; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Kim, Changsoo; Kwon, Hee-Dae; Lee, Jeehyun; Smith, Davey M.; Choi, Jun Yong

2014-01-01

Background Multiple prevention measures have the possibility of impacting HIV incidence in South Korea, including early diagnosis, early treatment, and pre-exposure prophylaxis (PrEP). We investigated how each of these interventions could impact the local HIV epidemic, especially among men who have sex with men (MSM), who have become the major risk group in South Korea. A mathematical model was used to estimate the effects of each these interventions on the HIV epidemic in South Korea over the next 40 years, as compared to the current situation. Methods We constructed a mathematical model of HIV infection among MSM in South Korea, dividing the MSM population into seven groups, and simulated the effects of early antiretroviral therapy (ART), early diagnosis, PrEP, and combination interventions on the incidence and prevalence of HIV infection, as compared to the current situation that would be expected without any new prevention measures. Results Overall, the model suggested that the most effective prevention measure would be PrEP. Even though PrEP effectiveness could be lessened by increased unsafe sex behavior, PrEP use was still more beneficial than the current situation. In the model, early diagnosis of HIV infection was also effectively decreased HIV incidence. However, early ART did not show considerable effectiveness. As expected, it would be most effective if all interventions (PrEP, early diagnosis and early treatment) were implemented together. Conclusions This model suggests that PrEP and early diagnosis could be a very effective way to reduce HIV incidence in South Korea among MSM. PMID:24662776

Ethical Issues in Using Social Media to Deliver an HIV Prevention Intervention: Results from the HOPE Peru Study.

PubMed

Garett, Renee; Menacho, Luis; Young, Sean D

2017-02-01

Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people's posts (p = 0.038) and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media-based HIV research.

Ethical issues in using social media to deliver an HIV prevention intervention: Results from the HOPE Peru Study

PubMed Central

Garett, Renee; Menacho, Luis; Young, Sean D.

2017-01-01

Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people’s posts (p = 0.038), and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media–based HIV research. PMID:27933425

A Network-Individual-Resource Model for HIV Prevention

PubMed Central

Johnson, Blair T.; Redding, Colleen A.; DiClemente, Ralph J.; Mustanski, Brian S.; Dodge, Brian M.; Sheeran, Paschal; Warren, Michelle R.; Zimmerman, Rick S.; Fisher, William A.; Conner, Mark T.; Carey, Michael P.; Fisher, Jeffrey D.; Stall, Ronald D.; Fishbein, Martin

2014-01-01

HIV is transmitted through dyadic exchanges of individuals linked in transitory or permanent networks of varying sizes. To optimize prevention efficacy, a complementary theoretical perspective that bridges key individual level elements with important network elements can be a foundation for developing and implementing HIV interventions with outcomes that are more sustainable over time and have greater dissemination potential. Toward that end, we introduce a Network-Individual-Resource (NIR) model for HIV prevention that recognizes how exchanges of resources between individuals and their networks underlies and sustains HIV-risk behaviors. Individual behavior change for HIV prevention, then, may be dependent on increasing the supportiveness of that individual's relevant networks for such change. Among other implications, an NIR model predicts that the success of prevention efforts depends on whether the prevention efforts (1) prompt behavior changes that can be sustained by the resources the individual or their networks possess; (2) meet individual and network needs and are consistent with the individual's current situation/developmental stage; (3) are trusted and valued; and (4) target high HIV-prevalence networks. PMID:20862606

Implementation and assessment of a prevention with positives intervention among people living with HIV at five hospitals in Thailand.

PubMed

Baipluthong, Benjamas; Anekthananon, Thanomsak; Munsakul, Warangkana; Jirajariyavej, Supunnee; Asavapiriyanont, Suvanna; Hancharoenkit, Ubonsri; Roongpisuthipong, Anuvat; Pattanasin, Sarika; Martin, Michael; Guntamala, Lisa; Lolekha, Rangsima

2017-01-01

We implemented a hospital-based prevention with positives (PwP) intervention among people living with HIV (PLHIV) that included HIV transmission risk screening, short HIV prevention messages, family planning, HIV disclosure counseling, and partner HIV testing at five hospitals in Thailand. We assessed changes in sexual risk behaviors among PLHIV who received the PwP services at the hospitals. From January 2008-March 2009, we systematically selected a subset of PLHIV receiving care at the five hospitals to offer participation in the PwP intervention. We collected demographic, risk behavior, and laboratory data using a standardized questionnaire. We analyzed data from PLHIV who completed at least four visits, using generalized estimating equations to identify baseline participant characteristics that were associated with adopting sexual practices less likely to be associated with HIV transmission during follow-up. A total of 830 PLHIV were interviewed and 756 (91.1%) completed four visits. The median age of these 756 participants was 37 years, 400 (52.9%) were women, and 475 (62.8%) had a steady partner. At baseline, 353 (74.3%) of the steady partners had been tested for HIV and 132 (37.4%) had tested negative. Among the 756 PLHIV, 427 (56.5%) reported having sex in the 3 months before enrollment and 413 (54.6%) in the 3 months before the fourth visit. The proportion reporting having vaginal or anal sex without a condom decreased from 20.8% at baseline to 5.1% at the fourth visit (p<0.001). Factors associated (p<0.05) with abstinence or 100% condom use at follow-up visits included: completing ≥ two visits, being diagnosed with HIV for longer than 3 months, and receiving HIV prevention messages from a doctor (versus a nurse or counselor). Safe sex behaviors increased among PLHIV receiving PwP services, suggesting that expansion of hospital-based PwP services may reduce the number of new HIV infections in Thailand.

Outcomes and lessons from a pilot RCT of a community-based HIV prevention multi-session group intervention for gay men.

PubMed

Harding, R; Bensley, J; Corrigan, N; Franks, L; Stratman, J; Waller, Z; Warner, J

2004-07-01

This paper presents the first outcome evaluation of multi-session groupwork for HIV prevention among gay men in the UK. This community-based RCT recruited 50 men, of whom 42% were HIV-positive or untested, and 32% reported status unknown or serodiscordant UAI in the previous 12 months. No knowledge, skills, attitudinal or behavioural differences were detected between intervention and control at baseline. At eight weeks, those attending the group reported significant gains over their control in making sexual choices, physical safety, HIV and STI transmission knowledge, and sexual negotiation skills. At 20 weeks, significant differences remained for HIV and STI transmission knowledge and comfort with sexual choices. Although no behavioural differences were detected, the aims of the National Prevention Strategy were met. This pilot RCT is appraised in the light of modest sample size and attrition, and recommendations for establishing behavioural outcomes are presented. This study has demonstrated that high-risk community samples can be recruited to multi-session interventions, and has provided feasibility data for future rigorous evaluation designs.

Exploring “Wine Shops” as a Venue for HIV Prevention Interventions in Urban India

PubMed Central

Johnson, Sethulakshmi; Bentley, Margaret E.; Srikrishnan, A. K.; Latkin, Carl A.; Go, Vivian F.; Solomon, Suniti; Celentano, David D.

2007-01-01

Addressing male heterosexual risk is a high priority for HIV prevention efforts in India. Particularly in urban India, which draws men for employment opportunities, these efforts are gaining momentum with a focus on understanding possible risk facilitators such as alcohol use. However, little is known about venues where such efforts might be targeted. In this paper, we explore community-based alcohol outlets or “wine shops” in Chennai, India, as potential venues. We conducted ethnographic research with wine shop staff and clients to understand alcohol use and sexual behaviors. We then surveyed 118 wine shop patrons to quantify these risk behaviors and plan an appropriate intervention. Our results show that wine shops are a venue where social and sexual networks converge. Reports and observations of regular and heavy drinking were frequent. Over 50% of patrons surveyed reported three or more sexual partners in the past 3 months, and 71% of all patrons reported a history of exchanging sex for money. Condom use history was low overall but, in the adjusted analyses, was significantly higher (OR = 20.1) among those who reported that their most recent partner was a sex worker and lower (OR = 0.28) among those who reported they drank to feel disinhibited. The data suggest that wine shops may be an appropriate location to target men for HIV prevention interventions. We discuss how these findings helped design such an intervention in Chennai. PMID:17486455

Averting HIV Infections in New York City: A Modeling Approach Estimating the Future Impact of Additional Behavioral and Biomedical HIV Prevention Strategies

PubMed Central

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Kowalski, Alexis; Sweeney, Monica; Toohey, Christopher; Khademi, Amin; Shepard, Colin; Cutler, Blayne; Braithwaite, R. Scott

2013-01-01

Background New York City (NYC) remains an epicenter of the HIV epidemic in the United States. Given the variety of evidence-based HIV prevention strategies available and the significant resources required to implement each of them, comparative studies are needed to identify how to maximize the number of HIV cases prevented most economically. Methods A new model of HIV disease transmission was developed integrating information from a previously validated micro-simulation HIV disease progression model. Specification and parameterization of the model and its inputs, including the intervention portfolio, intervention effects and costs were conducted through a collaborative process between the academic modeling team and the NYC Department of Health and Mental Hygiene. The model projects the impact of different prevention strategies, or portfolios of prevention strategies, on the HIV epidemic in NYC. Results Ten unique interventions were able to provide a prevention benefit at an annual program cost of less than $360,000, the threshold for consideration as a cost-saving intervention (because of offsets by future HIV treatment costs averted). An optimized portfolio of these specific interventions could result in up to a 34% reduction in new HIV infections over the next 20 years. The cost-per-infection averted of the portfolio was estimated to be $106,378; the total cost was in excess of $2 billion (over the 20 year period, or approximately $100 million per year, on average). The cost-savings of prevented infections was estimated at more than $5 billion (or approximately $250 million per year, on average). Conclusions Optimal implementation of a portfolio of evidence-based interventions can have a substantial, favorable impact on the ongoing HIV epidemic in NYC and provide future cost-saving despite significant initial costs. PMID:24058465

Engaging local businesses in HIV prevention efforts: the consumer perspective.

PubMed

Phillips-Guzman, Christina M; Martinez-Donate, Ana P; Hovell, Melbourne F; Blumberg, Elaine J; Sipan, Carol L; Rovniak, Liza S; Kelley, Norma J

2011-07-01

Participation of different community sectors, including the private business sector, is necessary to fight the HIV/AIDS epidemic. Local businesses may be reluctant to participate in HIV prevention because of fear of negative customer reactions and loss of revenue. This study examines the extent to which residents of two communities in San Diego, California, would support HIV prevention initiatives in local businesses. A population-based household survey (N = 200) is conducted in two communities with higher versus lower risk for HIV. The survey includes questions regarding the acceptability of HIV prevention activities, such as condom and brochure distribution in businesses, and history of exposure to HIV prevention activities in local businesses. Most residents agree that (a) business involvement in prevention activities would reduce HIV (92%), (b) free or low-cost condoms available in businesses could prevent the spread of HIV (90.9%) and increase condom accessibility (87%), and (c) they would prefer to shop at businesses that supported HIV prevention versus those that did not (87.4%). These findings suggest that HIV prevention in local businesses would be supported by residents and would be unlikely to adversely affect business profits. This information could be used to design interventions to engage local businesses in HIV-prevention efforts.

Feasibility, Acceptability, and Preliminary Efficacy of an Online HIV Prevention Program for Diverse Young Men who have Sex with Men: The Keep It Up! Intervention

PubMed Central

Mustanski, Brian; Garofalo, Robert; Monahan, Colleen; Gratzer, Beau; Andrews, Rebecca

2013-01-01

Young men who have sex with men (YMSM) are disproportionately infected with HIV/AIDS and there are few prevention programs with published efficacy for this population. This study evaluated the feasibility, acceptability, and preliminary efficacy of an online, interactive, and highly engaging HIV prevention program called Keep It Up! The intervention was designed to be delivered to diverse YMSM upon receiving an HIV negative text result, with the goal for them to “Keep It Up” and stay negative. In a randomized clinical trial, the intervention was compared to an online didactic HIV knowledge condition. The study sample included 102 sexually active YMSM. Participants reported completing online modules in settings that were private and not distracting. Mixed methods data showed intervention participants felt the program was valuable and acceptable. Compared to the control condition, participants in the intervention arm had a 44 % lower rate of unprotected anal sex acts at the 12-week follow-up (p < 0.05). PMID:23673793

Family-based HIV prevention and intervention services for youth living in poverty-affected contexts: the CHAMP model of collaborative, evidence-informed programme development

PubMed Central

2010-01-01

Family-based interventions with children who are affected by HIV and AIDS are not well established. The Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP) represents one of the few evidence-based interventions tested in low-income contexts in the US, Caribbean and South Africa. This paper provides a description of the theoretical and empirical bases of the development and implementation of CHAMP in two of these countries, the US and South Africa. In addition, with the advent of increasing numbers of children infected with HIV surviving into adolescence and young adulthood, a CHAMP+ family-based intervention, using the founding principles of CHAMP, has been developed to mitigate the risk influences associated with being HIV positive. PMID:20573290

Efficacy of an adapted HIV and sexually transmitted infection prevention intervention for incarcerated women: a randomized controlled trial.

PubMed

Fogel, Catherine I; Crandell, Jamie L; Neevel, A M; Parker, Sharon D; Carry, Monique; White, Becky L; Fasula, Amy M; Herbst, Jeffrey H; Gelaude, Deborah J

2015-04-01

We tested the efficacy of an adapted evidence-based HIV-sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women's Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities.

Are cultural values and beliefs included in U.S. based HIV interventions?

PubMed

Wyatt, Gail E; Williams, John K; Gupta, Arpana; Malebranche, Dominique

2012-11-01

To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual's risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. Copyright © 2011. Published by Elsevier Inc.

Mano a Mano Mujer: An Effective HIV Prevention for Chilean Women

PubMed Central

Cianelli, Rosina; Ferrer, Lilian; Norr, Kathleen F.; Miner, Sarah; Irarrazabal, Lisette; Bernales, Margarita; Peragallo, Nilda; Levy, Judith; Norr, James L.; McElmurry, Beverly

2012-01-01

The impact of a professionally-facilitated peer group intervention for HIV prevention among 400 low income Chilean women was examined using a quasi-experimental design. At three months post-intervention, the intervention group had higher HIV-related knowledge, more positive attitudes towards people living with HIV, fewer perceived condom use barriers, greater self-efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. However, they did not have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries. PMID:22420675

Effects through 24 months of an HIV/AIDS prevention intervention program based on protection motivation theory among preadolescents in the Bahamas.

PubMed

Gong, Jie; Stanton, Bonita; Lunn, Sonja; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Brathwaite, Nanika V; Cottrell, Leslie; Harris, Carole; Chen, Xinguang

2009-05-01

The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths' HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary to determine whether the apparent

Effects Through 24 Months of an HIV/AIDS Prevention Intervention Program Based on Protection Motivation Theory Among Preadolescents in the Bahamas

PubMed Central

Gong, Jie; Stanton, Bonita; Lunn, Sonja; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Brathwaite, Nanika V.; Cottrell, Leslie; Harris, Carole; Chen, Xinguang

2010-01-01

OBJECTIVES The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. METHODS We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. RESULTS Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths’ HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. CONCLUSIONS Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary

What community-level strategies are needed to secure women’s property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention

PubMed Central

Dworkin, Shari L.; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women’s HIV risks, few science-based programs have focused on securing women’s land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24–30%) and property rights violations were common. The program was designed to reduce women’s HIV risk at the community level by protecting and enhancing women’s access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women’s property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention. PMID:24116828

HIV prevention among diverse young MSM: Research needs, priorities, and opportunities

PubMed Central

Rhodes, Scott D.; Wong, Frank Y.

2016-01-01

There remains a profound need for innovative and effective interventions designed for young men who have sex with men (YMSM) generally; and racial and ethnic minority YMSM, YMSM living in rural communities, and low-income YMSM, particularly, to prevent HIV and improve health outcomes in the United States. This introduction to this theme issue identifies some of the research needs, priorities, and opportunities that emerged during a seminal NIMHD-sponsored workshop on HIV prevention behavioral interventions for diverse YMSM. It provides researchers, practitioners, and federal partners guidance in next steps to reduce the impact of the HIV epidemic among YMSMS. The needs, priorities, and opportunities identified serve as a foundation to push both the science and the practice of HIV prevention forward. We recognize that considerably more research is needed, and this issue highlights intervention research – where we have been and where we should go. With the disparities faced by YMSM, we must act rapidly to do the work it will take to meet their prevention needs, reduce infections, and save lives. PMID:27244188

What HIV-Positive Young Women Want from Behavioral Interventions: A Qualitative Approach

PubMed Central

Brothers, Jennifer; Lemos, Diana

2012-01-01

Abstract Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17–24 (mean age=21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components. PMID:22675725

Effects of a theory-based audio HIV/AIDS intervention for illiterate rural females in Amhara, Ethiopia.

PubMed

Bogale, Gebeyehu W; Boer, Henk; Seydel, Erwin R

2011-02-01

In Ethiopia the level of illiteracy in rural areas is very high. In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play. In a pretest and posttest experimental study with an intervention group (n = 210) and control group (n = 210), we investigated the effects on HIV/AIDS knowledge and social cognitions. The intervention led to significant and relevant increases in HIV/AIDS knowledge, self-efficacy, perceived vulnerability to HIV/AIDS infection, response efficacy of condoms and condom use intention. In the intervention group, self-efficacy at posttest was the main determinant of condom use intention, with also a significant contribution of vulnerability. We conclude that audio HIV/AIDS prevention interventions can play an important role in empowering rural illiterate females in the prevention of HIV/AIDS.

HIV/STI Prevention Among Heterosexually Active Black Adolescents With Mental Illnesses: Focus Group Findings for Intervention Development.

PubMed

Brawner, Bridgette M; Jemmott, Loretta Sweet; Wingood, Gina; Reason, Janaiya; Mack, Niya

Heterosexually active Black adolescents with mental illnesses are at increased risk for sexually transmitted infections (STIs), including HIV. However, few HIV/STI prevention interventions exist for this demographic. We held seven focus groups (N = 33) to elucidate social, cultural, and psychological factors that influence HIV/STI risk-related sexual behaviors in this understudied population. Seven themes emerged: (a) Blackness and media portrayals, (b) Blackness as a source of cultural resilience and pride, (c) psychosocial determinants of condom use, (d) consequences of engaging in sexual activity, (e) attitudes and beliefs toward sexual behaviors, (f) benefits of sexual activity, and (g) coping mechanisms. Participants also supported the feasibility of and interest in HIV/STI prevention programs integrated with mental health treatment. Transportation, potential breaches of confidentiality, and time were noted barriers to participation. Psychoeducational, skills-based programs are needed to address the sequelae of mental illnesses as they relate to the sexual decision-making process in adolescents. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Trends in Perinatal HIV Prevention in New York City, 1994–2003

PubMed Central

Liu, Kai-Lih; Robinson, Lisa-Gaye; Dominguez, Kenneth L.; Abrams, Elaine J.; Gill, Balwant S.; Thomas, Pauline A.

2008-01-01

Objectives. We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003 to ascertain the success of the interventions in reducing perinatal transmission. Methods. We used data obtained from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission. Results. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 86% in 1994 to 1996 and 90% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission. Conclusions. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates. Ongoing perinatal HIV surveillance allows for monitoring the implementation of guidelines to prevent mother-to-child transmission of HIV and determining factors that may contribute to perinatal HIV transmission. PMID:18309139

Secondary HIV prevention among kothi-identified MSM in Chennai, India.

PubMed

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali

2008-05-01

This study explored experiences and contexts of HIV risk and prevention among HIV-positive kothi-identified men in Chennai, India. In-depth, semi-structured interviews were conducted with 10 HIV-positive men and three service providers, recruited using purposive sampling. Interviews were audio-taped, transcribed in Tamil and translated into English. Data were analysed using a narrative thematic approach and constant comparative method. Misconceptions about HIV transmission; cultural taboos around discussing sexual behaviour and HIV; stigma related to same-sex behaviour; harassment; and the criminalization of consensual sex between men present formidable challenges to HIV prevention. Frank and open discussion about male-to-male sexual behaviour and living with HIV, which may support health and HIV prevention, may be dangerous in the context of pervasive risks due to stigmatization, violence and criminalization. Instead, culturally appropriate, multi-level interventions developed in collaboration with community stakeholders are needed to support HIV prevention among kothi-identified men in South India.

A cross-site intervention in Chinese rural migrants enhances HIV/AIDS knowledge, attitude and behavior.

PubMed

Li, Ning; Li, Xiaomei; Wang, Xueliang; Shao, Jin; Dou, Juanhua

2014-04-23

With the influx of rural migrants into urban areas, the spread of HIV has increased significantly in Shaanxi Province (China). Migrant workers are at high risk of HIV infection due to social conditions and hardships (isolation, separation, marginalization, barriers to services, etc.). We explored the efficacy of a HIV/AIDS prevention and control program for rural migrants in Shaanxi Province, administered at both rural and urban sites. Guidance concerning HIV/AIDS prevention was given to the experimental group (266 migrants) for 1 year by the center of disease control, community health agencies and family planning department. The intervention was conducted according to the HIV/AIDS Prevention Management Manual for Rural Migrants. A control group of migrants only received general population intervention. The impact of the intervention was evaluated by administering HIV/AIDS knowledge, attitudes and sexual behavior (KAB) questionnaires after 6 and 12 months. In the experimental group; 6 months of intervention achieved improvements in HIV/AIDS related knowledge. After 12 months; HIV/AIDS-related knowledge reached near maximal scores. Attitude and most behaviors scores were significantly improved. Moreover; the experimental group showed significant differences in HIV-AIDS knowledge; attitude and most behavior compared with the control group. The systematic long-term cross-site HIV/AIDS prevention in both rural and urban areas is a highly effective method to improve HIV/AIDS KAB among rural migrants.

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

Motivational barriers to retention of at-risk young adults in HIV-prevention interventions: perceived pressure and efficacy.

PubMed

Liu, Jiaying; Jones, Christopher; Wilson, Kristina; Durantini, Marta R; Livingood, William; Albarracín, Dolores

2014-01-01

Multi-session HIV-prevention interventions are efficacious but depend on the retention of clients over time. In a sample of at-risk young adults (N = 386), we investigated three potential motivational barriers that might affect the likelihood of retention. Perceived pressure, perceived efficacy and fear and anxiety during the initial session were measured, along with demographic characteristics, partner characteristics, and HIV-related health knowledge. Logistic regressions demonstrated that (1) in general, perceived ineffectiveness was negatively associated with retention; (2) perceived pressure or coercion was negatively associated with retention but only for younger clients; (3) experienced fear and anxiety had no significant association with retention. Implications for theory and counseling practices to reduce motivational barriers and effectively tailor interventions are discussed.

Motivational barriers to retention of at-risk young adults in HIV-prevention interventions: Perceived pressure and efficacy

PubMed Central

Liu, Jiaying; Jones, Christopher; Wilson, Kristina; Durantini, Marta R.; Livingood, William; Albarracín, Dolores

2014-01-01

Multi-session HIV-prevention interventions are efficacious but depend on the retention of clients over time. In a sample of at-risk young adults (N = 386), we investigated three potential motivational barriers that might affect the likelihood of retention. Perceived pressure, perceived efficacy and fear and anxiety during the initial session were measured, along with demographic characteristics, partner characteristics, and HIV-related health knowledge. Logistic regression demonstrated that (1) in general, perceived ineffectiveness was negatively associated with retention; (2) perceived pressure or coercion was negatively associated with retention, but only for younger clients; (3) experienced fear and anxiety had no significant association with retention. Implications for theory and counseling practices to reduce motivational barriers and effectively tailor interventions are discussed. PMID:24641552

Adaptation of a U.S. evidence-based Positive Prevention intervention for youth living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

PubMed Central

Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J.L.; Edmonds, A.; Golin, C.E.; Moracco, K.; Behets, F.

2013-01-01

Effective HIV prevention programs for people living with HIV/AIDS (PLWH) are important to reduce new infections and to ensure PLWH remain healthy. This paper describes the systematic adaptation of a U.S.-developed Evidence Based Intervention (EBI) using the Centers for Disease Control and Prevention (CDC) Map of Adaption Process for use at a Pediatric Hospital in Kinshasa, Democratic Republic of the Congo (DRC). The adapted intervention, Supporting Youth and Motivating Positive Action or SYMPA, a six-session risk reduction intervention targeted for youth living with HIV/AIDS (YLWH) in Kinshasa was adapted from the Healthy Living Project and guided by the Social Action Theory. This paper describes the process of implementing the first four steps of the ADAPT framework (Assess, Select, Prepare, and Pilot). Our study has shown that an EBI developed and implemented in the U.S. can be adapted successfully for a different target population in a low-resource context through an iterative process following the CDC ADAPT framework. This process included reviewing existing literature, adapting and adding components, and focusing on increasing staff capacity. This paper provides a rare, detailed description of the adaptation process and may aid organizations seeking to adapt and implement HIV prevention EBIs in sub-Saharan Africa and beyond. PMID:23063699

HIV prevention interventions for young male commercial sex workers.

PubMed

Ballester-Arnal, R; Gil-Llario, M D; Salmeron-Sánchez, P; Giménez-García, C

2014-03-01

The sex industry, where men sell sexual services to other men or women, has grown in recent years. These men who offer sexual services are particularly vulnerable to HIV infection due to such factors as: frequency of risky sexual practices, number of sex partners, drug-taking, prevalence of sexually-transmitted infections (STI) and their specific situation of social exclusion which may hinder access to health services. These multi-faceted realities faced by sex workers explain the burgeoning interest in new avenues of scientific research. There are too few preventive programs however aimed at this population group and the studies that evaluate their effectiveness are fewer still. In this article we survey more recent studies on the difficulties of implementing programs for HIV prevention in male sex workers (MSW), as well as the studies that have gauged the impact of preventive programs in this group.

HIV prevention among transgender women in Latin America: implementation, gaps and challenges.

PubMed

Silva-Santisteban, Alfonso; Eng, Shirley; de la Iglesia, Gabriela; Falistocco, Carlos; Mazin, Rafael

2016-01-01

Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate community and health workers in mixed teams; task

A Randomized Controlled Trial of a Parent-Centered Intervention in Preventing Substance Use and HIV Risk Behaviors in Hispanic Adolescents

ERIC Educational Resources Information Center

Prado, Guillermo; Pantin, Hilda; Briones, Ervin; Schwartz, Seth J.; Feaster, Daniel; Huang, Shi; Sullivan, Summer; Tapia, Maria I.; Sabillon, Eduardo; Lopez, Barbara; Szapocznik, Jose

2007-01-01

The present study evaluated the efficacy of Familias Unidas + Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior. Two hundred sixty-six 8th-grade Hispanic adolescents and their primary caregivers were randomly assigned to 1 of…

Determining a cost effective intervention response to HIV/AIDS in Peru.

PubMed

Aldridge, Robert W; Iglesias, David; Cáceres, Carlos F; Miranda, J Jaime

2009-09-18

The HIV epidemic in Peru is still regarded as concentrated -- sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its response through new interventions partly

Substance Use and HIV Prevention for Youth in Correctional Facilities

ERIC Educational Resources Information Center

Mouttapa, Michele; Watson, Donnie W.; McCuller, William J.; Reiber, Chris; Tsai, Winnie

2009-01-01

Evidence-based programs for substance use and HIV prevention (SUHIP) were adapted for high-risk juveniles detained at 24-hour secure correctional facilities. In this pilot study, comparisons were made between adolescents who received the SUHIP intervention and a control group on changes in: (1) knowledge of HIV prevention behaviors, (2) attitudes…

Developing a Safer Conception Intervention for Men Living with HIV in South Africa.

PubMed

Khidir, Hazar; Psaros, Christina; Greener, Letitia; O'Neil, Kasey; Mathenjwa, Mxolisi; Mosery, F N; Moore, Lizzie; Harrison, Abigail; Bangsberg, David R; Smit, Jennifer A; Safren, Steven A; Matthews, Lynn T

2018-06-01

Within sexual partnerships, men make many decisions about sexual behavior, reproductive goals, and HIV prevention. There are increasing calls to involve men in reproductive health and HIV prevention. This paper describes the process of creating and evaluating the acceptability of a safer conception intervention for men living with HIV who want to have children with partners at risk for acquiring HIV in KwaZulu-Natal, South Africa. Based on formative work conducted with men and women living with HIV, their partners, and providers, we developed an intervention based on principles of cognitive-behavioral therapy to support men in the adoption of HIV risk-reduction behaviors such as HIV-serostatus disclosure and uptake of and adherence to antiretroviral therapy. Structured group discussions were used to explore intervention acceptability and feasibility. Our work demonstrates that men are eager for reproductive health services, but face unique barriers to accessing them.

What Community-Based HIV Prevention Organizations Say About Their Role in Biomedical HIV Prevention.

PubMed

Smith, Dawn K; Maier, Emily; Betts, Joshua; Gray, Simone; Kolodziejski, Brian; Hoover, Karen W

2016-10-01

Community-based organizations (CBOs) are critical to delivery of effective HIV prevention because of their reach to key populations. This online survey of a national sample of CBOs assessed their awareness of, interest in, and resources needed to provide nonoccupational postexposure prophylaxis (nPEP), preexposure prophylaxis (PrEP), and HIV treatment as prevention (TasP). One hundred seventy-five CBOs participated: 87 clinical and 88 nonclinical CBOs. For nPEP, PrEP, and TasP, program managers reported that awareness was high (94%, 90%, 85%), meeting current client need was low (20%, 13%, 18%), and the likelihood of increasing their current provision with additional resources was somewhat high (62%, 64%, 62%). Clinical CBOs were more prepared to support expansion of these biomedical interventions than nonclinical CBOs. Meeting the information, training, and resource needs of CBOs is critical for effective collaboration to reduce the number of new HIV infections through expanded delivery of PrEP, nPEP, and TasP.

Gender-specific HIV prevention interventions for women who use alcohol and other drugs: The evolution of the science and future directions

PubMed Central

Wechsberg, Wendee M.; Deren, Sherry; Myers, Bronwyn; Kirtadze, Irma; Zule, William A.; Howard, Brittni; El-Bassel, Nabila

2015-01-01

The use of alcohol and other drugs (AODs) is an important driver of gender disparities in HIV prevalence. Consequently, there is a need for women-specific HIV interventions that are conceptualized to address (1) women’s risk behavior, their roles in sexual relationships, and gender power dynamics, and (2) other issues commonly faced by women who use AODs, such as gender-based violence and victimization. This article presents the evolution of HIV prevention intervention research with women who use AODs. It looks at three generations of women-focused HIV research interventions, including first-generation projects that started in the 1990s, second-generation efforts where projects expanded in scope and included adaptions of evidence-based interventions for global relevance, and finally third-generation projects currently underway that combine biobehavioral methods and are being implemented in real-world settings. Because women who use AODs continue to report risk behaviors related to HIV, emphasis should be placed on training scientists to conduct gender-specific studies, increasing funding for new studies, and advocating to ensure that stigma-free services are available for these at-risk women. PMID:25978479

Adolescents’ perceptions of a mobile cell phone text messaging-enhanced intervention and development of a mobile cell phone-based HIV prevention intervention

PubMed Central

Cornelius, Judith B.; St. Lawrence, Janet S.; Howard, Jacquelyn C.; Shah, Deval; Poka, Avinash; McDonald, Delilah; White, Ann C.

2013-01-01

Purpose This study examined African American adolescents’ perceptions of a mobile cell phone (MCP)-enhanced intervention and development of an MCP-based HIV prevention intervention. Design and Methods One focus group was conducted with 11 adolescents who participated in the Becoming a Responsible Teen Text Messaging project. Results Adolescents said they benefited from the MCP-enhanced approach and were receptive to the idea of developing an MCP-based intervention. Practice Implications Nurses can use the findings of this report as a starting point in examining the development of MCP-based sexuality education with parents and adolescents. PMID:22188273

An intervention to help community-based organizations implement an evidence-based HIV prevention intervention: the Mpowerment Project technology exchange system.

PubMed

Kegeles, Susan M; Rebchook, Gregory; Pollack, Lance; Huebner, David; Tebbetts, Scott; Hamiga, John; Sweeney, David; Zovod, Benjamin

2012-03-01

Considerable resources have been spent developing and rigorously testing HIV prevention intervention models, but such models do not impact the AIDS pandemic unless they are implemented effectively by community-based organizations (CBOs) and health departments. The Mpowerment Project (MP) is being implemented by CBOs around the U.S. It is a multilevel, evidence-based HIV prevention program for young gay/bisexual men that targets individual, interpersonal, social, and structural issues by using empowerment and community mobilization methods. This paper discusses the development of an intervention to help CBOs implement the MP called the Mpowerment Project Technology Exchange System (MPTES); CBOs' uptake, utilization and perceptions of the MPTES components; and issues that arose during technical assistance. The seven-component MPTES was provided to 49 CBOs implementing the MP that were followed longitudinally for up to two years. Except for the widely used program manual, other program materials were used early in implementing the MP and then their use declined. In contrast, once technical assistance was proactively provided, its usage remained constant over time, as did requests for technical assistance. CBOs expressed substantial positive feedback about the MPTES, but felt that it needs more focus on diversity issues, describing real world implementation approaches, and providing guidance on how to adapt the MP to diverse populations.

Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for female military personnel.

PubMed

Essien, E James; Mgbere, Osaro; Monjok, Emmanuel; Ekong, Ernest; Holstad, Marcia M; Kalichman, Seth C

2011-01-01

Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The objective of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasibility and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention, or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants' knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly, being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly improved behavioral intentions of participants as well as reduced alcohol use before sex by 25%, after 3 months; and number of sexual partners by 12% after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention among female military personnel from sub

Effectiveness of a Video-Based Motivational Skills-Building HIV Risk-Reduction Intervention for Female Military Personnel

PubMed Central

Essien, E. James; Mgbere, Osaro; Monjok, Emmanuel; Ekong, Ernest; Holstad, Marcia M.; Kalichman, Seth C.

2010-01-01

Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The object of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasible and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N=346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants’ knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly (p<0.05) increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly (p<0.01), being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly (p<0.001) improved behavioral intentions of participants as well as reduced alcohol use before sex by 25% (p<0.01), after 3 months; and number of sexual partners by 12% (p<0.05) after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention

The Cedar Project WelTel mHealth intervention for HIV prevention in young Indigenous people who use illicit drugs: study protocol for a randomized controlled trial.

PubMed

Jongbloed, Kate; Friedman, Anton J; Pearce, Margo E; Van Der Kop, Mia L; Thomas, Vicky; Demerais, Lou; Pooyak, Sherri; Schechter, Martin T; Lester, Richard T; Spittal, Patricia M

2016-03-09

Despite successes in preventing and treating HIV, Indigenous people in Canada continue to face disproportionately high rates of HIV infection. Programs that support healing from lifetime trauma, support connection to culture, and reduce drug-related harms are critical to preventing HIV among young Indigenous people who use drugs. The Cedar Project WelTel mHealth intervention proposed here is a structured mobile-phone initiative to connect young Indigenous people who use drugs with Cedar Case Managers in a community-based setting. The intervention consists of a package of supports, including a mobile phone and cellular plan, weekly two-way text messaging, and support from Cedar Case Managers. The Cedar Project WelTel mHealth study is a multi-site Zelen pre-randomized trial to measure the effect of a two-way supportive text-message intervention to reduce HIV vulnerability among young Indigenous people who use illicit drugs in two Canadian cities. The trial is nested within the Cedar Project, an ongoing cohort study addressing HIV and hepatitis C vulnerability among young Indigenous people who use drugs in Vancouver and Prince George, British Columbia. The Cedar Project Partnership, an independent body of Indigenous Elders, leaders, and health/social service experts, governs all aspects of the study. Two hundred participants will be followed over a 16-month period, with HIV propensity score at 6 months as the primary outcome. Secondary outcomes include HIV propensity at 1 year, HIV risk, resilience, psychological distress, access to drug-related services, and connection to culture measured at 6 months and 1 year. Primary analysis is by intention to treat. Culturally safe interventions that address barriers to HIV prevention while supporting the strength of young Indigenous people who use drugs are urgently needed. Despite presenting a tremendous opportunity to connect young, highly transient Indigenous people who use drugs to prevention services, supportive two-way m

Text-Messaging-Enhanced HIV Intervention for African American Adolescents: A Feasibility Study

PubMed Central

Cornelius, Judith B.; Dmochowski, Jacek; Boyer, Cherrie; St Lawrence, Janet; Lightfoot, Marguerita; Moore, Michael

2013-01-01

We examined the feasibility and acceptability of an HIV prevention intervention for African American adolescents delivered via mobile cell phones and looked at intervention-related changes in beliefs and sexual behaviors. We used a longitudinal one-group comparison design with data collected at three points. Forty adolescents, 13–18 years old, participated in the Becoming a Responsible Teen intervention followed by the delivery of daily multimedia messages for 3 months. The mobile-cell-phone enhanced intervention was feasible and acceptable to the participants. Greater HIV knowledge, improved attitudes toward condoms, and increased perceived HIV risk scores were observed with older adolescents (16–18 years old). Behavior trends showed a decrease in the number of times participants reported engaging in unprotected sexual intercourse over the previous 2 months. Mobile-cell-phone multimedia-text-messaging boosters tested in this study provided preliminary evidence of efficacy of the enhanced HIV prevention intervention for African American youth. PMID:23122907

Not just the needle: the state of HIV-prevention science among substance users and future directions.

PubMed

Shoptaw, Steve; Montgomery, Brooke; Williams, Chyvette T; El-Bassel, Nabila; Aramrattana, Apinun; Metsch, Lisa; Metzger, David S; Kuo, Irene; Bastos, Francisco I; Strathdee, Steffanie A

2013-07-01

Efforts to prevent HIV transmission among substance-using populations have focused primarily among injection drug users, which have produced measurable reductions in HIV incidence and prevalence. By contrast, the majority of substances used worldwide are administered by noninjectable means, and there is a dearth of HIV prevention interventions that target noninjecting substance users. Increased surveillance of trends in substance use, especially cocaine (including crack) and methamphetamine, in addition to new and emerging substances (eg, synthetic cannabinoids, cathinones, and other amphetamine analogs) are needed to develop and scale up effective and robust interventions for populations at risk for HIV transmission via sexual behaviors related to noninjection substance use. Strategies are needed that address unique challenges to HIV prevention for substance users who are HIV infected and those who are HIV uninfected and are at high risk. We propose a research agenda that prioritizes (1) combination HIV-prevention strategies in substance users; (2) behavioral HIV prevention programs that reduce sexual transmission behaviors in nontreatment seeking individuals; (3) medical and/or behavioral treatments for substance abuse that reduce/eliminate substance-related sexual transmission behaviors; and (4) structural interventions to reduce HIV incidence.

Shared Communities, Structural Contexts, and HIV Risk: Prioritizing the HIV Risk and Prevention Needs of Black Heterosexual Men

PubMed Central

Raj, Anita

2012-01-01

Black heterosexual men (BHM) are seldom mentioned in HIV prevention research, policy, and interventions, despite evidence that heterosexual contact is becoming the leading exposure category for BHM. The disparate effect of HIV/AIDS on BHM; the debunked “down low” myth; the contexts of BHM's lives in terms of disproportionate poverty, unemployment, and incarceration; and a growing empirical base linking these factors to increased HIV risk, underscore the need to prioritize HIV risk and prevention initiatives for BHM. We highlighted the structural contexts of HIV risk for BHM, and four community-based approaches to address HIV risk and prevention for BHM: (1) men's health programs; (2) workforce and postincarceration release programs; (3) linkages to women's prevention programs; and (4) faith-based initiatives. PMID:22401513

Predictors of Self-Efficacy for HIV Prevention Among Hispanic Women in South Florida

PubMed Central

Villegas, Natalia; Cianelli, Rosina; Gonzalez-Guarda, Rosa; Kaelber, Lorena; Ferrer, Lilian; Peragallo, Nilda

2012-01-01

Self-efficacy is a critical element for HIV prevention, however little is known about the predictors of self-efficacy for HIV prevention among Hispanic women. In this cross-sectional study we assessed if age, living with a partner, employment status, HIV knowledge, self-esteem, and intimate partner violence (IPV) predicted self-efficacy for HIV prevention in 548 Hispanic women in South Florida who participated in a randomized controlled trial (SEPA). The majority of Hispanic women reported high levels of self-efficacy for HIV prevention. Women who were older, living with a partner, with less HIV knowledge, and a history of IPV reported significantly lower levels of self-efficacy for HIV prevention. HIV knowledge was the most important predictor of self-efficacy for HIV prevention. Employment was not a significant predictor of self-efficacy for HIV prevention. Predictors identified in the study can be used to identify high-risk Hispanic women who are in need of HIV prevention interventions. PMID:22795758