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Sample records for hiv prevention programs

  1. HIV/AIDS Prevention Program Evaluation Report.

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Barker, Marybeth; Cassisy, Theresa; Hardy-Fanta, Carol; Hereen, Tim; Levenson, Suzette; McCloskey, Lois; Melendez, Michael

    This report addresses the four research objectives that were established by the Massachusetts Primary Prevention Group (MPPG) and the Massachusetts Department of Public Health's HIV/AIDS Bureau. The objectives were to: (1) review and summarize literature that formally evaluated HIV prevention interventions; (2) describe how currently funded…

  2. Youth-Initiated HIV Risk and Substance Use Prevention Program.

    ERIC Educational Resources Information Center

    Goggin, K.; Metcalf, K.; Wise, D.; Kennedy, S.; Murray, T.; Burgess, D.; Reese-Smith, J.; Terhune, N.; Broadus, K.; Downes, A.; Buckendahl, H.

    This study evaluates the first year of a novel HIV and substance use prevention program for inner city youth (Offering New Youth eXperiences--ONYX). Baseline and follow-up measures of knowledge, attitudes, and risk behaviors were administered seven months apart to 441 youth participating in the ONYX program. Youth (n=71) who provided data at both…

  3. Committed to the community: the Atlas HIV Prevention Program.

    PubMed

    Shepherd, Jennifer L; O'Caña, Frank

    2013-11-01

    Community-based organizations face multiple challenges in implementing preventive intervention programs that are both evidence based and sustainable under limited resources and staffing. This article describes the development and preliminary evaluation of the theory-based Atlas HIV prevention program, which includes a unique service-learning component and capitalizes on a committed core of volunteers. Supporting research is presented for the effectiveness among the volunteers of service learning and popular opinion leader approaches; the Atlas program was developed using these principles, in alignment with state and federal HIV prevention strategies. Nearly 40% of the Atlas volunteers were retained for more than 2 years, and 25% have served more than 3 years. During their tenure with Atlas, the volunteers demonstrated improved knowledge of HIV transmission and prevention and increased sexual efficacy, and nearly all had been tested for HIV. Community-based organizations are encouraged to incorporate service-learning when implementing prevention programs and develop committed volunteers in order to increase the effectiveness and sustainability of their prevention efforts.

  4. Conceptualizing Community Mobilization for HIV Prevention: Implications for HIV Prevention Programming in the African Context

    PubMed Central

    Lippman, Sheri A.; Maman, Suzanne; MacPhail, Catherine; Twine, Rhian; Peacock, Dean; Kahn, Kathleen; Pettifor, Audrey

    2013-01-01

    Introduction Community mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation. Objectives We aimed to identify the key domains of community mobilization (CM) essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting. Method We studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge. Results CM domains include: 1) shared concerns, 2) critical consciousness, 3) organizational structures/networks, 4) leadership (individual and/or institutional), 5) collective activities/actions, and 6) social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks. Conclusions To date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural

  5. EFFECT OF HIV PREVENTION AND TREATMENT PROGRAM ON HIV AND HCV TRANSMISSION AND HIV MORTALITY AT AN INDONESIAN NARCOTIC PRISON.

    PubMed

    Nelwan, Erni J; Indrati, Agnes K; Isa, Ahmad; Triani, Nurlita; Alam, Nisaa Nur; Herlan, Maria S; Husen, Wahid; Pohan, Herdiman T; Alisjahbana, Bachti; Meheus, Andre; Van Crevel, Reinout; van der Ven, Andre Jam

    2015-09-01

    Validated data regarding HIV-transmission in prisons in developing countries is scarce. We examined sexual and injecting drug use behavior and HIV and HCV transmission in an Indonesian narcotic prison during the implementation of an HIV prevention and treatment program during 2004-2007 when the Banceuy Narcotic Prison in Indonesia conducted an HIV transmission prevention program to provide 1) HIV education, 2) voluntary HIV testing and counseling, 3) condom supply, 4) prevention of rape and sexual violence, 5) antiretroviral treatment for HIV-positive prisoners and 6) methadone maintenance treatment. During a first survey that was conducted between 2007 and 2009, new prisoners entered Banceuy Narcotics Prison were voluntary tested for HIV and HCV-infection after written informed consent was obtained. Information regarding sexual and injecting risk behavior and physical status were also recorded at admission to the prison. Participants who tested negative for both HIV and HCV during the first survey were included in a second survey conducted during 2008-2011. During both surveys, data on mortality among HIV-seropositive patients were also recorded. All HIV-seropositive participants receive treatment for HIV. HIV/ AIDS-related deaths decreased: 43% in 2006, 18% in 2007, 9% in 2008 and 0% in 2009. No HIV and HCV seroconversion inside Banceuy Narcotic Prison were found after a median of 23 months imprisonment (maximum follow-up: 38 months). Total of 484.8 person-years observation was done. Participants reported HIV transmission risk-behavior in Banceuy Prison during the second survey was low. After implementation of HIV prevention and treatment program, no new HIV or HCV cases were detected and HIV-related mortality decreased. PMID:26863859

  6. EFFECT OF HIV PREVENTION AND TREATMENT PROGRAM ON HIV AND HCV TRANSMISSION AND HIV MORTALITY AT AN INDONESIAN NARCOTIC PRISON.

    PubMed

    Nelwan, Erni J; Indrati, Agnes K; Isa, Ahmad; Triani, Nurlita; Alam, Nisaa Nur; Herlan, Maria S; Husen, Wahid; Pohan, Herdiman T; Alisjahbana, Bachti; Meheus, Andre; Van Crevel, Reinout; van der Ven, Andre Jam

    2015-09-01

    Validated data regarding HIV-transmission in prisons in developing countries is scarce. We examined sexual and injecting drug use behavior and HIV and HCV transmission in an Indonesian narcotic prison during the implementation of an HIV prevention and treatment program during 2004-2007 when the Banceuy Narcotic Prison in Indonesia conducted an HIV transmission prevention program to provide 1) HIV education, 2) voluntary HIV testing and counseling, 3) condom supply, 4) prevention of rape and sexual violence, 5) antiretroviral treatment for HIV-positive prisoners and 6) methadone maintenance treatment. During a first survey that was conducted between 2007 and 2009, new prisoners entered Banceuy Narcotics Prison were voluntary tested for HIV and HCV-infection after written informed consent was obtained. Information regarding sexual and injecting risk behavior and physical status were also recorded at admission to the prison. Participants who tested negative for both HIV and HCV during the first survey were included in a second survey conducted during 2008-2011. During both surveys, data on mortality among HIV-seropositive patients were also recorded. All HIV-seropositive participants receive treatment for HIV. HIV/ AIDS-related deaths decreased: 43% in 2006, 18% in 2007, 9% in 2008 and 0% in 2009. No HIV and HCV seroconversion inside Banceuy Narcotic Prison were found after a median of 23 months imprisonment (maximum follow-up: 38 months). Total of 484.8 person-years observation was done. Participants reported HIV transmission risk-behavior in Banceuy Prison during the second survey was low. After implementation of HIV prevention and treatment program, no new HIV or HCV cases were detected and HIV-related mortality decreased.

  7. Client Preferences for STD/HIV Prevention Programs.

    ERIC Educational Resources Information Center

    Hennessy, Michael; Mercier, Michele M.; Williams, Samantha P.; Arno, Janet N.

    2002-01-01

    Conducted a formative research study designed to elicit preferences for sexually transmitted disease (STD)/HIV prevention programs from clients at a midwestern STD clinic. Responses of 126 participants show preferences for mixed group or individual meetings with counselors, with extensive intervention less favored than single sessions. Discusses…

  8. Secondary HIV prevention.

    PubMed

    Temoshok, L R; Frerichs, R R

    1998-06-01

    Primary HIV prevention, preventing HIV exposure among uninfected persons, has been the focus of much attention. However, secondary HIV prevention, preventing HIV transmission from infected people to their uninfected contacts, has not received as much interest or attention from HIV researchers, clinicians, and policymakers. The concept of secondary HIV prevention, as distinguished from primary prevention, is clarified, and the current and future strategies to further secondary HIV prevention efforts are explored. Secondary prevention strategies can be incorporated into comprehensive programs and result in shifts in attitudes and behaviors. This could reduce the size of the epidemic, while also benefiting the individual and his or her close relationships.

  9. 77 FR 36550 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ...: National HIV Program for Enhanced HIV/AIDS Screening and Engagement in Care Announcement Type: New. Funding Announcement Number: HHS-2012-IHS-OCPS-HIV-0001. Catalog of Federal Domestic Assistance Number: 93.933. DATES... applications for the Office of Clinical and Preventive Services: National HIV Program for Enhanced...

  10. 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…

  11. Adapting a Multifaceted U.S. HIV Prevention Education Program for Girls in Ghana

    ERIC Educational Resources Information Center

    Fiscian, Vivian Sarpomaa; Obeng, E. Kwame; Goldstein, Karen; Shea, Judy A.; Turner, Barbara J.

    2009-01-01

    We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic…

  12. Effectiveness of a Theory-Based Risk Reduction HIV Prevention Program for Rural Vietnamese Adolescents

    ERIC Educational Resources Information Center

    Kaljee, Linda M.; Genberg, Becky; Riel, Rosemary; Cole, Matthew; Tho, Le Huu; Thoa, Le Thi Kim; Stanton, Bonita; Li, Xiaoming; Minh, Tuong Tan

    2005-01-01

    As of April 2003, 64,801 HIV cases have been documented in Vietnam (Policy Project 2003), 53.9% of which are among individuals 20-29 years of age. Although HIV education efforts have increased, there remains a need for proven effective programs. We present findings from a randomized-controlled effectiveness trial of an HIV prevention program for…

  13. The urgent need for HIV and hepatitis prevention in drug treatment programs in Hungary

    PubMed Central

    Rácz, József; Neaigus, Alan; Ujhelyi, Eszter

    2008-01-01

    We assess HIV and hepatitis testing and counseling in drug treatment programs in Hungary, a country with low rates of HIV but high rates of HCV among injecting drug users. The official context of drug treatment programs is described, and, using key informants from representative drug treatment programs, the practice of HIV and hepatitis testing and counseling in such programs is assessed. While HIV testing and counseling occurs, testing and counseling for HBV and HCV are rare, especially in outpatient settings; and sexual risk in the drug use context is ineffectively addressed by treatment programs. Drug treatment centers are not adequately addressing the need to provide either HIV or hepatitis prevention services. There is an urgent need for preventing HIV and related infections among drug users by integrating HIV and hepatitis B and C prevention with drug treatment. PMID:15237056

  14. 75 FR 13550 - Office of Clinical and Preventive Services: National HIV Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ..., surveillance, Healthy People 2010 Objectives, and other HIV disease control activities; (b) Design and... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services: National HIV Program Announcement Type: Cooperative Agreement. Funding Opportunity Number: HHS-2010-IHS-OCPS-HIV-0001. Catalog...

  15. 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…

  16. An Interactive Multimedia Program to Prevent HIV Transmission in Men with Intellectual Disability

    ERIC Educational Resources Information Center

    Wells, Jennifer; Clark, Khaya; Sarno, Karen

    2014-01-01

    The efficacy of a computer-based interactive multimedia HIV/AIDS prevention program for men with intellectual disability (ID) was examined using a quasi-experimental within-subjects design. Thirty-seven men with mild to moderate intellectual disability evaluated the program. The pretest and posttest instruments assessed HIV/AIDS knowledge…

  17. An overview of the effectiveness and efficiency of HIV prevention programs.

    PubMed Central

    Holtgrave, D R; Qualls, N L; Curran, J W; Valdiserri, R O; Guinan, M E; Parra, W C

    1995-01-01

    Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs. PMID:7630989

  18. Where are the young men in HIV prevention efforts? Comments on HIV prevention programs and research from young men who sex with men in Los Angeles county.

    PubMed

    Holloway, Ian W; Cederbaum, Julie A; Ajayi, Antonette; Shoptaw, Steven

    2012-12-01

    Despite increasing rates of HIV infection among young men who have sex with men (YMSM), only a minority participate in formal HIV prevention efforts. Semi-structured mixed-methods interviews were conducted with a diverse sample of YMSM (N = 100, M(age) = 25.0 years) in Los Angeles, California, to identify facilitators and barriers to participation in HIV prevention programs. Summative content analyses were used to evaluate transcribed field notes from these interviews. Results showed that 28.0 % of all participants had previously attended an HIV prevention program, and that 21.3 % of those who were also asked if they had ever participated in any research pertaining to HIV prevention had done so. A significantly higher percentage of those who had participated in HIV prevention programs had been tested for HIV in the past 6 months compared to those who had not (p < .05). The most frequently mentioned barriers to participation in such a program were being too busy to attend (12.0 %), not perceiving themselves to be at risk for HIV infection (14.0 %), and believing that they already knew everything they needed to know about HIV transmission (23.0 %). YMSM suggested that future interventions should use technology (e.g., the Internet, mobile devices), engage their social networks, and highlight HIV prevention as a means for community connection. Collectively, these results provide some explanations for why YMSM account for a minority of HIV prevention program participants and offer possible directions for future HIV prevention efforts that target YMSM. PMID:23132515

  19. HIV prevention among detained immigrants: report of a program of the Immigration and Naturalization Service.

    PubMed

    Loue, S; Lloyd, L S

    2001-07-01

    HIV prevention programs have been developed for a wide variety of populations and settings through which those target populations can be reached. However, no program to date has targeted immigrants in Immigration and Naturalization Service (INS) detention facilities. This study examines the risk factors identified among detainees in detention facilities in San Diego, and the development and implementation of an HIV prevention program. Given the success of this program, the INS approved filming a video and a peer training program for detainees to serve as peer educators so that the program will continue.

  20. Translating an Effective Group-Based HIV Prevention Program to a Program Delivered Primarily by a Computer: Methods and Outcomes

    ERIC Educational Resources Information Center

    Card, Josefina J.; Kuhn, Tamara; Solomon, Julie; Benner, Tabitha A.; Wingood, Gina M.; DiClemente, Ralph J.

    2011-01-01

    We describe development of SAHARA (SiSTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1)…

  1. Adapting a multifaceted U.S. HIV prevention education program for girls in Ghana.

    PubMed

    Fiscian, Vivian Sarpomaa; Obeng, E Kwame; Goldstein, Karen; Shea, Judy A; Turner, Barbara J

    2009-02-01

    We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. A pre-post evaluation of the intervention showed significant gains in three domains: HIV knowledge (p = .001) and self efficacy to discuss HIV and sex with men (p < .001) and with boys (p < .001). Responses to items about social norms of HIV risk behavior were also somewhat improved (p = .09). Subjects rated most program features highly. Although short-term knowledge and self-efficacy to address HIV improved significantly, longer term research is needed to address cultural and economic factors placing young women at risk of HIV infection.

  2. Participation in Counseling Programs: High-Risk Participants Are Reluctant to Accept HIV-Prevention Counseling

    PubMed Central

    Earl, Allison; Albarracín, Dolores; Durantini, Marta R.; Gunnoe, Joann B.; Leeper, Josh; Levitt, Justin H.

    2013-01-01

    HIV-prevention intervention effectiveness depends on understanding whether clients with highest need for HIV-prevention counseling accept it. With this objective, a field study with a high-risk community sample from the southeastern United States (N = 350) investigated whether initial knowledge about HIV, motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use correlate with subsequent acceptance of an HIV-prevention counseling session. Ironically, participants with high (vs. low) motivation to use condoms, high (vs. low) condom-use-relevant behavioral skills, and high (vs. low) prior condom use were more likely to accept the HIV-prevention counseling. Moreover, the influence of motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use on acceptance of the counseling was mediated by expectations that the counseling session would be useful. Methods to reduce barriers to recruitment of clients for counseling programs are discussed. PMID:19634960

  3. Collaborating With an Urban Community to Develop an HIV and AIDS Prevention Program for Black Youth and Families

    ERIC Educational Resources Information Center

    Baptiste, Donna R.; Paikoff, Roberta L.; McKay, Mary McKernan; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl

    2005-01-01

    This article describes a collaboration between academic researchers and residents of a low-income, inner-city community to develop and deliver an HIV and AIDS prevention program for Black youth. The Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP) Program was developed and implemented to decrease HIV and AIDS risk exposure among…

  4. HIV/Hepatitis Prevention in Drug Abuse Treatment Programs: Guidance From Research

    PubMed Central

    Sorensen, James L.; Masson, Carmen L.; Perlman, David C.

    2002-01-01

    A large body of research examines the relationship between HIV and drug dependence, but considerably less information is available on viral hepatitis and drug dependence. This article summarizes research indicating what drug abuse treatment programs can do to prevent their patients from acquiring HIV or hepatitis infection and to limit the consequences for patients who are already infected. Drug treatment programs can play a pivotal role in preventing, detecting, and treating HIV and hepatitis. Some activities can be accomplished by providers’ simply becoming aware of the issues; others will require significant infusion of leadership, education, and fiscal support. PMID:18567957

  5. Evaluation of large-scale combination HIV prevention programs: essential issues.

    PubMed

    Padian, Nancy S; McCoy, Sandra I; Manian, Shanthi; Wilson, David; Schwartländer, Bernhard; Bertozzi, Stefano M

    2011-10-01

    HIV prevention research has shifted to the evaluation of combination prevention programs whereby biomedical, behavioral, and structural interventions are implemented concurrently to maximize synergies among interventions. However, these kinds of combination prevention packages, particularly when implemented at scale, pose significant evaluation challenges, including how best to determine impact and how and whether to measure the effectiveness of component strategies. In addition, methodological challenges unique to HIV infection such as the absence of a reliable incidence assay, the lack of naive control groups, and no suitable surrogates further complicate rigorous evaluation. In this commentary, we discuss the key considerations for planning impact evaluations of combination HIV prevention programs in light of these challenges, including defining the evaluable package, determining which component programs require independent assessment of impact, choosing study designs with valid counterfactuals, selecting appropriate outcomes of interest, and the importance of mid-course program corrections. PMID:21694607

  6. HIV Prevention

    MedlinePlus

    ... to treat HIV infection (called antiretroviral therapy, or ART) the right way, every day and his or ... way, every day, the medicine to treat HIV (ART) reduces the amount of HIV (called “viral ...

  7. Faith-Based HIV Prevention and Counseling Programs: Findings from the Cincinnati Census of Religious Congregations

    PubMed Central

    Ritchey, P. Neal; Jacobson, C. Jeffrey; Williams, Rhys H.; Grau, Amy Baumann; Meganathan, Karthikeyan; Ellison, Christopher G.; Tsevat, Joel

    2013-01-01

    Congregations are well positioned to address HIV in their communities, but their response to HIV has been mixed. An emerging literature describes HIV programming in urban, predominantly black congregations, but population-based data remain limited. This study examined the levels of HIV prevention and counseling programs and associated factors (e.g., religious, organizational) by using data from a phone census of congregations in the Greater Cincinnati area (N = 447). Over 10 % of congregations (36 % of Black Protestant and 5–18 % of other types of congregations) offered HIV education/prevention alone or in combination with counseling or with counseling and testing. Path analysis results showed notable significant (p < 0.05) total effects of theology-polity on HIV prevention/counseling programs, but these effects were fully mediated by other factors, including other community work and racial composition. The levels of HIV programming in this study were high by national standards, but further outreach is needed in high-risk African American communities. PMID:23568226

  8. HIV/sexual and reproductive health program for HIV prevention: the youth-adult partnership with schools approach.

    PubMed

    Fongkaew, Warunee; Fongkaew, Kangwan; Muecke, Marjorie

    2006-10-01

    The aim of the present study was to describe the development and evaluation of a program designed to prevent HIV/AIDS. A participatory action research (PAR) approach was used in collaboration with ten schools in Chiang Mai Province, Thailand, to develop a youth- adult partnership with schools (YAPS) model. The YAPS model included curricula using participatory learning experiences, edutainment approaches, and skills building strategies for enhancing youth leaders'capacities. Results showed that the YAPS model was effective in leadership role preparation and in empowering youth leaders to undertake activities on their own, initiate creativity and share knowledge on sexuality education and HIV prevention messages with students in schools. The use of partnerships and the participatory process mobilized parents, teachers, and school administrators to play a proactive role in sexuality education and HIV prevention for early adolescents in schools, resulting in the integration of the program into the school system. PMID:17128849

  9. Cost Savings Threshold Analysis of a Capacity-Building Program for HIV Prevention Organizations

    ERIC Educational Resources Information Center

    Dauner, Kim Nichols; Oglesby, Willie H.; Richter, Donna L.; LaRose, Christopher M.; Holtgrave, David R.

    2008-01-01

    Although the incidence of HIV each year remains steady, prevention funding is increasingly competitive. Programs need to justify costs in terms of evaluation outcomes, including economic ones. Threshold analyses set performance standards to determine program effectiveness relative to that threshold. This method was used to evaluate the potential…

  10. Preventing HIV with Medicine

    MedlinePlus

    ... information in Spanish ( en español ) Preventing HIV with medicine Get medicine right after you are exposed to ... to top More information on Preventing HIV with medicine Explore other publications and websites National HIV and ...

  11. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    PubMed

    Sgaier, Sema K; Reed, Jason B; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-05-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform.

  12. Achieving the HIV prevention impact of voluntary medical male circumcision: lessons and challenges for managing programs.

    PubMed

    Sgaier, Sema K; Reed, Jason B; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-05-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009-2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection "Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up." The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform. PMID:24800840

  13. Achieving the HIV Prevention Impact of Voluntary Medical Male Circumcision: Lessons and Challenges for Managing Programs

    PubMed Central

    Sgaier, Sema K.; Reed, Jason B.; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-01-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009–2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection “Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up.” The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform. PMID:24800840

  14. A Suicide Prevention Program for HIV-Positive Patients.

    ERIC Educational Resources Information Center

    Shaw, Seana; Rothberg, Joseph M.

    Research has shown that suicide risk is elevated in the patient who has tested positive for Human Immunodeficiency Virus (HIV). Studies within the Army have found that the three most turbulent periods for the soldier with HIV infection are: (1) at the time of notification of diagnosis; (2) when the family and peer group learn of the diagnosis; and…

  15. African American College Students: Establishing HIV Prevention Programs.

    ERIC Educational Resources Information Center

    Duncan, Cecil

    African American college students are among the age group of African Americans who are at significantly higher risk for heterosexual transmission of human immunodeficiency virus (HIV). Much of the research in this area suggests that for the majority of these students, there is little or no relationship between the knowledge of HIV transmission and…

  16. Respecting and Protecting Our Relationships: A Community Research HIV Prevention Program for Teen Fathers and Mothers

    ERIC Educational Resources Information Center

    Lesser, Janna; Verdugo, Robert L.; Koniak-Griffin, Deborah; Tello, Jerry; Kappos, Barbara; Cumberland, William G.

    2005-01-01

    This article describes a two-phase community and academic collaboration funded by the California Collaborative Research Initiative to develop and test the feasibility of an innovative HIV prevention program relevant to the needs of the population of inner-city Latino teen parenting couples and realistic for implementation in community settings.…

  17. Family-Based HIV Preventive Intervention: Child Level Results from the CHAMP Family Program

    PubMed Central

    McBride, Cami K.; Baptiste, Donna; Traube, Dorian; Paikoff, Roberta L.; Madison-Boyd, Sybil; Coleman, Doris; Bell, Carl C.; Coleman, Ida; McKay, Mary M.

    2010-01-01

    SUMMARY Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth’s exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth’s best hope to grow up and survive multiple-dangers in urban neighborhoods (Pequegnat & Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided. PMID:20852742

  18. Assessing barriers and facilitators of implementing an integrated HIV prevention and property rights program in Western Kenya.

    PubMed

    Lu, Tiffany; Zwicker, Lindsey; Kwena, Zachary; Bukusi, Elizabeth; Mwaura-Muiru, Esther; Dworkin, Shari L

    2013-04-01

    Despite the recognized need for structural HIV prevention interventions, few scientific programs have integrated women's property and inheritance rights with HIV prevention and treatment. The current study focused on a community-led land and property rights intervention that was implemented in two rural areas of Western Kenya with high HIV prevalence rates (24-30%). The program was designed to respond to women's property rights violations in order to reduce HIV risk at the local level. Through in-depth interviews with twenty program leaders, we identified several facilitators to program implementation, including the leadership of home-based HIV caregivers and involvement of traditional leaders in mediating property rights disputes. We also identified the voluntary basis of the intervention and its lack of integration with the formal justice system as implementation barriers. Our findings can guide future research and design of structural HIV prevention strategies that integrate women's economic empowerment through property and inheritance rights.

  19. HIV prevention in action on the football field: the WhizzKids United program in South Africa.

    PubMed

    Balfour, Louise; Farrar, Thomas; McGilvray, Marcus; Wilson, Douglas; Tasca, Giorgio A; Spaans, Johanna N; Mathews, Catherine; Maziya, Lungile; Khanyile, Siphosihle; Dalgleish, Tracy L; Cameron, William D

    2013-07-01

    The Africaid Trust is a grassroots South African non-profit organization that engages youth in HIV prevention by harnessing the popularity of football (i.e. soccer). WhizzKids United, the organization's primary program, operates a 12-week program in elementary schools in Pietermaritzburg, South Africa, which aims to impart knowledge and life skills critical to HIV prevention. The goal of this research was to compare elementary school youth who received the program to youth who only received traditional classroom-based HIV education on health behaviors and HIV-related knowledge and stigma. A secondary objective was to evaluate HIV knowledge, sexual behaviors, attitudes towards HIV and health care seeking behaviors among South African youth in grades 9-12. Elementary students who participated in the program reported greater HIV knowledge and lower HIV stigma (p < .001) than those who had not. The majority of youth in grades 9-12 report having sexual relations (55.6%), despite low levels of HIV testing (29.9%) in this high HIV prevalence region of South Africa. The results highlight the importance of supporting community-based HIV educational initiatives that engage high-risk youth in HIV prevention and the need for youth-friendly health services.

  20. Culturally appropriate HIV/AIDS and substance abuse prevention programs for urban Native youth.

    PubMed

    Aguilera, Solis; Plasencia, Ana Vanesa

    2005-09-01

    This article will examine HIV/AIDS and substance abuse prevention for urban Native youth in Oakland, California. It will highlight the Native American Health Center's Youth Services programs. These programs incorporate solutions based on a traditional value system rooted in Native culture and consisting of youth empowerment, leadership training, prevention activities, traditional cultural activities and wellness and life skills education. They aim to reduce HIV/AIDS and substance abuse risk for American Indian/Alaska Native (AI/AN) youth through structured, community-based interventions. The Youth Services Program's events, such as the Seventh Native American Generation and the Gathering of Native Americans, offer effective and culturally relevant ways of teaching youth about American Indian/Alaska Native history, intergenerational trauma, and traditional Native culture. Satisfaction surveys gathered from these youth provide invaluable data on the positive effects of these prevention efforts. The need for culturally relevant and culturally appropriate HIV/AIDS and substance abuse prevention programs for urban AI/AN youth is apparent. These prevention efforts must be creatively integrated into the multidimensional and complex social structures of Native American youth.

  1. Opportunities for technology-based HIV prevention programming among high school students in Cape Town, South Africa.

    PubMed

    Ybarra, Michele L; Mwaba, Kelvin; Prescott, Tonya L; Roman, Nicolette V; Rooi, Bronwyn; Bull, Sheana

    2014-01-01

    One in three new cases of HIV in South Africa is among adolescents. Given that adolescents are particularly affected, scalable, and cost-effective prevention programs are urgently needed. This study aims to identify opportunities to integrate technology into youth HIV prevention efforts. In 2012, 1107 8th-11th graders completed a paper-and-pencil survey. Respondents were enrolled in one of three public high schools in Langa, a lower income community in Cape Town, South Africa. Eighty-nine percent of respondents have used text messaging (SMS) and 86% have gone online. If an HIV prevention program was offered online, 66% of youth would be somewhat or extremely likely to access it; slightly fewer (55%) felt the same about SMS-based programming. In comparison, 85% said they would be somewhat or extremely likely to access a school-based HIV prevention program. Interest in Internet- (60%) and SMS-based (54%) HIV prevention programming was similar for youth who had a self-appraised risk of HIV compared to youth who appraised their risk to be lower, as it was for youth who were tired of hearing messages about HIV prevention. Technology use is common - even among high school students who live in lower income communities. At the same time, these data reveal that it is not uncommon for youth to be tired of hearing messages about HIV prevention, and many of the typical topics key to HIV prevention have low interest levels among youth. HIV prevention researchers need to be mindful of the extent of existing programming that youth are exposed to. Technology-based programming may be especially amenable to meeting these requirements because of its novelty especially in developing countries, and because interactive functionality can be easily integrated into the program design. Given the preference for school- and Internet-based programming, it seems that a hybrid approach is likely feasible and acceptable.

  2. Using Anatomical Dolls in HIV/AIDS Prevention Programs

    ERIC Educational Resources Information Center

    Morgan, Marcia

    2009-01-01

    Research has shown that the correct and consistent use of the male latex condom is the single most efficient, cost-effective way to reduce the sexual transmission of HIV and other infections. Yet information must be communicated in a way that is clearly understood and actually contributes to behavior change for both women and men. Anatomical…

  3. 78 FR 45246 - Office of Clinical and Preventive Services National HIV Program: Enhanced HIV/AIDS Screening and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... increasing routine HIV screening for adults as per 2006 Centers for Disease Control and Prevention (CDC..., surveillance, Healthy People 2020 Objectives, and other HIV disease control activities; (2) Design and... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services National HIV...

  4. Systematic Review of Abstinence-Plus HIV Prevention Programs in High-Income Countries

    PubMed Central

    Underhill, Kristen; Operario, Don; Montgomery, Paul

    2007-01-01

    Background Abstinence-plus (comprehensive) interventions promote sexual abstinence as the best means of preventing HIV, but also encourage condom use and other safer-sex practices. Some critics of abstinence-plus programs have suggested that promoting safer sex along with abstinence may undermine abstinence messages or confuse program participants; conversely, others have suggested that promoting abstinence might undermine safer-sex messages. We conducted a systematic review to investigate the effectiveness of abstinence-plus interventions for HIV prevention among any participants in high-income countries as defined by the World Bank. Methods and Findings Cochrane Collaboration systematic review methods were used. We included randomized and quasi-randomized controlled trials of abstinence-plus programs for HIV prevention among any participants in any high-income country; trials were included if they reported behavioural or biological outcomes. We searched 30 electronic databases without linguistic or geographical restrictions to February 2007, in addition to contacting experts, hand-searching conference abstracts, and cross-referencing papers. After screening 20,070 abstracts and 325 full published and unpublished papers, we included 39 trials that included approximately 37,724 North American youth. Programs were based in schools (10), community facilities (24), both schools and community facilities (2), health care facilities (2), and family homes (1). Control groups varied. All outcomes were self-reported. Quantitative synthesis was not possible because of heterogeneity across trials in programs and evaluation designs. Results suggested that many abstinence-plus programs can reduce HIV risk as indicated by self-reported sexual behaviours. Of 39 trials, 23 found a protective program effect on at least one sexual behaviour, including abstinence, condom use, and unprotected sex (baseline n = 19,819). No trial found adverse program effects on any behavioural outcome

  5. Sampling for evaluation. Issues and strategies for community-based HIV prevention programs.

    PubMed

    O'Connell, A A

    2000-06-01

    Sampling methods are an important issue in the evaluation of community-based HIV prevention initiatives because it is through responsible sampling procedures that a valid model of the population is produced and reliable estimates of behavior change determined. This article provides an overview on sampling with particular focus on the needs of community-based organizations (CBOs). As these organizations continue to improve their capacity for sampling and program evaluation activities, comparisons across CBOs can become more rigorous, resulting in valuable information collectively regarding the effectiveness of particular HIV prevention initiatives. The author reviews several probability and non-probability sampling designs; discusses bias, cost, and feasibility factors in design selection; and presents six guidelines designed to encourage community organizations to consider these important sampling issues as they plan their program evaluations.

  6. A profile of six community-based HIV prevention programs targeting Asian and Pacific Islander Americans.

    PubMed

    Wong, F Y; Chng, C L; Lo, W

    1998-06-01

    Based on a framework (i.e., research and evaluation, prevention and services, and advocacy and policy), the goal of this article is to profile six community-based HIV prevention programs targeting Asian and Pacific Islander (API) Americans, especially among men who have sex with men. These six programs were chosen based on one or more of the following three criteria: (a) epidemiological profiles of AIDS cases among Asian and Pacific Islander Americans, (b) ethnic diversity, and (b) community development among Asian and Pacific Islander Americans in the fight against HIV. The six programs are (a) the Kokua Kalih Valley Health Center, Honolulu; (b) the Asian and Pacific Islander Wellness Center, San Francisco; (c) the Asian Pacific AIDS Intervention Team, Los Angeles; (d) the Asian and Pacific Islander Coalition on HIV and AIDS, New York City; (e) the AIDS Services in Asian Communities, Philadelphia; and (f) the Massachusetts Asian AIDS Prevention Project, Boston. The present analysis reveals that five programs have their roots in the gay or bisexual communities. Two programs have existed for about 3 years (the epidemic is going into its 17th year). Major financial support for the six programs are federal, state, or county sources; private support is generally minimal. All six programs offer a wide range of culturally competent and linguistically appropriate prevention activities and services (including two national projects) targeting a diverse API population. However, gaps in services exist in the younger programs. In addition to a paucity of epidemiological, surveillance, and empirical data, most reported that barriers fall into one or two interrelated categories: (a) structural (e.g., lack of governmental or private funding) or (b) cultural (e.g., denial of risk, homophobia, fear of confidentiality). These findings suggest that HIV prevention activities and services for Asian and Pacific Islander Americans should be based on empirical and cultural data, and that

  7. How the Avahan HIV prevention program transitioned from the Gates Foundation to the government of India.

    PubMed

    Sgaier, Sema K; Ramakrishnan, Aparajita; Dhingra, Neeraj; Wadhwani, Alkesh; Alexander, Ashok; Bennett, Sara; Bhalla, Aparajita; Kumta, Sameer; Jayaram, Matangi; Gupta, Pankaj; Piot, Peter K; Bertozzi, Stefano M; Anthony, John

    2013-07-01

    Developing countries face diminishing development aid and time-limited donor commitments that challenge the long-term sustainability of donor-funded programs to improve the health of local populations. Increasing country ownership of the programs is one solution. Transitioning managerial and financial responsibility for donor-funded programs to governments and local stakeholders represents a highly advanced form of country ownership, but there are few successful examples among large-scale programs. We present a transition framework and describe how it was used to transfer the Bill & Melinda Gates Foundation's HIV/AIDS prevention program, the Avahan program, to the Government of India. Essential features recommended for the transition of donor-funded programs to governments include early planning with the government, aligning donor program components with government structures and funding models prior to transition, building government capacity through active technical and management support, budgeting for adequate support during and after the transition, and dividing the transition into phases to allow time for adjustments and corrections. The transition of programs to governments is an important sustainability strategy for efforts to scale up HIV prevention programs to reach the populations most at risk.

  8. Participation in Counseling Programs: High-Risk Participants are Reluctant to Accept HIV-Prevention Counseling

    ERIC Educational Resources Information Center

    Earl, Allison; Albarracin, Dolores; Durantini, Marta R.; Gunnoe, Joann B.; Leeper, Josh; Levitt, Justin H.

    2009-01-01

    HIV-prevention intervention effectiveness depends on understanding whether clients with highest need for HIV-prevention counseling accept it. With this objective, a field study with a high-risk community sample from the southeastern United States (N = 350) investigated whether initial knowledge about HIV, motivation to use condoms,…

  9. Family Wellness, Not HIV Prevention

    PubMed Central

    Swendeman, Dallas; Flannery, Diane

    2010-01-01

    HIV exceptionalism (and disease-specific programs generally) garner both unbalanced funding and the most talented personnel, distorting local health priorities. In support of HIV exceptionalism, the successful mobilization of significant global health sector resources was not possible prior to HIV. Both sides of the debate have merits; rather than perpetuating polarization, we suggest that sustained improvements in global health require creating a prevention infrastructure to meet multiple health challenges experienced by local communities. We propose four fundamental shifts in HIV and disease prevention: (1) horizontally integrating prevention at one site locally, with priorities tailored to local health challenges and managed by local community leaders; (2) using a family wellness metaphor for services, not disease prevention; (3) implementing evidence-based prevention programs (EBPP) based on common principles, factors, and processes, rather than replication of specific programs; and (4) utilizing the expertise of private enterprise to re-design EBPP into highly attractive, engaging, and accessible experiences. PMID:19148744

  10. Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.

    PubMed

    Lambdin, Barrot H; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C; Cattamanchi, Adithya; Geng, Elvin H; Volberding, Paul

    2015-01-01

    Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap. PMID:25986374

  11. Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.

    PubMed

    Lambdin, Barrot H; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C; Cattamanchi, Adithya; Geng, Elvin H; Volberding, Paul

    2015-01-01

    Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.

  12. Evaluation of a regional pilot program to prevent mother-infant HIV transmission--Thailand, 1998-2000.

    PubMed

    2001-07-20

    Worldwide, approximately 2.2 million women and 600,000 infants are infected with human immunodeficiency virus (HIV) each year. Extended zidovudine prophylaxis and other antiretroviral and obstetric interventions and the avoidance of breast-feeding have reduced dramatically mother-infant HIV transmission in countries with adequate health-care resources. However, in developing countries, where the impact of HIV is greatest, implementation has been limited by the complexity and expense of these interventions. In Thailand, where approximately 15,000 infants are born to HIV-infected women each year, the Ministry of Public Health (MOPH) has collaborated with other organizations to identify simpler and more cost-effective interventions to reduce mother-infant HIV transmission. In 1998, a placebo-controlled clinical trial in Thailand using a simplified zidovudine regimen from 36 weeks' gestation until delivery reduced the risk for mother-infant transmission by 50%. In 1998, MOPH initiated a pilot program to prevent mother-infant HIV transmission in region 7, a rural area in northeastern Thailand with an antenatal HIV prevalence of approximately 1%, to assess program feasibility, effectiveness, and acceptability. This report summarizes an evaluation of the 2-year pilot program, which indicated that acceptance of HIV testing and adherence to zidovudine were high and HIV transmission was reduced. The findings demonstrate the feasibility of implementing programs to prevent mother-infant HIV transmission on a large scale in a developing country.

  13. Gender-Specific HIV Prevention with Urban Early-Adolescent Girls: Outcomes of the Keepin' It Safe Program

    ERIC Educational Resources Information Center

    Di Noia, Jennifer; Schinke, Steven P.

    2007-01-01

    This study evaluates the efficacy of Keepin' It Safe, a theory-based, gender-specific, CD-ROM-mediated HIV prevention program for urban, early adolescent girls. Intervention effects were examined in a randomized, pretest-posttest wait-list control-group design. Changes in HIV/AIDS knowledge, protective attitudes, and skills for reducing HIV…

  14. Preventing HIV Infection among Youth.

    ERIC Educational Resources Information Center

    Alcohol, Drug Abuse, and Mental Health Administration (DHHS/PHS), Rockville, MD. Office for Substance Abuse Prevention.

    This document notes that a recent threat to American's youth is the risk of infection from the human immunodeficiency virus (HIV). It views youth at high risk for alcohol or other drug use as also being, in all probability, at highest risk for exposure to HIV, and suggests that programs set up to prevent adolescents from becoming involved with…

  15. Community-based program to prevent HIV/STD infection among heterosexual black women.

    PubMed

    Painter, Thomas M; Herbst, Jeffrey H; Diallo, Dázon Dixon; White, Lisa Diane

    2014-04-18

    Heterosexual non-Hispanic black women in the United States are far more affected than women of other races or ethnicities by human immunodeficiency virus (HIV). SisterLove, Inc., a community-based organization in Atlanta, Georgia, responded to this disparity early in the epidemic by creating the Healthy Love HIV and sexually transmitted disease (STD) prevention intervention in 1989. Since then, SisterLove has been delivering the intervention to black women in metropolitan Atlanta. This report describes successful efforts by SisterLove, Inc., to develop, rigorously evaluate, and demonstrate the efficacy of Healthy Love, a 3-4-hour interactive, educational workshop, to reduce HIV- and sexually transmitted disease-related risk behaviors among heterosexual black women. On the basis of the evaluation findings, CDC packaged the intervention materials for use by service provider organizations in their efforts to reduce HIV disparities that affect black women in metropolitan Atlanta, the South, and the United States. This report also describes initiatives by SisterLove after the efficacy study to increase the potential effectiveness and reach of the Healthy Love intervention and further address HIV-related disparities that affect black women. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion that follows to provide an example of a program that might be effective in reducing HIV-related disparities in the United States. The results of the randomized controlled efficacy trial highlight the potential of culturally tailored, interactive group intervention efforts to reduce health disparities. CDC's support for evaluating and packaging SisterLove's intervention materials, and making the materials available (www.effectiveinterventions.org) for use by service provider organizations, are important contributions toward efforts to address HIV-related disparities that affect black women.

  16. Adaptation of an Alcohol and HIV School-Based Prevention Program for Teens

    PubMed Central

    Springer, Carolyn; Leu, Cheng-Shiun; Ghosh, Shivnath; Sharma, Sunil Kumar; Rapkin, Bruce

    2010-01-01

    Given the current status of HIV infection in youth in India, developing and implementing HIV education and prevention interventions is critical. The goal for School-based Teenage Education Program (STEP) was to demonstrate that a HIV/AIDS and alcohol abuse educational program built with specific cultural, linguistic, and community-specific characteristics could be effective. Utilizing the Train-the-Trainer model, the instructors (17–21 years) were trained to present the 10 session manualized program to primarily rural and tribal youth aged 13–16 years in 23 schools (N = 1,421) in the northern state of Himachal Pradesh in India. The intervention had a greater impact on girls; girls evidenced greater communication skills and a trend towards greater self efficacy and reduced risk taking behavior. The STEP has been successfully adapted by the community organizations that were involved in coordinating the program at the local level. Their intention to continue STEP beyond extra funding shows that utilizing the local community in designing, implementing and evaluating programs promotes ownership and sustainability. PMID:20589528

  17. An Assessment of Cost, Quality and Outcomes for Five HIV Prevention Youth Peer Education Programs in Zambia

    ERIC Educational Resources Information Center

    Burke, H. M.; Pedersen, K. F.; Williamson, N. E.

    2012-01-01

    Youth peer education (YPE) programs are a popular strategy for HIV prevention in sub-Saharan Africa. However, research on the effectiveness of YPE programs is scarce and the wide variation in programs makes it difficult to generalize research findings. Measuring quality and comparing program effectiveness require the use of standardized…

  18. 77 FR 41190 - Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-12

    ... June 19, 2012, in FR DOC 2012-14891, on page 36550, in the third column, under the heading ``Dates: Key...: National HIV Program for Enhanced HIV/AIDS Screening and Engagement in Care AGENCY: Indian Health...

  19. Making HIV prevention programming count: identifying predictors of success in a parent-based HIV prevention program for youth.

    PubMed

    Miller, Kim S; Forehand, Rex; Wiegand, Ryan; Fasula, Amy M; Armistead, Lisa; Long, Nicholas; Wyckoff, Sarah C

    2011-02-01

    Predictors of change in the number of sexual topics parents discussed and responsiveness during sex communication with their preadolescent after participating in a five-session sexual risk reduction intervention for parents were examined. Data were from 339 African American parents of preadolescents enrolled in the intervention arm of a randomized-controlled trial of the Parents' Matter! Program (PMP). Four categories of predictors of success were examined: time and resource constraints, personal characteristics, the parent-child relationship, and parent perceptions of child readiness for sex communication. There were only sporadic associations between success and time and resource constraints for either outcome. Parent perception of child readiness for sex communication was positively associated with discussions of sex topics (b = 1.11, confidence interval [CI]: 0.24-1.97) and parental responsiveness (b = .68, CI:0.22-1.15). Although parents face time and resource constraints, most attended at least four sessions, and demographics such as income had limited effects on program success.

  20. 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

  1. From brochures to videos to counseling: exposure to HIV-prevention programs.

    PubMed

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

    2008-05-01

    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.

  2. The PASHA Program Sourcebook: Promising Teen Pregnancy and STD/HIV/AIDS Prevention Programs.

    ERIC Educational Resources Information Center

    Card, Josefina J., Ed.; Becker, Stephani R., Ed.; Hill, Denise M. K., Ed.

    By providing in-depth descriptions of the 23 promising programs available from the Program Archive on Sexuality, Health and Adolescence (PASHA), the "PASHA Program Sourcebook" offers practitioners a detailed look at "what works" to prevent pregnancy and sexually transmitted diseases/human immunodeficiency virus and acquired immune deficiency…

  3. Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their Families: Youth, Families and Health Care Providers Coming Together to Address Complex Needs

    PubMed Central

    McKay, Mary; Block, Megan; Mellins, Claude; Traube, Dorian E.; Brackis-Cott, Elizabeth; Minott, Desiree; Miranda, Claudia; Petterson, Jennifer; Abrams, Elaine J.

    2010-01-01

    SUMMARY This article describes a family-based HIV prevention and mental health promotion program specifically designed to meet the needs of perinatally-infected preadolescents and their families. This project represents one of the first attempts to involve perinatally HIV-infected youth in HIV prevention efforts while simultaneously addressing their mental health and health care needs. The program, entitled CHAMP+ (Collaborative HIV Prevention and Adolescent Mental Health Project-Plus), focuses on: (1) the impact of HIV on the family; (2) loss and stigma associated with HIV disease; (3) HIV knowledge and understanding of health and medication protocols; (4) family communication about puberty, sexuality and HIV; (5) social support and decision making related to disclosure; and (6) parental supervision and monitoring related to sexual possibility situations, sexual risk taking behavior and management of youth health and medication. Findings from a preliminary evaluation of CHAMP+ with six families are presented along with a discussion of challenges related to feasibility and implementation within a primary health care setting for perinatally infected youth. PMID:20852676

  4. Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique.

    PubMed

    Figueroa, Maria Elena; Poppe, Patricia; Carrasco, Maria; Pinho, Maria Dirce; Massingue, Felisberto; Tanque, Maria; Kwizera, Amata

    2016-05-01

    Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009-2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program's effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners. PMID:27123984

  5. Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique.

    PubMed

    Figueroa, Maria Elena; Poppe, Patricia; Carrasco, Maria; Pinho, Maria Dirce; Massingue, Felisberto; Tanque, Maria; Kwizera, Amata

    2016-05-01

    Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009-2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program's effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners.

  6. Development of a Curriculum to Enhance Community-Based Organizations' Capacity for Effective HIV Prevention Programming and Management

    ERIC Educational Resources Information Center

    Richter, Donna L.; Potts, Linda H.; Prince, Mary S.; Dauner, Kim Nichols; Reininger, Belinda M.; Thompson-Robinson, Melva; Corwin, Sara J.; Getty, Cindy; Jones, Rhondette

    2006-01-01

    Community-based organizations (CBOs), particularly minority-based CBOs, are instrumental in the delivery of HIV/AIDS prevention programs and services. Despite a tremendous need, many CBOs lack the capacity to plan, implement, and evaluate targeted prevention interventions to serve culturally diverse populations. This article describes a…

  7. Effectiveness of Community Dialogue in Changing Gender and Sexual Norms for HIV Prevention: Evaluation of the Tchova Tchova Program in Mozambique

    PubMed Central

    Figueroa, Maria Elena; Poppe, Patricia; Carrasco, Maria; Pinho, Maria Dirce; Massingue, Felisberto; Tanque, Maria; Kwizera, Amata

    2016-01-01

    Structural HIV prevention interventions have gained prominence as ways to address underlying social and cultural factors that fuel the HIV epidemic. Identifying theories that explain how structural interventions are expected to change such factors can substantially increase their success. The Tchova Tchova community dialogue program, a theory-based intervention implemented in 2009–2010 in the provinces of Zambezia and Sofala, Mozambique, aimed to change gender and sexual norms for HIV prevention. Through facilitated sessions, the program sparked critical thinking and open dialogue among participants. This article measures the program’s effectiveness based on a sample of 462 participants and 453 nonparticipants. The results show that the program was successful in producing changes in three of the underlying structural factors of HIV: gender attitudes, gender roles, and HIV stigma. The program was also successful in changing other factors associated with HIV infection, including HIV prevention knowledge, discussion of HIV between sex partners, and having multiple sex partners. PMID:27123984

  8. The Program Evaluation and Monitoring System: a key source of data for monitoring evidence-based HIV prevention program processes and outcomes.

    PubMed

    Thomas, Craig W; Smith, Bryce D; Wright-DeAgüero, Linda

    2006-08-01

    The Centers for Disease Control and Prevention (CDC) Division of HIV/AIDS Prevention (DHAP) has responded to the need for accurate and timely data to monitor and evaluate federally funded HIV prevention programs by designing and implementing the Program Evaluation and Monitoring System (PEMS). PEMS is a national data reporting system that includes a standardized set of HIV prevention data variables, Web-based software for data entry and management, data collection and evaluation guidance and training, and software implementation support services. This article discusses the purposes of evaluation and the need for and development of PEMS and also describes how PEMS strengthens the monitoring and evaluation of HIV prevention services nationally and program planning, management, and monitoring locally. PEMS data may be used by prevention stakeholders at all levels to examine program fidelity, adaptation and tailoring, and key program health service utilization and behavioral outcomes. PEMS provides a strong foundation to bring a program closer to its intended goals and to serve the needs of the clients and the community, provides a means for agencies to fulfill their reporting mandates and funding obligations, and enables the CDC to monitor HIV prevention efforts in a consistent, efficient, and effective manner across the United States. PMID:16987090

  9. Development and preliminary evaluation of a behavioural HIV prevention program for teenage girls of Latino descent in the USA

    PubMed Central

    Davidson, Tatiana M.; Lopez, Cristina M.; Saulson, Raelle; Borkman, April L.; Soltis, Kathryn; Ruggiero, Kenneth J.; de Arellano, Michael; Wingood, Gina M.; DiClemente, Ralph J.; Danielson, Carla Kmett

    2014-01-01

    National data suggests that teenage girls of Latino descent in the USA are disproportionately affected by HIV with the rate of new infections being approximately 4 times higher compared to White women of comparable age (Centers for Disease Control and Prevention 2013). This paper highlights the need for an effective single-sex HIV prevention program for teenage girls of Latino descent and describes the development and preliminary evaluation of Chicas Healing, Informing, Living and Empowering (CHILE), a culturally-tailored, HIV prevention programme exclusively for teenage girls of Latino descent that was adapted from Sisters Informing, Healing, Living, and Empowering (SiHLE), an evidence-based HIV prevention program that is culturally tailored for African American young women. Theatre testing, a pre-testing methodology to assess consumer response to a demonstration of a product, was utilised to evaluate the relevance and utility of the HIV program as well as opportunities for the integration of cultural constructs. Future directions for the evaluation of CHILE are discussed. PMID:24697607

  10. Online focus groups as an HIV prevention program for gay, bisexual, and queer adolescent males.

    PubMed

    Ybarra, Michele L; DuBois, L Zachary; Parsons, Jeffrey T; Prescott, Tonya L; Mustanski, Brian

    2014-12-01

    Seventy-five 14-18-year-old gay, bisexual, and queer (GBQ) males provided feedback about how their participation in national, online focus groups (FG) about GBQ sexual health related topics resulted in behavioral and attitudinal changes. Most sexually experienced youth agreed that their participation positively changed their views and behavioral intentions. Some said that being in the FG made them more comfortable talking about sex, their sexuality, and making safer choices such as negotiating condoms. Others indicated intentions to become more involved in the LGBT community. Sexually inexperienced FG participants similarly said that the FG discussion positively affected them-most commonly by reducing their sense of isolation as young GBQ men who were waiting to have sex. Many also thought that they would become more vocal advocates of abstinence and/or safe sex. Online FGs and facilitated discussion boards should be further explored as a low-cost HIV prevention program for GBQ youth.

  11. Online focus groups as an HIV prevention program for gay, bisexual, and queer adolescent males.

    PubMed

    Ybarra, Michele L; DuBois, L Zachary; Parsons, Jeffrey T; Prescott, Tonya L; Mustanski, Brian

    2014-12-01

    Seventy-five 14-18-year-old gay, bisexual, and queer (GBQ) males provided feedback about how their participation in national, online focus groups (FG) about GBQ sexual health related topics resulted in behavioral and attitudinal changes. Most sexually experienced youth agreed that their participation positively changed their views and behavioral intentions. Some said that being in the FG made them more comfortable talking about sex, their sexuality, and making safer choices such as negotiating condoms. Others indicated intentions to become more involved in the LGBT community. Sexually inexperienced FG participants similarly said that the FG discussion positively affected them-most commonly by reducing their sense of isolation as young GBQ men who were waiting to have sex. Many also thought that they would become more vocal advocates of abstinence and/or safe sex. Online FGs and facilitated discussion boards should be further explored as a low-cost HIV prevention program for GBQ youth. PMID:25490735

  12. Where Are the Young Men in HIV Prevention Efforts? Comments on HIV Prevention Programs and Research from Young Men Who Sex with Men in Los Angeles County

    ERIC Educational Resources Information Center

    Holloway, Ian W.; Cederbaum, Julie A.; Ajayi, Antonette; Shoptaw, Steven

    2012-01-01

    Despite increasing rates of HIV infection among young men who have sex with men (YMSM), only a minority participate in formal HIV prevention efforts. Semi-structured mixed-methods interviews were conducted with a diverse sample of YMSM (N = 100, M[subscript age] = 25.0 years) in Los Angeles, California, to identify facilitators and barriers to…

  13. The Impact of Teachers' Modifications of an Evidenced-Based HIV Prevention Intervention on Program Outcomes.

    PubMed

    Wang, Bo; Stanton, Bonita; Lunn, Sonja; Rolle, Glenda; Poitier, Maxwell; Adderley, Richard; Li, Xiaoming; Koci, Veronica; Deveaux, Lynette

    2016-01-01

    The degree to which evidence-based program outcomes are affected by modifications is a significant concern in the implementation of interventions. The ongoing national implementation of an evidence-based HIV prevention program targeting grade 6 students in The Bahamas [Focus on Youth in The Caribbean (FOYC)] offers an opportunity to explore factors associated with teachers' modification of FOYC lessons and to examine the impact of types and degrees of modifications on student outcomes. Data were collected in 2012 from 155 teachers and 3646 students in 77 government elementary schools. Results indicate that teachers taught 16 of 30 core activities, 24.5 of 46 total activities and 4.7 of 8 sessions. Over one-half of the teachers made modifications to FOYC core activities; one-fourth of the teachers modified 25 % or more core activities that they taught (heavily modified FOYC). Omitting core activities was the most common content modification, followed by lengthening FOYC lessons with reading, writing assignments or role-play games, and shortening core activities or adding educational videos. Mixed-effects modeling revealed that omitting core activities had negative impacts on all four student outcomes. Shortening core activities and adding videos into lessons had negative impacts on HIV/AIDS knowledge and/or intention to use condom protection. Heavy modifications (>1/4 core activities) were associated with diminished program effectiveness. Heavy modifications and omitting or shortening core activities were negatively related to teachers' level of implementation. We conclude that poorer student outcomes were associated with heavy modifications. PMID:26297497

  14. The Impact of Teachers' Modifications of an Evidenced-Based HIV Prevention Intervention on Program Outcomes.

    PubMed

    Wang, Bo; Stanton, Bonita; Lunn, Sonja; Rolle, Glenda; Poitier, Maxwell; Adderley, Richard; Li, Xiaoming; Koci, Veronica; Deveaux, Lynette

    2016-01-01

    The degree to which evidence-based program outcomes are affected by modifications is a significant concern in the implementation of interventions. The ongoing national implementation of an evidence-based HIV prevention program targeting grade 6 students in The Bahamas [Focus on Youth in The Caribbean (FOYC)] offers an opportunity to explore factors associated with teachers' modification of FOYC lessons and to examine the impact of types and degrees of modifications on student outcomes. Data were collected in 2012 from 155 teachers and 3646 students in 77 government elementary schools. Results indicate that teachers taught 16 of 30 core activities, 24.5 of 46 total activities and 4.7 of 8 sessions. Over one-half of the teachers made modifications to FOYC core activities; one-fourth of the teachers modified 25 % or more core activities that they taught (heavily modified FOYC). Omitting core activities was the most common content modification, followed by lengthening FOYC lessons with reading, writing assignments or role-play games, and shortening core activities or adding educational videos. Mixed-effects modeling revealed that omitting core activities had negative impacts on all four student outcomes. Shortening core activities and adding videos into lessons had negative impacts on HIV/AIDS knowledge and/or intention to use condom protection. Heavy modifications (>1/4 core activities) were associated with diminished program effectiveness. Heavy modifications and omitting or shortening core activities were negatively related to teachers' level of implementation. We conclude that poorer student outcomes were associated with heavy modifications.

  15. HIV prevention strategies in Africa.

    PubMed

    Menting, A

    2000-01-01

    This paper concerns the administration of governmental and nongovernmental programs for the prevention of HIV/AIDS in Africa. A 1986 government campaign in the prevention of HIV in Senegal has been initiated and has been guided consistently. The Society for Women and AIDS in Africa (SWAA) is a nongovernmental organization (NGO) which assembles young population, women, and communities, towards their goal to prevent HIV infection. Marocaine de Lutte Contre le SIDA (ALCS), another NGO in Morocco believes that early intervention and education could help prevent further spread of infection. ALCS focused on the education of sex workers and the use of condoms. They also work with a group of men to promote safe sex and tackle the need for better testing facilities. In Uganda, the focus of the organization is to control the high incidence found in couples with only one infected partner. Another organization incorporates accurate HIV/AIDS information during prayers and other religious activities. Another approach was adopted by teaching English in secondary schools with AIDS information, values on education, family, and employment as content. An NGO in Cape Town was established to form loose cooperative to exchange information and resources within the community. An ongoing nationwide campaign for HIV prevention and control especially among high-risk groups and an effort on STD treatment is being organized.

  16. Effect of social cognitive theory-based HIV education prevention program among high school students in Nanjing, China.

    PubMed

    Li, Xiaoming; Zhang, Liying; Mao, Rong; Zhao, Qun; Stanton, Bonita

    2011-06-01

    This study was designed to evaluate potential preventive effects of a cultural adaption of the Focus on Kids (FOK) program among Chinese adolescents through a quasi-experimental intervention trial in Nanjing, China. High school students were assigned to either experimental groups (n = 140) or control groups (n = 164) by schools (with three schools in each condition). The participants completed a confidential questionnaire at baseline and 6-month post-intervention with a follow-up rate of 94.4% (287 of 304). The outcome measures included HIV knowledge, HIV-related perceptions based on the protection motivation theory, stigmatizing attitude toward people living with HIV/AIDS (PLWHA), intentions of health-related risk behaviors and sexual intercourse in the previous 6 months. Results showed a significant intervention effect at 6-month post-intervention in increasing HIV knowledge, decreasing perceptions of response cost associated with abstinence and reducing stigmatizing attitudes toward PLWHA, after controlling for key demographic characteristics and relevant baseline measures. Further mediation analysis suggested that HIV knowledge mediated the effect of intervention on stigma reduction. Findings from this study support the feasibility and initial efficacy of the cultural adaptation of FOK HIV prevention program among high school students in China.

  17. Strategies for universalistic and targeted HIV prevention.

    PubMed

    Des Jarlais, D C; Padian, N

    1997-10-01

    The controversy over "targeted" versus "universalistic" programs for HIV prevention has persisted throughout the history of the HIV/AIDS epidemic in the United States and in some European countries. Building on previous analyses, we outline methods for integrating universalistic and targeted HIV prevention programming. The outline considers possible synergy between targeted and universalistic programs, rather than a forced choice between the two. Components within this framework include a continuum of the intensity of targeted programs, specification of local risk behavior populations, categories of risk behavior, and HIV seroprevalence within local risk-behavior populations. Given the scarce resources currently available, preventing all new HIV infections is not a realistic public health goal, but with better use of current scientific knowledge, it should be possible to greatly reduce the rate of new HIV infections. PMID:9358108

  18. Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi

    PubMed Central

    Wirtz, AL; Trapence, G; Jumbe, V; Umar, E; Ketende, S; Kamba, D; Berry, M; Strömdahl, SK; Beyrer, C; Muula, AS; Baral, S

    2016-01-01

    Introduction The use of combination HIV prevention interventions (CHPI) now represent the standard of care to minimize HIV acquisition risks among men who have sex with men (MSM). There has been limited evaluation of these approaches in generalized HIV epidemics and/or where MSM are stigmatized. A peer-based CHPI program to target individual, social, and structural risks for HIV was developed for MSM in Blantyre, Malawi. Methods To test the feasibility of CHPI, adult MSM were followed prospectively from January 2012-May 2013. Participants (N=103) completed sociobehavioral surveys and HIV testing at each of three follow-up study visits. Results Approximately 90% of participants attended each study visit and 93.2% (n=96) completed the final visit. Participants met with peer-educators a median of 3 times (range: 1-10) in follow-up visits 2 and 3. Condom use at last sex improved from baseline through follow-up visit 3 with main (Baseline:62.5%, Follow-up 3:77.0%, p=0.02) and casual male partners (Baseline:70.7%, Follow-up 3:86.3%, p=0.01). Disclosure of sexual behaviors/orientation to family increased from 25% in follow-up 1 to 55% in follow-up 3 (p<0.01). Discussion Participants maintained a high level of retention in the study highlighting the feasibility of leveraging community based organizations to recruit and retain MSM in HIV prevention and treatment interventions in stigmatizing settings. Group-level changes in sexual behavior and disclosure in safe settings for MSM were noted. CHPI may represent a useful model to providing access to other HIV prevention for MSM and aiding retention in care and treatment services for MSM living with HIV in challenging environments. PMID:26010028

  19. An HIV-Preventive Intervention for Youth Living with HIV

    ERIC Educational Resources Information Center

    Lightfoot, Marguerita; Rotheram-Borus, Mary Jane; Tevendale, Heather

    2007-01-01

    As the number of youth infected with HIV rises, secondary prevention programs are needed to help youth living with HIV meet three goals: (1) increase self-care behaviors, medical adherence, and health-related interactions; (2) reduce transmission acts; and (3) enhance their quality of life. This article describes an intervention program for youth…

  20. Effectiveness of a School HIV/AIDS Prevention Program for Spanish Adolescents

    ERIC Educational Resources Information Center

    Espada, Jose P.; Orgiles, Mireia; Morales, Alexandra; Ballester, Rafael; Huedo-Medina, Tania B.

    2012-01-01

    Due to a lack of controlled studies on HIV prevention interventions among Spanish adolescents, COMPAS, a five-session behavioral intervention, was developed and tested on Spanish adolescents aged 15-18. Participants included 827 adolescents from central, east and north Spain. Six hundred and seven students (M = 15.71 years) received the…

  1. Cross-sectional study assessing HIV-related knowledge, attitudes and behavior in the Namibian truck transport sector: Readjusting HIV prevention programs in the workplace.

    PubMed

    Kiderlen, Til R; Conteh, Michael; Roll, Stephanie; Seeling, Stefanie; Weinmann, Stefan

    2015-01-01

    The objectives of this study were to assess the current status of HIV-related knowledge, attitudes, and behavior (KAB) of employees in the private transport sector in Namibia and to compare companies with established HIV workplace program (WPPs) with those that have recently initiated the implementation of such programs. The study was designed as a cross-sectional questionnaire-based survey. Between January and March 2011, the survey was conducted in the Namibian truck transport sector in six companies of different sizes. The participants were selected randomly from the workforce. Data collection was based on a KAB questionnaire. The range of correct answers to the survey concerning the knowledge of HIV transmission was 67-95%. Twenty percent of the employees had never been tested for HIV. Additionally, risky sexual behaviors were quite prevalent and included having multiple concurrent partners and the use of sex for incentives. This study revealed that drivers and laborers were especially at risk for such behaviors. The employees of companies with established WPPs were tested for HIV more often than those of companies with new WPPs; however, aside from this difference, only minor differences were observed between the two groups. The findings of this study highlight the need for on-going HIV information and prevention campaigns that focus on the special needs of mobile and low-income workers. WPPs should be tailored accordingly and shift their focus to more practical approaches, such as voluntary counseling and testing (VCT), to increase their effectiveness. PMID:25805432

  2. Cross-sectional study assessing HIV-related knowledge, attitudes and behavior in the Namibian truck transport sector: Readjusting HIV prevention programs in the workplace.

    PubMed

    Kiderlen, Til R; Conteh, Michael; Roll, Stephanie; Seeling, Stefanie; Weinmann, Stefan

    2015-01-01

    The objectives of this study were to assess the current status of HIV-related knowledge, attitudes, and behavior (KAB) of employees in the private transport sector in Namibia and to compare companies with established HIV workplace program (WPPs) with those that have recently initiated the implementation of such programs. The study was designed as a cross-sectional questionnaire-based survey. Between January and March 2011, the survey was conducted in the Namibian truck transport sector in six companies of different sizes. The participants were selected randomly from the workforce. Data collection was based on a KAB questionnaire. The range of correct answers to the survey concerning the knowledge of HIV transmission was 67-95%. Twenty percent of the employees had never been tested for HIV. Additionally, risky sexual behaviors were quite prevalent and included having multiple concurrent partners and the use of sex for incentives. This study revealed that drivers and laborers were especially at risk for such behaviors. The employees of companies with established WPPs were tested for HIV more often than those of companies with new WPPs; however, aside from this difference, only minor differences were observed between the two groups. The findings of this study highlight the need for on-going HIV information and prevention campaigns that focus on the special needs of mobile and low-income workers. WPPs should be tailored accordingly and shift their focus to more practical approaches, such as voluntary counseling and testing (VCT), to increase their effectiveness.

  3. Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation

    PubMed Central

    Bennett, Sara; Singh, Suneeta; Rodriguez, Daniela; Ozawa, Sachiko; Singh, Kriti; Chhabra, Vibha; Dhingra, Neeraj

    2015-01-01

    Background Between 2009–2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition. Methods The evaluation drew upon (1) a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2) a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI) programs, one year post-transition; and (3) case studies of 15 TI programs. Findings Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition. Interpretation The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified. PMID:26327591

  4. A Computational Future for Preventing HIV in Minority Communities: How Advanced Technology Can Improve Implementation of Effective Programs

    PubMed Central

    Brown, C Hendricks; Mohr, David C.; Gallo, Carlos G.; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G.; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

    2013-01-01

    African Americans and Hispanics in the U.S. have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. While a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We propose that innovative approaches involving computational technologies be explored for their use in both developing new interventions as well as in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Secondly, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods, including social network analysis, agent based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and three effective HIV prevention programs, we illustrate how eight areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability. PMID:23673892

  5. A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs.

    PubMed

    Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

    2013-06-01

    African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.

  6. A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs.

    PubMed

    Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

    2013-06-01

    African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability. PMID:23673892

  7. Pattern and levels of spending allocated to HIV prevention programs in low- and middle-income countries

    PubMed Central

    2012-01-01

    Background AIDS continues to spread at an estimated 2.6 new million infections per year, making the prevention of HIV transmission a critical public health issue. The dramatic growth in global resources for AIDS has produced a steady scale-up in treatment and care that has not been equally matched by preventive services. This paper is a detailed analysis of how countries are choosing to spend these more limited prevention funds. Methods We analyzed prevention spending in 69 low- and middle-income countries with a variety of epidemic types, using data from national domestic spending reports. Spending information was from public and international sources and was analyzed based on the National AIDS Spending Assessment (NASA) methods and classifications. Results Overall, prevention received 21% of HIV resources compared to 53% of funding allocated to treatment and care. Prevention relies primarily on international donors, who accounted for 65% of all prevention resources and 93% of funding in low-income countries. For the subset of 53 countries that provided detailed spending information, we found that 60% of prevention resources were spent in five areas: communication for social and behavioral change (16%), voluntary counselling and testing (14%), prevention of mother-to-child transmission (13%), blood safety (10%) and condom programs (7%). Only 7% of funding was spent on most-at-risk populations and less than 1% on male circumcision. Spending patterns did not consistently reflect current evidence and the HIV specific transmission context of each country. Conclusions Despite recognition of its importance, countries are not allocating resources in ways that are likely to achieve the greatest impact on prevention across all epidemic types. Within prevention spending itself, a greater share of resources need to be matched with interventions that approximate the specific needs and drivers of each country's epidemic. PMID:22436141

  8. 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 Central

    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

    2014-01-01

    Background 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. Objective 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. Methods 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. Results 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

  9. Cancer prevention in HIV-infected populations.

    PubMed

    Goncalves, Priscila H; Montezuma-Rusca, Jairo M; Yarchoan, Robert; Uldrick, Thomas S

    2016-02-01

    People living with human immunodeficiency virus (HIV) are living longer since the advent of effective combined antiretroviral therapy (cART). While cART substantially decreases the risk of developing some cancers, HIV-infected individuals remain at high risk for Kaposi sarcoma, lymphoma, and several solid tumors. Currently HIV-infected patients represent an aging group, and malignancies have become a leading cause of morbidity and mortality. Tailored cancer-prevention strategies are needed for this population. In this review we describe the etiologic agents and pathogenesis of common malignancies in the setting of HIV, as well as current evidence for cancer prevention strategies and screening programs. PMID:26970136

  10. The Preliminary Findings of a Study Exploring the Perceptions of a Sample of Young Heterosexual Males regarding HIV Prevention Education Programming in Nova Scotia, Canada

    ERIC Educational Resources Information Center

    Gahagan, Jacqueline; Rehman, Laurene; Barbour, Laura; McWilliam, Susan

    2007-01-01

    Despite the increasing numbers of young Canadian females becoming infected with HIV through heterosexual transmission with an infected male sexual partner, the majority of current HIV prevention programs and services in Canada continue to ignore the needs of young heterosexual males. This research is derived from 30 in-depth interviews, 9 focus…

  11. Estimating the Size of the Female Sex Worker Population in Kenya to Inform HIV Prevention Programming

    PubMed Central

    Odek, Willis Omondi; Githuka, George N.; Avery, Lisa; Njoroge, Peter K.; Kasonde, Lombe; Gorgens, Marelize; Kimani, Joshua; Gelmon, Lawrence; Gakii, Gloria; Isac, Shajy; Faran, Emmanuel; Musyoki, Helgar; Maina, William; Blanchard, James F.; Moses, Stephen

    2014-01-01

    Background The high burden of HIV infections among female sex workers (FSW) in sub-Saharan Africa has been long recognised, but effective preventive interventions have largely not been taken to scale. We undertook a national geographical mapping exercise in 2011/2012 to assess the locations and population size of FSW in Kenya, to facilitate targeted HIV prevention services for this population. Methods and Findings We used a geographical mapping approach, consisting of interviews with secondary key informants to identify “hot” spots frequented by FSW, their operational dynamics and the estimated numbers of FSW in those spots. This was followed by validation of the estimates through interviews with FSW at each spot identified. The mapping covered Nairobi, the capital city of Kenya, and 50 other major urban centres. In total, 11,609 secondary key informant interviews were conducted to identify FSW spots. Further, a total of 6,360 FSW were interviewed for spot validation purposes. A total of 10,670 spots where FSW congregate were identified. The estimated FSW population in all the towns mapped was 103,298 (range 77,878 to 128, 717). Size estimates in the towns mapped were extended to smaller towns that were not mapped, using a statistical model. The national urban FSW population estimate was 138,420 (range 107, 552 to 169, 288), covering all towns of over 5,000 population. We estimated that approximately 5% of the urban female population of reproductive age in Kenya could be sex workers, which is consistent with previous estimates from other sub-Saharan African countries. Conclusions This study provides the first national level data on the size of the FSW population in Kenya. These data can be used to enhance HIV prevention programme planning and implementation for FSW, to form the basis for impact evaluations, and to improve programme coverage by directing efforts to locations with the greatest need. PMID:24595029

  12. Impact of school-based HIV prevention program in post-conflict Liberia.

    PubMed

    Atwood, Katharine A; Kennedy, Stephen B; Shamblen, Steve; Tegli, Jemee; Garber, Salome; Fahnbulleh, Pearl W; Korvah, Prince M; Kolubah, Moses; Mulbah-Kamara, Comfort; Fulton, Shannon

    2012-02-01

    This paper presents findings of a feasibility study to adapt and evaluate the impact of an evidence-based HIV prevention intervention on sexual risk behaviors of in-school 6th grade youth in post-conflict Liberia (n = 812). The study used an attention-matched, group randomized controlled trial. Four matched pairs of elementary/middle schools in Monrovia, Liberia, were randomly assigned to either an adapted eight-module HIV prevention or a general health curriculum. Three- and nine-month impacts of the intervention on sexual risk behaviors and on mediating variables are presented. The intervention significantly impacted protective peer norms and positive condom attitudes and increased frequency of condom use at the nine-month follow-up. The intervention did not impact sexual initiation or multiple sex partnerships. Future intervention research should address the salient pressures that are unique to post-conflict settings and include longer follow-up time periods and smaller class sizes to meaningfully impact sexual initiation and multiple sex partnerships.

  13. IMPACT OF SCHOOL-BASED HIV PREVENTION PROGRAM IN POST-CONFLICT LIBERIA

    PubMed Central

    Atwood, Katharine A.; Kennedy, Stephen B.; Shamblen, Steve; Tegli, Jemee; Garber, Salome; Fahnbulleh, Pearl W.; Korvah, Prince M.; Kolubah, Moses; Mulbah-Kamara, Comfort; Fulton, Shannon

    2013-01-01

    This paper presents findings of a feasibility study to adapt and evaluate the impact of an evidence-based HIV prevention intervention on sexual risk behaviors of in-school 6th grade youth in post-conflict Liberia (n = 812). The study used an attention-matched, group randomized controlled trial. Four matched pairs of elementary/middle schools in Monrovia, Liberia, were randomly assigned to either an adapted eight-module HIV prevention or a general health curriculum. Three- and nine-month impacts of the intervention on sexual risk behaviors and on mediating variables are presented. The intervention significantly impacted protective peer norms and positive condom attitudes and increased frequency of condom use at the nine-month follow-up. The intervention did not impact sexual initiation or multiple sex partnerships. Future intervention research should address the salient pressures that are unique to post-conflict settings and include longer follow-up time periods and smaller class sizes to meaningfully impact sexual initiation and multiple sex partnerships. PMID:22339146

  14. Development of The Johns Hopkins University School of Nursing Adult/Geriatric Primary Care Nurse Practitioner Program in HIV Prevention, Treatment, and Care.

    PubMed

    Farley, Jason E; Stewart, Jennifer; Kub, Joan; Cumpsty-Fowler, Carolyn; Lowensen, Kelly; Becker, Kathleen

    2016-01-01

    In response to the call to create an AIDS Education and Training Center for Nurse Practitioner Education by the Health Resources and Services Administration, The Johns Hopkins University School of Nursing embarked on a transformative curriculum overhaul to integrate HIV prevention, treatment, and care into the Adult/Geriatric Nurse Practitioner Program. A six-step process outlined in the Curriculum Development for Medical Education was followed. A pilot cohort of Adult/Geriatric Nurse Practitioner students were enrolled, including 50% primary care setting and 50% HIV-focused primary care through a 12-month HIV continuity clinic experience. Through this pilot, substantive changes to the program were adopted. Programmatic outcomes were not compromised with the modification in clinical hours. The model of a 12-month HIV continuity clinical experience reduced the number of required preceptors. This model has important implications for the HIV workforce by demonstrating successful integration of HIV and primary care training for nurse practitioners.

  15. Can money prevent the spread of HIV? A review of cash payments for HIV prevention

    PubMed Central

    Pettifor, Audrey; MacPhail, Catherine; Nguyen, Nadia; Rosenberg, Molly

    2013-01-01

    Cash payments to improve health outcomes have been used for many years, however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. We identified 16 studies meeting our criteria; 10 are completed. The majority of studies have been conducted with adolescents in developing countries and payments are focused on addressing structural risk factors such as poverty. Most have seen reductions in sexual behavior and one large trial has documented a difference in HIV prevalence between young women getting cash transfers and those not. Cash transfer programs focused on changing risky sexual behaviors to reduce HIV risk suggest promise. The context in which programs are situated, the purpose of the cash transfer, and the population will all affect the impact of such programs; ongoing RCTs with HIV incidence endpoints will shed more light on the efficacy of cash payments as strategy for HIV prevention. PMID:22760738

  16. Luba-Kasai Men and the Prevention of Mother to Child Transmission (PMTCT) of HIV program in Lusaka.

    PubMed

    Auvinen, Jaana; Kylmä, Jari; Välimäki, Maritta; Bweupe, Max; Suominen, Tarja

    2015-09-01

    Male participation in the prevention of mother-to-child transmission (PMTCT) of HIV has been determined as one of the key factors in sub-Saharan African countries, but its realization is challenging because of male-related and institutional factors. The purpose of this study is two-fold: first, we explored the views of Luba-Kasai men, living in Zambia in the Lusaka Province, on the factors that encourage, inconvenience or inhibit them in accompanying their wives to the antenatal clinic and their ideas to improve their experience. Secondly, the study considered their knowledge of the PMTCT program and how such knowledge conformed to the Zambian National Protocol Guidelines Integrated PMTCT of HIV /: AIDS. Twenty-one interviews were analyzed using qualitative inductive content analysis. The National Protocol Guidelines Integrated PMTCT of HIV/AIDS were analyzed using the deductive content analysis. The encouraging factors that emerged were involvement in the program, the time of delivery, love and care, and also the suspicion of corruption. The inconveniencing factors were the arrangements and working culture of the clinic, together with stigma and guilt. A lack of motivation, fear of death, socioeconomic circumstances and again the arrangements and working culture at the clinic were held as inhibiting factors. The ideas to remove inconvenient factors were maintaining a spiritual outlook on life, education, interaction, a good mood and a sense of meaningfulness. Considering such male views and paying attention to minorities in the development of national PMTCT of HIV Programs may enhance male participation in the process.

  17. Luba-Kasai Men and the Prevention of Mother to Child Transmission (PMTCT) of HIV program in Lusaka.

    PubMed

    Auvinen, Jaana; Kylmä, Jari; Välimäki, Maritta; Bweupe, Max; Suominen, Tarja

    2015-09-01

    Male participation in the prevention of mother-to-child transmission (PMTCT) of HIV has been determined as one of the key factors in sub-Saharan African countries, but its realization is challenging because of male-related and institutional factors. The purpose of this study is two-fold: first, we explored the views of Luba-Kasai men, living in Zambia in the Lusaka Province, on the factors that encourage, inconvenience or inhibit them in accompanying their wives to the antenatal clinic and their ideas to improve their experience. Secondly, the study considered their knowledge of the PMTCT program and how such knowledge conformed to the Zambian National Protocol Guidelines Integrated PMTCT of HIV /: AIDS. Twenty-one interviews were analyzed using qualitative inductive content analysis. The National Protocol Guidelines Integrated PMTCT of HIV/AIDS were analyzed using the deductive content analysis. The encouraging factors that emerged were involvement in the program, the time of delivery, love and care, and also the suspicion of corruption. The inconveniencing factors were the arrangements and working culture of the clinic, together with stigma and guilt. A lack of motivation, fear of death, socioeconomic circumstances and again the arrangements and working culture at the clinic were held as inhibiting factors. The ideas to remove inconvenient factors were maintaining a spiritual outlook on life, education, interaction, a good mood and a sense of meaningfulness. Considering such male views and paying attention to minorities in the development of national PMTCT of HIV Programs may enhance male participation in the process. PMID:24449707

  18. Sociocultural Contexts and Communication About Sex in China: Informing HIV/STD Prevention Programs

    PubMed Central

    Leiber, Eli; Chin, Dorothy; Li, Li; Rotheram-Borus, Mary Jane; Detels, Roger; Wu, Zunyou; Guan, Jihui

    2010-01-01

    HIV may be particularly stigmatizing in Asia because of its association with “taboo” topics, including sex, drugs, homosexuality, and death (Aoki, Ngin, Mo, & Ja, 1989). These cultural schemata expose salient boundaries and moral implications for sexual communication (Chin, 1999, Social Science and Medicine, 49, 241-251). Yet HIV/STD prevention efforts are frequently conducted in the public realm. Education strategies often involve conversations with health “experts” about condom use, safe sex, and partner communication. The gap between the public context of intervention efforts and the private and norm-bound nature of sex conversation is particularly challenging. Interviews with 32 market workers in eastern China focused on knowledge, beliefs, and values surrounding sexual practices, meanings, and communication. Sex-talk taboos, information seeking, vulnerability, partner communication, and cultural change emerged as central to understanding intervention information flow and each theme's relative influence is described. Findings illustrate the nature of how sexual communication schemata in Chinese contexts impact the effectiveness of sexual health message communication. PMID:19842826

  19. Sociocultural contexts and communication about sex in China: informing HIV/STD prevention programs.

    PubMed

    Lieber, Eli; Chin, Dorothy; Li, Li; Rotheram-Borus, Mary Jane; Detels, Roger; Wu, Zunyou; Guan, Jihui

    2009-10-01

    HIV may be particularly stigmatizing in Asia because of its association with "taboo" topics, including sex, drugs, homosexuality, and death (Aoki, Ngin, Mo, & Ja, 1989). These cultural schemata expose salient boundaries and moral implications for sexual communication (Chin, 1999, Social Science and Medicine, 49, 241-251). Yet HIV/STD prevention efforts are frequently conducted in the public realm. Education strategies often involve conversations with health "experts" about condom use, safe sex, and partner communication. The gap between the public context of intervention efforts and the private and norm-bound nature of sex conversation is particularly challenging. Interviews with 32 market workers in eastern China focused on knowledge, beliefs, and values surrounding sexual practices, meanings, and communication. Sex-talk taboos, information seeking, vulnerability, partner communication, and cultural change emerged as central to understanding intervention information flow and each theme's relative influence is described. Findings illustrate the nature of how sexual communication schemata in Chinese contexts impact the effectiveness of sexual health message communication. PMID:19842826

  20. Sociocultural contexts and communication about sex in China: informing HIV/STD prevention programs.

    PubMed

    Lieber, Eli; Chin, Dorothy; Li, Li; Rotheram-Borus, Mary Jane; Detels, Roger; Wu, Zunyou; Guan, Jihui

    2009-10-01

    HIV may be particularly stigmatizing in Asia because of its association with "taboo" topics, including sex, drugs, homosexuality, and death (Aoki, Ngin, Mo, & Ja, 1989). These cultural schemata expose salient boundaries and moral implications for sexual communication (Chin, 1999, Social Science and Medicine, 49, 241-251). Yet HIV/STD prevention efforts are frequently conducted in the public realm. Education strategies often involve conversations with health "experts" about condom use, safe sex, and partner communication. The gap between the public context of intervention efforts and the private and norm-bound nature of sex conversation is particularly challenging. Interviews with 32 market workers in eastern China focused on knowledge, beliefs, and values surrounding sexual practices, meanings, and communication. Sex-talk taboos, information seeking, vulnerability, partner communication, and cultural change emerged as central to understanding intervention information flow and each theme's relative influence is described. Findings illustrate the nature of how sexual communication schemata in Chinese contexts impact the effectiveness of sexual health message communication.

  1. 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

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

    2013-11-01

    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).

  2. Preventing HIV Infection in Women

    PubMed Central

    Adimora, Adaora A.; Ramirez, Catalina; Auerbach, Judith D.; Aral, Sevgi O.; Hodder, Sally; Wingood, Gina; El-Sadr, Wafaa; Bukusi, Elizabeth Anne

    2014-01-01

    Although the number of new infections has declined recently, women still constitute almost half of the world's 34 million people with HIV infection, and HIV remains the leading cause of death among women of reproductive age. Prevention research has made considerable progress during the past few years in addressing the biological, behavioral and social factors that influence women's vulnerability to HIV infection. Nevertheless, substantial work still must be done in order to implement scientific advancements and to resolve the many questions that remain. This article highlights some of the recent advances and persistent gaps in HIV prevention research for women and outlines key research and policy priorities. PMID:23764631

  3. The future of HIV prevention.

    PubMed

    Padian, Nancy S; Isbell, Michael T; Russell, Elizabeth S; Essex, M

    2012-08-01

    In the decades since the emergence of HIV, numerous approaches to prevent transmission have been tested with varying degrees of success. Because a highly effective vaccine will not be available within the next decade, it is increasingly clear that preventing new HIV infections will require successful implementation of promising behavioral and biomedical interventions in combination. These prevention packages must be sufficiently flexible to include a variety of evidence-based interventions that serve each dynamic population they target, particularly those who are most vulnerable. To optimize the impact of combination intervention packages, well-designed implementation science studies are vital. Efficacy in a clinical trial does not necessarily translate to effectiveness at the population-level, and prioritized research studies should investigate programmatic implementation and operations scale-up and new methods to monitor and evaluate these processes both for organization and cost-effectiveness. With an estimated 2.7 million people becoming newly infected with HIV in 2010, the prevention of HIV remains an urgent global health priority. Since the emergence of HIV/AIDS more than 30 years ago, the evidence base for HIV prevention has expanded and evolved. Here we explore the status of evidence-based HIV prevention, describing both the continuing challenges and the emerging opportunities to reduce HIV incidence. PMID:22772385

  4. The Uptake of Integrated Perinatal Prevention of Mother-to-Child HIV Transmission Programs in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Tudor Car, Lorainne; Brusamento, Serena; Elmoniry, Hoda; van Velthoven, Michelle H. M. M. T.; Pape, Utz J.; Welch, Vivian; Tugwell, Peter; Majeed, Azeem; Rudan, Igor; Car, Josip; Atun, Rifat

    2013-01-01

    Background The objective of this review was to assess the uptake of WHO recommended integrated perinatal prevention of mother-to-child transmission (PMTCT) of HIV interventions in low- and middle-income countries. Methods and Findings We searched 21 databases for observational studies presenting uptake of integrated PMTCT programs in low- and middle-income countries. Forty-one studies on programs implemented between 1997 and 2006, met inclusion criteria. The proportion of women attending antenatal care who were counseled and who were tested was high; 96% (range 30–100%) and 81% (range 26–100%), respectively. However, the overall median proportion of HIV positive women provided with antiretroviral prophylaxis in antenatal care and attending labor ward was 55% (range 22–99%) and 60% (range 19–100%), respectively. The proportion of women with unknown HIV status, tested for HIV at labor ward was 70%. Overall, 79% (range 44–100%) of infants were tested for HIV and 11% (range 3–18%) of them were HIV positive. We designed two PMTCT cascades using studies with outcomes for all perinatal PMTCT interventions which showed that an estimated 22% of all HIV positive women attending antenatal care and 11% of all HIV positive women delivering at labor ward were not notified about their HIV status and did not participate in PMTCT program. Only 17% of HIV positive antenatal care attendees and their infants are known to have taken antiretroviral prophylaxis. Conclusion The existing evidence provides information only about the initial PMTCT programs which were based on the old WHO PMTCT guidelines. The uptake of counseling and HIV testing among pregnant women attending antenatal care was high, but their retention in PMTCT programs was low. The majority of women in the included studies did not receive ARV prophylaxis in antenatal care; nor did they attend labor ward. More studies evaluating the uptake in current PMTCT programs are urgently needed. PMID:23483887

  5. Global HIV Prevention Programs for Long-Haul Truckers: Considerations for the U.S.

    ERIC Educational Resources Information Center

    Winkelman, Sloane Burke; Kimuna, Sitawa R.; Haithcox-Dennis, Melissa

    2012-01-01

    In the United States, an estimated 1.2 million people are living with HIV/AIDS, and approximately 50,000 new cases of HIV are diagnosed each year. Globally, it is estimated that 33.3 million people are living with HIV/AIDS. The role of mobile populations in the spread of STIs and HIV is well-documented in many countries around the world. Long-haul…

  6. Sexual Risk Behaviors Among HIV-Infected South African Men and Women with Their Partners in a Primary Care Program: Implications for Couples-Based Prevention

    PubMed Central

    de Bruyn, Guy; Lurie, Mark N.; Modisenyane, Tebogo; Triche, Elizabeth W.; Gray, Glenda E.; Welte, Alex; Martinson, Neil A.

    2011-01-01

    We studied 1163 sexually-active HIV-infected South African men and women in an urban primary care program to understand patterns of sexual behaviors and whether these behaviors differed by partner HIV status. Overall, 40% reported a HIV-positive partner and 60% a HIV-negative or status unknown partner; and 17.5% reported >2 sex acts in the last 2 weeks, 16.4% unprotected sex in the last 6 months, and 3.7% >1 sex partner in the last 6 months. Antiretroviral therapy (ART) was consistently associated with decreased sexual risk behaviors, as well as with reporting a HIV-negative or status unknown partner. The odds of sexual risk behaviors differed by sex; and were generally higher among participants reporting a HIV-positive partner, but continued among those with a HIV-negative or status unknown partner. These data support ART as a means of HIV prevention. Engaging in sexual risk behaviors primarily with HIV-positive partners was not widely practiced in this setting, emphasizing the need for couples-based prevention. PMID:21476005

  7. The Solaar HIV prevention program for gay and bisexual Latino men: using social marketing to build capacity for service provision and evaluation.

    PubMed

    Conner, Ross F; Takahashi, Lois; Ortiz, Eloy; Archuleta, Eduardo; Muniz, Juan; Rodriguez, Julio

    2005-08-01

    Community-researcher partnerships can be powerful mechanisms to understand and effectively address health and social problems such as HIV/AIDS prevention. When the partnership is a positive, productive one, the combined expertise and energy of both parties result in a more effective program and a better evaluation of its effects. This article describes one such partnership and how a program challenge provided the opportunity for both partners to develop new capacities and strengthen others. The program is Proyecto SOLAAR, a community-based and culturally-sensitive HIV prevention program for gay and bisexual Latino men. The program is an experiential, daylong retreat focused on personal aspects of the men (e.g., self-concept), ideas about and aspects of their relationship behavior (e.g., cultural misunderstandings, dating behavior), and HIV prevention; there is a follow-up reunion a month later to share experiences with other participants about new dating and HIV prevention behaviors. The article focuses in particular on how the partners built new capacity in the area of social marketing to address the challenge of participant recruitment and describes the components of the new campaign. These components included distinctive images in ads in publications read by the target population, a toll-free telephone number and Web site for easy initial contact with the program, phone cards and postcards featuring the specially created program image to reinforce a connection to the program, and other aspects. The article describes the partnership between the HIV service providers and the researchers and how the collaborative effort was key to understanding and addressing the recruitment problem, identifying potential solutions, and implementing the new social marketing strategy. This process resulted in four kinds of capacities that were built or strengthened, including program recruitment, program content and implementation, program evaluation, and the partnership itself. The

  8. The Solaar HIV prevention program for gay and bisexual Latino men: using social marketing to build capacity for service provision and evaluation.

    PubMed

    Conner, Ross F; Takahashi, Lois; Ortiz, Eloy; Archuleta, Eduardo; Muniz, Juan; Rodriguez, Julio

    2005-08-01

    Community-researcher partnerships can be powerful mechanisms to understand and effectively address health and social problems such as HIV/AIDS prevention. When the partnership is a positive, productive one, the combined expertise and energy of both parties result in a more effective program and a better evaluation of its effects. This article describes one such partnership and how a program challenge provided the opportunity for both partners to develop new capacities and strengthen others. The program is Proyecto SOLAAR, a community-based and culturally-sensitive HIV prevention program for gay and bisexual Latino men. The program is an experiential, daylong retreat focused on personal aspects of the men (e.g., self-concept), ideas about and aspects of their relationship behavior (e.g., cultural misunderstandings, dating behavior), and HIV prevention; there is a follow-up reunion a month later to share experiences with other participants about new dating and HIV prevention behaviors. The article focuses in particular on how the partners built new capacity in the area of social marketing to address the challenge of participant recruitment and describes the components of the new campaign. These components included distinctive images in ads in publications read by the target population, a toll-free telephone number and Web site for easy initial contact with the program, phone cards and postcards featuring the specially created program image to reinforce a connection to the program, and other aspects. The article describes the partnership between the HIV service providers and the researchers and how the collaborative effort was key to understanding and addressing the recruitment problem, identifying potential solutions, and implementing the new social marketing strategy. This process resulted in four kinds of capacities that were built or strengthened, including program recruitment, program content and implementation, program evaluation, and the partnership itself. The

  9. Monitoring and Evaluating the National Program to Prevent Mother-to-Child HIV Transmission in Thailand

    ERIC Educational Resources Information Center

    Kanshana, Siripon; Naiwatanakul, Thananda; Simonds, R. J.; Amornwichet, Pornsinee; Teeraratkul, Achara; Culnane, Mary; Chantharojwong, Nartlada; Limpakarnjanarat, Khanchit

    2004-01-01

    Thailand has had an epidemic of heterosexually transmitted human immunodeficiency virus (HIV) infection since the mid-1980s that has affected both high-risk populations (such as commercial sex workers) and low-risk populations (such as wives of men who have sex with commercial sex workers). As a result, the prevalence of HIV infection among…

  10. The Evaluation of a Latino Community Health Worker HIV Prevention Program

    ERIC Educational Resources Information Center

    Martin, Molly; Camargo, Maria; Ramos, Lori; Lauderdale, Diane; Krueger, Kristin; Lantos, John

    2005-01-01

    This study evaluated the effectiveness of a community health promotion project to increase HIV knowledge in an urban, immigrant Latino community in Chicago. Latino participants (N = 704) answered questions on HIV before and after an education intervention given by community health workers. Outcomes included changes in knowledge and self-perceived…

  11. What Would Your Journal Say if It Could Talk Back? Using Dialogue Journals as a Technique in Adolescent HIV/STI Prevention and Sexual Health Promotion Programs

    ERIC Educational Resources Information Center

    Sclafane, Jamie Heather

    2013-01-01

    Dialogue journaling is a technique that is useful for enhancing the goals of sexual health promotion and HIV/STI prevention programs with 14-to 17-year-old at-risk youth. Included is a detailed lesson plan on how to implement dialogue journaling in this context, a discussion of advantages and concerns about using them, and future implications for…

  12. A School-Based Program to Improve Life Skills and to Prevent HIV Infection in Multicultural Transgendered Youth in Hawai'i

    ERIC Educational Resources Information Center

    Bopp, P. Jayne; Juday, Timothy R.; Charters, Cloudia W.

    2004-01-01

    Chrysalis is a weekly after-school drop-in group on O'ahu high school campuses for transgendered and questioning youth. Nine Chrysalis members, nine demographically matched TG youth, and five key informants participated in a study to evaluate program effectiveness in improving life skills and preventing HIV infection. Chrysalis members scored…

  13. The Solaar HIV Prevention Program for Gay and Bisexual Latino Men: Using Social Marketing to Build Capacity for Service Provision and Evaluation

    ERIC Educational Resources Information Center

    Conner, Ross F.; Takahashi, Lois; Ortiz, Eloy; Archuleta, Eduardo; Muniz, Juan; Rodriguez, Julio

    2005-01-01

    Community-researcher partnerships can be powerful mechanisms to understand and effectively address health and social problems such as HIV/AIDS prevention. When the partnership is a positive, productive one, the combined expertise and energy of both parties result in a more effective program and a better evaluation of its effects. This article…

  14. Individual-Level Predictors of Nonparticipation and Dropout in a Life-Skills HIV Prevention Program for Adolescents in Foster Care

    ERIC Educational Resources Information Center

    Thompson, Ronald G., Jr.; Auslander, Wendy F.; Alonzo, Dana

    2012-01-01

    The purpose of this study is to identify individual-level characteristics of foster care adolescents who are more likely to not participate in, and drop out of, a life-skills HIV prevention program delivered over 8 months. Structured interviews were conducted with 320 foster care adolescents (15-18 years). Logistic regression and survival analyses…

  15. Differentiated Typology of Sex Work and Implication for HIV Prevention Programs among Female Sex Workers in Nepal

    PubMed Central

    Mishra, Shiva Raj; Neupane, Sanjeev Raj

    2015-01-01

    Background: Sex work in exchange for kind and cash has long been practiced in Nepal. The HIV prevention program in Nepal is focused mainly on these two typologies of sex work. There might be more typologies of sex work beyond streets and establishments seeking research and programmatic attention. The objective of the study is to explore the differentiated typologies of sex work. Methods: This is a cross-sectional study conducted using a qualitative technique. Researchers carried out eight Focus Group Discussions with female sex workers (FSWs) (n = 50) in different places of Tanahu district. Data were analyzed using a deductive thematic analysis approach. Results: We identified a more differentiated typology of sex work. Private contact-based sex work and the covert sex work on the cruising areas along the major highways were common. Sex work has become easier to operate with the advent of new technologies such as cell phone. With limited role of facilitation by brokers and pimps, now FSWs are better off and have longer duration of relationship with clients. Soft prostitution was common, as FSWs complemented their income through sex work. Conclusion: The conventional mode of peer and outreach educational approach needs to be further strengthened and modified according to the changing typology of sex work. HIV testing sites need to be further expanded to cruising areas along the highways. PMID:25785259

  16. Urban African-American males' perceptions of condom use, gender and power, and HIV/STD prevention program.

    PubMed Central

    Kennedy, Stephen B.; Nolen, Sherry; Applewhite, Jeffrey; Waiter, Elizabeth

    2007-01-01

    The overall goal of the research project was to develop, administer and assess a brief male-focused condom promotion program for inner-city young adult African-American males. To achieve that goal, we conducted a formative study consisting of both quantitative and qualitative research methods. For the qualitative component, which was guided by the relevant tenets of the social cognitive theory and the stages of change model, a series of focus group discussions was conducted among the target population based upon a thematic topic guide that covered three broad areas: young men's perceptions of condom use relative to pregnancy and HIV/sexually transmitted disease (STD) prevention, gender-based issues surrounding condom use, and potential guidelines for the development of customized condom promotion programs. Those focus group discussions were audiotaped and the transcribed data summarized and analyzed based on those thematic topics. The findings revealed that respondents were more likely to assume that they know the risk behaviors of their sexual partners, more likely to consider pregnancy as a socially desirable outcome, more likely to control condom use within relationship dynamics and sexual contexts, and also more likely to provide suggestions on suitable components for program development. The implications and limitations of those findings from this qualitative component of the project are herein described, including potential recommendations for program development. PMID:18229776

  17. Government priorities for preventing HIV / AIDS.

    PubMed

    Ainsworth, M

    1998-08-01

    No cure has been found for HIV/AIDS. Therefore, until one is found which is affordable and feasible for use in developing countries, preventing HIV infection is the best way to combat the HIV/AIDS pandemic. All of the many biological characteristics of HIV which affect its rate of spread in a population can be affected through individual behavior. The two most important behaviors which spread HIV are having sexual intercourse with an HIV-infected sex partner without using a condom and sharing unsterilized drug injecting equipment. Strategies to reduce risky behavior include providing information, lowering the costs of condom use and safe injecting behavior, and raising the costs of risky behavior. The costs of condom use include the financial and time costs of buying the condoms, the potential inconvenience and social embarrassment of buying and using them, and reduced pleasure among some users. IV drug users face the problems of getting into and remaining in drug treatment programs, and obtaining sterile injecting equipment. Government priorities in preventing HIV/AIDS and mobilizing political support against AIDS are discussed.

  18. HIV / AIDS: Symptoms, Diagnosis, Prevention and Treatment

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: Symptoms , Diagnosis, Prevention and Treatment Past Issues / ... Most people who have become recently infected with HIV will not have any symptoms. They may, however, ...

  19. Risk, HIV, and STD prevention.

    PubMed

    1999-06-01

    The risk of becoming infected with HIV and other sexually transmitted diseases (STDs) is discussed. The concept of risk is defined in three ways: the risk of exposure to an infectious agent, the risk of infection after exposure, and the risk of severe consequences after infection. Determining the most effective STD prevention intervention for a person involves assessing his or her beliefs regarding each type of risk and adapting the discussion of STD prevention accordingly. Preventive behavior questions should be phrased conditionally to indicate both use, and lack of use, of precautionary behaviors. This will aid a counselor's assessment of a client's beliefs and the resultant behavior. Some STDs, such as herpes simplex and chlamydia, are more common than HIV, increase susceptibility to HIV by two to six times, and should not be omitted from the discussion of risk of infection.

  20. Multidimensionality Matters: An Effective HIV, Hepatitis C, and Substance-Use Prevention Program for Minority Parolees

    ERIC Educational Resources Information Center

    Shepherd, Jennifer L.; Fandel, Johnna; Esposito, Rashaun; Pace, Elizabeth; Banks, Mekka; Denious, Jean E.

    2012-01-01

    African Americans and Hispanics are more likely than Whites to be incarcerated, and are also disparately affected by HIV, hepatitis C, and substance use. Reaching these populations as they leave prison is important given high rates of substance use and sexual risk-taking behaviors among U.S. prisoners. A 12-session, culturally appropriate,…

  1. HIV prevention transformed: the new prevention research agenda.

    PubMed

    Padian, Nancy S; McCoy, Sandra I; Karim, Salim S Abdool; Hasen, Nina; Kim, Julia; Bartos, Michael; Katabira, Elly; Bertozzi, Stefano M; Schwartländer, Bernhard; Cohen, Myron S

    2011-07-16

    We have entered a new era in HIV prevention whereby priorities have expanded from biomedical discovery to include implementation, effectiveness, and the effect of combination prevention at the population level. However, gaps in knowledge and implementation challenges remain. In this Review we analyse trends in the rapidly changing landscape of HIV prevention, and chart a new path for HIV prevention research that focuses on the implementation of effective and efficient combination prevention strategies to turn the tide on the HIV pandemic. PMID:21763938

  2. Capacity building for HIV / AIDS prevention.

    PubMed

    Loughran, L

    1995-07-01

    Some organizations involved in programs to prevent HIV/AIDS have considerable skill and experience, while others have only minimal skill and experience with which to achieve project goals. Some organizations consistently deliver high quality services when and where individuals and communities need them, while others have neither the infrastructure nor experience to sustain their efforts independently. No single nongovernmental organization (NGO) can do all that is needed to prevent and control HIV/AIDS. NGOs need to instead learn what are their real capacities to deliver services. The success and quality of HIV/AIDS prevention programs depend upon long-term investments to build the technical and organizational capacities of the public, private, and NGO institutions which deliver services. These investments are made to enhance the ability of organizations and national programs to design, manage, evaluate, and sustain their own prevention programs. Capacity building is defined with discussion of skill building, organizational development, and networking. The author also discusses constraints, capacity building as a controversial component of development programs, evaluating capacity building, and accountability. PMID:12291829

  3. Barriers to the Assessment of Unmet Need in Planning HIV/AIDS Prevention Programs.

    ERIC Educational Resources Information Center

    Valdiserri, Ronald O.; West, Gary R.

    1994-01-01

    Major barriers to conducting needs assessment for AIDS prevention are resource deficits, technical deficits, environmental complexity, and apprehension about expectations. Comprehensive, methodologically sound assessments conducted collaboratively by consumers and providers of prevention services are essential. (SK)

  4. National Implementation of an Evidence-Based HIV Prevention and Reproductive Health Program for Bahamian Youth

    PubMed Central

    Knowles, Valerie; Kaljee, Linda; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Stanton, Bonita

    2014-01-01

    A wide range of behavioral prevention interventions have been demonstrated through longitudinal, randomized controlled trials to reduce sexual risk behaviors. Many of these interventions have been made available at little cost for implementation on a public health scale. However, efforts to utilize such programs typically have been met with a range of problems to be addressed, leading to the recognition that new processes must be identified and integrated into the emerging field of implementation science. A randomized, controlled trial conducted among Bahamian grade six students attending fifteen elementary schools found the sexual risk-reduction intervention “Focus on Youth in the Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT)” to be effective through three years of follow-up. Based on these results, the Bahamian Ministry of Education decided to implement FOYC-CImPACT throughout all government grade six classes in The Bahamas. This manuscript describes the considerations, approaches, and actions taken regarding national implementation of this evidence-based intervention. The implementation process included active data-gathering, observation and feedback components to inform subsequent intervention phases. This manuscript reviewed the success and challenges to date within this framework and described changes made to enable next stages of the national implementation effort. PMID:25197265

  5. 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…

  6. Building a peer network for a community level HIV prevention program among injecting drug users in Denver.

    PubMed Central

    Simons, P Z; Rietmeijer, C A; Kane, M S; Guenther-Grey, C; Higgins, D L; Cohn, D L

    1996-01-01

    As part of a multi-site Centers for Disease Control and Prevention-funded initiative, a community-level HIV prevention project targeting injection drug users was implemented in the FivePoints community in Denver, Colorado. The protocol for the initiative included the use of peer networks to conduct outreach and disseminate intervention materials to injecting drug users. Since April 1993, project staff established a peer network of 119 participants who distribute approximately 3,000 materials per month. PMID:8862157

  7. Combination prevention: a deeper understanding of effective HIV prevention.

    PubMed

    Hankins, Catherine A; de Zalduondo, Barbara O

    2010-10-01

    Evidence-informed and human rights-based combination prevention combines behavioural, biomedical, and structural interventions to address both the immediate risks and underlying causes of vulnerability to HIV infection, and the pathways that link them. Because these are context-specific, no single prescription or standard package will apply universally. Anchored in 'know your epidemic' estimates of where the next 1000 infections will occur and 'know your response' analyses of resource allocation and programming gaps, combination prevention strategies seek to realign programme priorities for maximum effect to reduce epidemic reproductive rates at local, regional, and national levels. Effective prevention means tailoring programmes to local epidemics and ensuring that components are delivered with the intensity, quality, and scale necessary to achieve intended effects. Structural interventions, addressing the social, economic, cultural, and legal constraints that create HIV risk environments and undermine the agency of individuals to protect themselves and others, are also public goods in their own right. Applying the principles of combination prevention systematically and consistently in HIV programme planning, with due attention to context, can increase HIV programme effectiveness. Better outcome and impact measurement using multiple methods and data triangulation can build the evidence base on synergies between the components of combination prevention at individual, group, and societal levels, facilitating iterative knowledge translation within and among programmes. PMID:21042055

  8. Use of service data to inform pediatric HIV-free survival following prevention of mother-to-child transmission programs in rural Malawi

    PubMed Central

    2012-01-01

    Background Recent years have seen rapid and significant progress in science and implementation of programs to prevent mother-to-child transmission of HIV. Programs that support PMTCT routinely monitor service provision but very few have measured their effectiveness. The objective of the study was to use service data to inform HIV-free survival among HIV exposed children that received antiretroviral drugs to prevent mother-to-child transmission (PMTCT) of HIV. The study was conducted in two rural districts in Malawi with support from FHI 360. Methods A descriptive observational study of PMTCT outcomes was conducted between June 2005 and June 2009. The dataset included patient-level data of all pregnant women 1) that tested HIV-positive, 2) that were dispensed with antiretroviral prophylaxis, and 3) whose addresses were available for home visits. The data were matched to each woman’s corresponding antenatal clinic data from home visit registers. Results Out of 438 children whose home addresses were available, 33 (8%) were lost to follow-up, 35 (8%) were alive but not tested for HIV by the time home visit was conducted, and 52 (12%) were confirmed deceased. A total of 318 children were alive at the time of the home visit and had an HIV antibody test done at median age 15 months. The resulting estimated 24-month probability of HIV-free survival over all children was 78%. Among children who did not receive nevirapine, the estimated 24-month probability of HIV-free survival was 61%, and among those who did receive NVP syrup the estimate was 82%. Conclusions When mothers and newborns received nevirapine, the estimated 24-month probability of HIV-free survival among children was high at 82% (CI: 54% to 99%). However this conclusion should be interpreted cautiously 1) due to the wide confidence interval; and 2) because the confidence interval range includes 55%, which is the natural HIV-free survival rate in the absence of a PMTCT intervention. This analysis highlighted

  9. Asserting a Positive Role: HIV-Positive People in Prevention

    ERIC Educational Resources Information Center

    Allan, Brent; Leonard, William

    2005-01-01

    The best HIV prevention programs--those that effect change on a multiplicity of levels by changing knowledge, attitudes, and behaviors and that are sustained over time--are also those that place HIV-positive people at the center of program design, implementation, and evaluation.

  10. Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

    PubMed Central

    Kamali, Anatoli; Price, Matt A.; Lakhi, Shabir; Karita, Etienne; Inambao, Mubiana; Sanders, Eduard J.; Anzala, Omu; Latka, Mary H.; Bekker, Linda-Gail; Kaleebu, Pontiano; Asiki, Gershim; Ssetaala, Ali; Ruzagira, Eugene; Allen, Susan; Farmer, Paul; Hunter, Eric; Mutua, Gaudensia; Makkan, Heeran; Tichacek, Amanda; Brill, Ilene K.; Fast, Pat; Stevens, Gwynn; Chetty, Paramesh; Amornkul, Pauli N.; Gilmour, Jill

    2015-01-01

    HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner. PMID:25602351

  11. Personalized Biobehavioral HIV Prevention for Women and Adolescent Girls

    PubMed Central

    Teitelman, Anne M.; Bevilacqua, Amanda W.; Jemmott, Loretta Sweet

    2013-01-01

    Background: Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. Primary Study Objective: The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. Methods: We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. Results: The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk—reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk—reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Conclusions: Generalized programs and

  12. Informing Comprehensive HIV Prevention: A Situational Analysis of the HIV Prevention and Care Context, North West Province South Africa

    PubMed Central

    Lippman, Sheri A.; Treves-Kagan, Sarah; Gilvydis, Jennifer M.; Naidoo, Evasen; Khumalo-Sakutukwa, Gertrude; Darbes, Lynae; Raphela, Elsie; Ntswane, Lebogang; Barnhart, Scott

    2014-01-01

    Objective Building a successful combination prevention program requires understanding the community’s local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. Method The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO’s Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. Results We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Conclusions Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four ‘themes’ identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills

  13. Positive images: primary prevention for people with HIV.

    PubMed

    Senterfitt, W

    1998-06-01

    The Los Angeles City Council authorized a pilot project targeting the prevention needs of HIV-positive city residents. The Positive Images Program offers a drop-in support group program and a chat line for seropositives to talk anonymously about their HIV status and general living. The differences that were found during the discussion groups, among male and female responses, are discussed. The program is viewed as a powerful step toward enlisting seropositives in the primary prevention of HIV and offering easy access to a facilitated discussion of emotionally charged issues. It is designed to allow a deeper understanding of the attitudes and behaviors needed to help stem the epidemic's growth.

  14. Latino recruitment and retention strategies: community-based HIV prevention.

    PubMed

    McQuiston, C; Uribe, L

    2001-04-01

    Latinos are disproportionately affected by HIV/AIDS. The need for community-based AIDS prevention programs that are culture specific is well recognized. Lay Health Advisor (LHA) interventions are a culturally appropriate way to provide information about HIV/AIDS to community members. LHA programs use natural helpers in the community to disseminate information through their social networks. Natural helpers are community members who informally provide support to their neighbors and to whom others naturally turn for advice. This paper reports the recruitment and retention experiences of a Lay Health Advisor Program: Protegiendo Nuestra Familia (Protecting Our Family) for prevention of HIV/AIDS among Latinos in North Carolina.

  15. Building capacity for HIV/AIDS prevention among Asian Pacific Islander organizations: the experience of a culturally appropriate capacity-building program in Southern California.

    PubMed

    Takahashi, Lois M; Candelario, Jury; Young, Tim; Mediano, Elizabeth

    2007-01-01

    This article has two goals: (1) to outline a conceptual model for culturally appropriate HIV prevention capacity building; (2) to present the experiences from a 3-year program provided by Asian Pacific AIDS Intervention Team to Asian Pacific Islander (API) organizations in southern California. The participating organizations were of two types: lesbian, gay, bisexual, transgender, and questioning (LGBTQ) social organizations and social service agencies not targeting LGBTQ. These organizations were selected for participation because of their commitment to HIV/AIDS issues in API communities. An organizational survey and staff observations were used to explore changes in capacity. The organizations were mostly small, targeted diverse populations, served a large geographic area (southern California as a region), and were knowledgeable about HIV. Organizations became more viable (more capacity in human resources, financial, external relations, and strategic management), but also more unstable (large growth in paid staff and board members), and showed more capacity in HIV knowledge environments (especially less stigma and more sensitivity to diverse populations). The results suggest that capacity can expand over a short period of time, but as capacity increases, organizational viability/stability and HIV knowledge environments change, meaning that different types of technical assistance would be needed for sustainability.

  16. Mothers' Voices: Enhancing Mother-Child Communication for HIV Prevention

    ERIC Educational Resources Information Center

    Silitsky, Cindy; Jones, Sande Gracia

    2004-01-01

    Parents are an important component of HIV prevention efforts for adolescents. The purpose of this study was to work with a community-based organization, Mothers' Voices South Florida, to evaluate the effectiveness of their educational program that teaches mothers how to talk to their children about HIV and safer sexual practices. Questionnaires…

  17. School-Based HIV Prevention: A Multidisciplinary Approach.

    ERIC Educational Resources Information Center

    Kerr, Dianne L.; And Others

    This manual was written to help school-based professionals implement school health education programs to prevent the spread of the human immunodeficiency virus (HIV). The manual provides a framework and plan to promote an interdisciplinary approach to HIV education in schools. The manual begins with a review of basic facts about acquired immune…

  18. An STD/HIV prevention intervention framework.

    PubMed

    Cohen, D A; Scribner, R

    2000-01-01

    Historically, interventions to prevent STD/HIV transmission have been categorized by program methodology rather than defining the content and nature of the intervention. A new taxonomy is needed to help expand the scope of interventions that can be used to prevent STD and HIV transmission. The taxonomy defines two major types of interventions, individual-level and structural level. The former targets risk factors attributable to individuals. Structural interventions target conditions outside the control of the individual. Individual-level interventions focus on counseling, screening, and treatment. They include psychological and biological interventions. Structural-level interventions address accessibility of relevant consumer products (condoms, needles), physical structures (e.g. blighted and abandoned housing, lighting, design of social facilities), social structures (policies that facilitate or constrain behaviors such as supervision of youth, and enforcement of alcohol beverage laws); and media messages (messages and images in the broadcast and print media that portray high-risk behaviors as positive and without serious consequences). A new taxonomy not only clarifies the content of preventive interventions but highlights neglected strategies involving individual biological interventions and structural interventions to prevent STD/HIV transmission.

  19. The Global HIV Archive: Facilitating the Transition from Science to Practice of Efficacious HIV Prevention Interventions*

    PubMed Central

    Card, Josefina J.; Newman, Emily N.; Golden, Rachel E.; Kuhn, Tamara; Lomonaco, Carmela

    2014-01-01

    This paper describes the development, content, and capabilities of the online Global HIV Archive (GHA). With the goal of facilitating widespread adaptation and appropriate use of efficacious HIV prevention programs throughout the globe, GHA has: first, expanded and updated the search for HIV prevention programs originating in low-resource countries; second, identified those meritorious HIV prevention programs meeting established efficacy criteria of technical merit, replicability, and positive outcomes; third, prepared both implementation and evaluation materials from the efficacious programs for public use; fourth, developed interactive wizards or capacity-building tools to facilitate appropriate program selection, implementation, and adaptation; and, fifth, made the efficacious programs and accompanying wizards available to health practitioners throughout the globe in both printed and online formats. PMID:24563820

  20. HIV prevention transformed: the new prevention research agenda

    PubMed Central

    Padian, Nancy S.; McCoy, Sandra I.; Karim, Salim Abdool; Hasen, Nina; Kim, Julia; Bartos, Michael; Katabira, Elly; Bertozzi, Stefano; Schwartländer, Bernhard; Cohen, Myron S.

    2013-01-01

    SUMMARY We have entered a new era in HIV prevention whereby priorities have expanded from biomedical discovery to include implementation, effectiveness, and the effect of combination prevention at the population level. However, gaps in knowledge and implementation challenges remain. In this Review we analyse trends in the rapidly changing landscape of HIV prevention, and chart a new path for HIV prevention research that focuses on the implementation of effective and efficient combination prevention strategies to turn the tide on the HIV pandemic. PMID:21763938

  1. Effectiveness of Integrated HIV Prevention Interventions among Chinese Men Who Have Sex with Men: Evaluation of a 16-City Public Health Program

    PubMed Central

    Ye, Shaodong; Xiao, Yan; Jin, Canrui; Cassell, Holly; Blevins, Meridith; Sun, Jiangping; Vermund, Sten H.; Qian, Han-Zhu

    2012-01-01

    To examine the impacts of a multi-city HIV prevention public health program (China Global Fund Round 5 Project) on condom use and HIV infection, we analyzed four yearly cross-sectional surveys from 2006 through 2009 among 20,843 men who have sex with men (MSM) in 16 Chinese cities. Self-reported condom use at last sex with a male partner increased from 58% in 2006 to 81% in 2009 (trend test, P<0.001). HIV prevalence increased from 2.3% in 2006 to 5.3% in 2009 (P<0.001). Multivariable logistic regression analysis showed that self-reported receipt of interventions was an independent predictor of increased condom use at last sex with a male partner over time (adjusted odds ratio [aOR], 1.63 in 2006 to 2.33 in 2009; P<0.001), and lower HIV prevalence (aOR, 1.08 in 2006 to 0.45 in 2009; P<0.001). HIV prevalence increased from 2006–2009 for participants with no self-reported receipt of interventions (2.1% in 2006 to 10.3% in 2009) and less so for those with interventions (2.4% to 4.7%). This Chinese public health program had positive impacts on both behaviors and disease rate among MSM population. Escalation of the coverage and intensity of effective interventions is needed for further increasing condom use and for reversing the rising trend of HIV epidemic. PMID:23300528

  2. Integrating HIV Care and HIV Prevention: Legal, Policy, and Programmatic Recommendations

    PubMed Central

    Remien, Robert H.; Berkman, Alan; Myer, Landon; Bastos, Francisco I.; Kagee, Ashraf; El-Sadr, Wafaa

    2009-01-01

    Since the start of the HIV epidemic we have witnessed significant advances in our understanding of the impact of HIV disease worldwide. Further, breakthroughs in treatment and the rapid expansion of HIV care and treatment programs in heavily impacted countries over the past five years are potentially critical assets in a comprehensive approach to controlling the continued spread of HIV globally. A strategic approach to controlling the epidemic requires continued and comparable expansion and integration of care, treatment, and prevention programs. As every new infection involves transmission, whether vertically or horizontally, from a person already living with HIV/AIDS (PLWHA), integration of HIV prevention into HIV care settings has the potential to prevent thousands of new infections, as well as improve the lives of PLWHAs. In this paper, we highlight how to better utilize opportunities created by the antiretroviral (ARV) roll-out to achieve more effective prevention, particularly in Sub Saharan Africa. We offer specific recommendations for action in the domains of healthcare policy and practice in order to better utilize the advances in HIV treatment to advance HIV prevention. PMID:18641470

  3. eHealth interventions for HIV prevention

    PubMed Central

    Noar, Seth M.; Willoughby, Jessica Fitts

    2015-01-01

    The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed. PMID:22519523

  4. Implementation and evaluation of an isoniazid preventive therapy pilot program among HIV-infected patients in Vietnam, 2008–2010

    PubMed Central

    Trinh, Thuy T.; Han, Dien T.; Bloss, Emily; Le, Thai H.; Vu, Tung T.; Mai, Anh H.; Nguyen, Nhung V.; Nguyen, Long T.; Dinh, Sy N.; Whitehead, Sara

    2016-01-01

    Background WHO recommends screening for TB and evaluation for isoniazid preventive therapy (IPT) based on evidence that they reduce TB-related morbidity and mortality among HIV-infected persons. In Vietnam, an IPT pilot was implemented in two provinces; TB screening, treatment and outcomes were evaluated to inform the adoption and scale-up of IPT. Methods During April 2008 to March 2010, eligible HIV-infected persons aged >15 years, with no previous or current TB treatment, alcohol abuse or liver disease were screened for TB. If TB disease was ruled out based on symptoms, chest x-rays and sputum smears, isoniazid was administered for 9 months. Results Among 1281 HIV-infected persons who received initial eligibility screening, 520 were referred to and evaluated at district TB clinics for TB disease or IPT eligibility. Active TB was diagnosed in 17 patients and all were started on treatment. Of 520 patients evaluated, 416 (80.0%) initiated IPT: 382 (91.8%) completed IPT, 17 (4.1%) stopped treatment, 8 (1.9%) died, 3 (0.7%) developed TB during IPT and 6 (1.4%) had unknown outcomes. No severe adverse events were reported. Conclusions IPT treatment completion was high; no serious complications occurred. Improving and expanding intensified case-finding and IPT should be considered in Vietnam. PMID:26385936

  5. HIV Prevention Readiness in Undergraduates and Inmates.

    ERIC Educational Resources Information Center

    Antonio, Michael E.; And Others

    Prevention of Human Immunodeficiency Virus (HIV) transmission is increasingly an international priority. Education of high-risk populations, such as incarcerated individuals, is particularly important in thwarting the spread of HIV. To address this concern, the attitudes, beliefs, and knowledge of inmates concerning HIV and AIDS related issues are…

  6. Opportunity Knocks: HIV Prevention in Primary Care.

    PubMed

    Thrun, Mark W

    2014-06-01

    Expansions in health care coverage, a comprehensive framework for HIV prevention and care, electronic medical records, and novel HIV prevention modalities create a current opportunity to change the trajectory of the HIV epidemic in the United States. HIV is increasingly disproportionately found in populations historically at higher risk, including gay men and other men who have sex with men, transgender women, injection drug users, and persons of color. This underscores the need for providers to identify persons at higher risk for HIV and assure the provision of screening and prevention services. In turn, universal screening for HIV-testing every adolescent and adult at least once in their lifetime-will increasingly be necessary to find the infrequent cases of HIV in lower risk populations. In both these domains, primary care providers will play a unique role in complementing traditional providers of HIV prevention and care services by increasing the proportion of their patients who have been screened for HIV, opening dialogues around sexual health, including asking about sexual orientation and gender identity, and prescribing antivirals as pre- and postexposure prophylaxis for their non-HIV-infected patients. Primary care providers must understand and embrace their importance along the HIV prevention and care continuum. PMID:26789615

  7. Empowering Peer Group Leaders for HIV Prevention in Malawi

    PubMed Central

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

    2013-01-01

    Purpose 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. Design 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. Methods We used inductive content analysis and comparisons within and between cases. Findings: 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. Conclusion 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. Clinical Relevance 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. PMID:23590557

  8. Preventing the spread of HIV infection.

    PubMed

    Perry, Nicky

    Approximately 96,000 people are living with HIV in the UK, a quarter of whom are unaware they are infected. While in some parts of the world the number of people newly infected with HIV has fallen, in the UK in 2011 there was a rise in the number of men who have sex with men being diagnosed. HIV prevention strategies are a public health priority, while ongoing research into HIV testing in all clinical settings remains a priority. This article explores preventive measures that can be used to reduce the spread of HIV and offers advice on how nurses can contribute to these.

  9. Descriptive study of the utility of individual tracking tool in program monitoring for prevention of mother-to-child transmission of HIV, Maharashtra, India

    PubMed Central

    Gupta, R.S.; Hegde, Asha; Mulik, Tejas; Yewale, Kiran; Babu, P.K. Amarnath; Pardeshi, Kushalsinh; Balkrishnan, Sudha; Seguy, Nicole; Reddy, D.C.S.

    2016-01-01

    Objective The objective is to describe the utility of prevention of parent-to-child transmission tracking tool in terms of the in-depth information that it provides for better decision making to improve the services. Methods The excel-based tracking tool is initiated by 578 Integrated Counselling and Testing Centre (ICTC) Counsellor and shared with 70 antiretroviral treatment (ART) centres. Between April and September 2014, total of 1118 HIV-infected pregnant women were registered in the tool. The secondary data for this period that is captured in the prevention of parent-to-child transmission tracking tool has been analyzed and presented in this descriptive study. Results Of the total 1118 HIV-positive pregnant women, registered in the tool, 760 (68%) were newly detected with HIV infection and 358 (32%) had already been detected before their current pregnancy. In total, 1095 (98%) pregnant women were registered at ART centre out of which 1007 (91%) were initiated on lifelong ART. The average time delay between HIV detection and registration at ART centre was 12 days (n = 844). In this cohort of 1118 pregnant women, 45% delivered live babies, 7% underwent medical termination of pregnancy, 2% were stillbirths and abortions, and 46% were yet to deliver. Only 29 infants were tested for HIV at 6 weeks of age and six were found reactive. Conclusion The tracking tool provides in-depth information regarding the pregnant women registered in the program and in the tracking tool. The information throws more light on the characteristics of the registered women and the various services provided to them and highlight key areas where the program has to be improved. The tool is effective for assessing the treatment status of HIV-positive pregnant woman, retention in care and early infant diagnosis of the baby. The tool has identified programmatic bottlenecks component wise such as the need to focus on earlier detection of HIV-positive women during pregnancy, decreasing the

  10. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    PubMed

    Wilson, David

    2015-06-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  11. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs

    PubMed Central

    Wilson, David

    2015-01-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work. PMID:26079267

  12. Should home-based HIV testing and counseling services be offered periodically in programs of ARV treatment as prevention? A case study in Likoma (Malawi)

    PubMed Central

    Helleringer, Stéphane; Mkandawire, James; Reniers, Georges; Kalilani-Phiri, Linda; Kohler, Hans-Peter

    2012-01-01

    To reduce HIV incidence, prevention programs centered on the use of antiretrovirals require scaling-up HIV testing and counseling (HTC). Home-based HTC services (HBHTC) increase HTC coverage, but HBHTC has only been evaluated during one-off campaigns. Two years after an initial HBHTC campaign (“round 1”), we conducted another HBHTC campaign (“round 2”) in Likoma (Malawi). HBHTC participation increased during round 2 among women (from 74% to 83%, p<0.01). New HBHTC clients were recruited, especially at ages 25 and older. Only 6.9% of women but 15.9% of men remained unreached by HBHTC after round 2. HIV prevalence during round 2 was low among clients who were HIV-negative during round 1 (0.7%), but high among women who first tested during round 2 (42.8%). The costs per newly diagnosed infection increased significantly during round 2. Periodically conducting HBHTC campaigns can further increase HTC, but supplementary interventions to enroll individuals not reached by HBHTC are needed. PMID:23180155

  13. Advances in HIV Prevention for Serodiscordant Couples

    PubMed Central

    Muessig, Kathryn E.; Cohen, Myron S.

    2014-01-01

    Serodiscordant couples play an important role in maintaining the global HIV epidemic. This review summarizes biobehavioral and biomedical HIV prevention options for serodiscordant couples focusing on advances in 2013 and 2014, including World Health Organization guidelines and best-evidence for couples counseling, couples-based interventions, and the use of antiviral agents for prevention. In the past few years marked advances have been made in HIV prevention for serodiscordant couples and numerous ongoing studies are continuously expanding HIV prevention tools, especially in the area of pre-exposure prophylaxis. Uptake and adherence to antiviral therapy remains a key challenge. Additional research is needed to develop evidence-based interventions for couples, and especially for male-male couples. Randomized trials have demonstrated the prevention benefits of antiretroviral-based approaches among serodiscordant couples; however, residual transmission observed in recognized serodiscordant couples represents an important and resolvable challenge in HIV prevention. PMID:25145645

  14. 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. PMID:26412083

  15. Antibodies for HIV Prevention in young women

    PubMed Central

    Abdool Karim, Salim S.; Karim, Quarraisha Abdool; Baxter, Cheryl

    2016-01-01

    Purpose of review Young women in sub-Saharan Africa bear a disproportionate HIV burden. They urgently require new HIV prevention approaches that women can use. This review provides an overview of the use of antiretrovirals for HIV pre-exposure prophylaxis (PrEP), highlighting some of the challenges with this technology and explores the potential role of monoclonal antibodies (mAbs) for HIV prevention in women. Recent findings Recent findings on the initial steps in viral entry and establishment of a productive local infectious nidus in the vaginal epithelium has provided important clues for HIV prevention in the female genital tract. Topical and oral formulations of antiretroviral drugs have been shown to prevent HIV infection in women with varying levels of success, depending principally on adherence. Further, a number of new broad and potent mAbs have been isolated over the last 5 years. Non-human primate studies demonstrate that broadly neutralizing HIV mAbs can protect rhesus macaques from SHIV infection. These findings have created newfound enthusiasm for passive immunization as a potential prevention strategy for women. Summary If potent broadly neutralising mAbs are effective in preventing HIV infection in women, it could fill an important gap in HIV prevention technologies for young women, especially in Africa. PMID:25700207

  16. HIV prevention: integrating biomedical and behevioral interventions.

    PubMed

    Del Rio, Carlos

    Recommendations for HIV prevention in clinical care settings by an IAS-USA panel were recently published. They include recommendations on HIV testing, antiretroviral therapy initiation, risk-reduction counseling, and antiretroviral therapy adherence counseling for HIV-infected individuals. For individuals at risk for HIV infection, recommendations for preexposure prophylaxis, other risk-reduction strategies, adherence counseling, and postexposure prophylaxis are included. Many HIV-infected individuals in the United States are not fully engaged in HIV care and are not virologically suppressed, thus a crucial component of efforts to reduce HIV transmission is moving patients through the HIV care continuum. This article summarizes an IAS-USA continuing education webinar presented by Carlos del Rio, MD, in September 2014.

  17. Risk appraisal and HIV prevention.

    PubMed

    Odets, W

    1996-09-01

    Previous HIV prevention efforts, particularly for gay men, focused largely on the elimination of risk through condom use or abstinence. However, as evidenced by current levels of new HIV seroconversions, gay men are still practicing unprotected anal sex. Many public health officials previously attributed this behavior to continued ignorance, chemically-induced impairment, malice, or psychopathology. Evidence now demonstrates that these factors have had little influence on risky behaviors. Researchers are finding that what is absent from the risk elimination strategy are the feelings about trust, intimacy, and sexual communication. Exercising harm reduction approaches that weigh the relative value of the activity and the costs of taking the risks is a better strategy. Client-centered counseling is a key means of facilitating this harm reduction approach. Designed to address some of the psychosocial issues, client-centered counseling takes into account an individual's experience of the risks and benefits involved, and allows the client to weigh personal values against potential risks. However, the strategy can be flawed when educators are not properly trained. Counselors and educators may find client-centered approaches uncomfortable if they have not examined their own value systems. Respect for clients, their values, and their efforts are necessary for effective client-centered counseling.

  18. Preventing Mother-to-Child Transmission of HIV during Childbirth

    MedlinePlus

    HIV and Pregnancy Preventing Mother-to-Child Transmission of HIV During Childbirth (Last updated 8/17/2015; last ... the risk of mother-to-child transmission of HIV reduced during childbirth? During childbirth, women with HIV ...

  19. Estimates of Intraclass Correlation Coefficients from Longitudinal Group-Randomized Trials of Adolescent HIV/STI/Pregnancy Prevention Programs

    ERIC Educational Resources Information Center

    Glassman, Jill R.; Potter, Susan C.; Baumler, Elizabeth R.; Coyle, Karin K.

    2015-01-01

    Introduction: Group-randomized trials (GRTs) are one of the most rigorous methods for evaluating the effectiveness of group-based health risk prevention programs. Efficiently designing GRTs with a sample size that is sufficient for meeting the trial's power and precision goals while not wasting resources exceeding them requires estimates of the…

  20. Effect of Social Cognitive Theory-Based HIV Education Prevention Program among High School Students in Nanjing, China

    ERIC Educational Resources Information Center

    Li, Xiaoming; Zhang, Liying; Mao, Rong; Zhao, Qun; Stanton, Bonita

    2011-01-01

    This study was designed to evaluate potential preventive effects of a cultural adaption of the Focus on Kids (FOK) program among Chinese adolescents through a quasi-experimental intervention trial in Nanjing, China. High school students were assigned to either experimental groups (n = 140) or control groups (n = 164) by schools (with three schools…

  1. Assessing Training Needs of HIV Program Providers

    ERIC Educational Resources Information Center

    Sleezer, Catherine M.; Spector, Melanie

    2006-01-01

    This article describes a mixed-methods needs assessment, or developmental evaluation, that was conducted for the providers and stakeholders of Oklahoma's community-based organizations (CBOs). The needs assessment, which was the first phase in developing training on outcome monitoring for their HIV prevention programs, relied on three evaluation…

  2. Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

    PubMed Central

    Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

    2013-01-01

    Background This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. Methods The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald’s business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). Results The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001). A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001), and participated in health exhibitions (6% to 35%, P < 0.001). Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001), and attended one-one counseling (15% to 21%, P < 0.01). Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001). Conclusion Adoption of a business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high

  3. Loss to Followup: A Major Challenge to Successful Implementation of Prevention of Mother-to-Child Transmission of HIV-1 Programs in Sub-Saharan Africa.

    PubMed

    Kalembo, Fatch W; Zgambo, Maggie

    2012-01-01

    Purpose. The purpose of this paper was to explore how loss to followup (LFTU) has affected the successful implementation of prevention of mother to child transmission of HIV-1 (PMTCT) programs in sub-Saharan Africa. Methods. We conducted an electronic search from the following databases PubMed, ScienceDirect, Directory of Open Access Journals (DOAJs), and PyscINFO. Additional searches were made in WHO, UNAIDS, UNICEF, Google, and Google scholar websites for (1) peer-reviewed published research, (2) scientific and technical reports, and (3) papers presented on scientific conferences. Results. A total of 678 articles, published from 1990 to 2011, were retrieved. Only 44 articles met our inclusion criteria and were included in the study. The rates of LTFU of mother-child pairs ranged from 19% to 89.4 in the reviewed articles. Health facility factors, fear of HIV-1 test, stigma and discrimination, home deliveries and socioeconomic factors were identified as reasons for LTFU. Conclusion. There is a great loss of mother-child pairs to follow up in PMTCT programs in sub-Saharan Africa. There is need for more research studies to develop public health models of care that can help to improve followup of mother-child pairs in PMTCT programs in Sub-Saharan Africa. PMID:24052879

  4. The Extent and Nature of Fluidity in Typologies of Female Sex Work in Southern India: Implications for HIV Prevention Programs.

    PubMed

    Jain, Anrudh K; Saggurti, Niranjan

    2012-04-01

    These authors examine the nature and extent of fluidity in defining the typology of female sex work based on the place of solicitation or place of sex or both places together, and whether sex workers belonging to a particular typology are at increased risk of HIV in southern India. Data are drawn from a cross-sectional survey conducted during 2007-2008 among mobile female sex workers (N = 5301) in four Indian states. Findings from this study address an important policy issue: Should programmatic prevention interventions be spread to cover all places of sex work or be focused on a few places that cover a large majority of sex workers? Results indicate that most female sex workers, including those who are usually hard to reach such as those who are mobile or who use homes for soliciting clients or sex, can be reached programmatically multiple times by concentrating on a smaller number of categories, such as street-, lodge-, and brothel-based sex workers.

  5. Impact of HIV on and the constructions of masculinities among HIV-positive men in South Africa: implications for secondary prevention programs

    PubMed Central

    Sikweyiya, Yandisa M.; Jewkes, Rachel; Dunkle, Kristin

    2014-01-01

    Background To date, whilst there have been many published studies exploring the links between masculinity and HIV, not much work has been done to explore how an HIV-positive diagnosis impacts men's sense of masculinity and contextualizing the masculinities as fluid and changing. Objective To explore how human immunodeficiency virus (HIV) impacts the lives of men and their constructions of masculinity through interviews with 18 men living with HIV. Design Qualitative study involving conveniently and purposively selected black South African adult men who lived with HIV. In-depth interviews were conducted with 18 men who resided in Johannesburg and Mthatha, South Africa. Results Our analysis suggests that the performance of risky masculinity may influence the acquisition of HIV. Yet, it also reveals that HIV can have a significant effect on men and their masculinities. Men's constructions of harmful notions of hegemonic masculinity pre-HIV diagnosis negatively affected their help-seeking behavior and coping and adjustment to living with HIV, post-diagnosis. The dominant discourse that men are strong and healthy visibly presented challenges for men when faced with an HIV-positive status. They interpreted HIV diagnosis as a loss, a sign of failure as a man, and evidence of an inability to retain control. Being sick undermined their ability to perform roles expected of them, and this led to feelings of powerlessness, worthlessness, and distress. Conclusions Interventions with men living with HIV need to provide safe spaces for men to critically explore gender and constructions of social identities and the pressures these place on men and implications for their health. With this approach, harmful constructions of masculinities may be challenged and mitigated, and this process may render men amenable to change. PMID:25280735

  6. The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals.

    PubMed Central

    Janssen, R S; Holtgrave, D R; Valdiserri, R O; Shepherd, M; Gayle, H D; De Cock, K M

    2001-01-01

    In the United States, HIV prevention programs have historically tailored activities for specific groups primarily on the basis of behavioral risk factors and demographic characteristics. Through the Serostatus Approach to Fighting the Epidemic (SAFE), the Centers for Disease Control and Prevention is now expanding prevention programs, especially for individuals with HIV, to reduce the risk of transmission as a supplement to current programs that primarily focus on reducing the risk of acquisition of the virus. For individuals with HIV, SAFE comprises action steps that focus on diagnosing all HIV-infected persons, linking them to appropriate high-quality care and prevention services, helping them adhere to treatment regimens, and supporting them in adopting and sustaining HIV risk reduction behavior. SAFE couple a traditional infectious disease control focus on the infected person with behavioral interventions that have been standard for HIV prevention programs. PMID:11441723

  7. Rethinking Prevention of HIV Type 1 Infection

    PubMed Central

    Burns, David N.; Dieffenbach, Carl W.; Vermund, Sten H.

    2010-01-01

    Research on the prevention of human immunodeficiency virus (HIV)–1 infection is at a critical juncture. Major methodological challenges to performing prevention trials have emerged, and one after another promising biomedical interventions have failed to reduce the incidence of HIV-1 infection. Nevertheless, there is growing optimism that progress can be achieved in the near term. Mathematical modeling indicates that 2 new strategies, “test and treat” and preexposure prophylaxis, could have a major impact on the incidence of HIV-1 infection. Will our hopes be justified? We review the potential strengths and limitations of these antiretroviral “treatment as prevention” strategies and outline other new options for reducing the incidence of HIV-1 infection in the near term. By maximizing the potential of existing interventions, developing other effective strategies, and combining them in an optimal manner, we have the opportunity to bring the HIV-1 epidemic under control. PMID:20707698

  8. Adolescent Abstinence and Unprotected Sex in CyberSenga, an Internet-Based HIV Prevention Program: Randomized Clinical Trial of Efficacy

    PubMed Central

    Ybarra, Michele L.; Bull, Sheana S.; Prescott, Tonya L.; Korchmaros, Josephine D.; Bangsberg, David R.; Kiwanuka, Julius P.

    2013-01-01

    Context Cost-effective, scalable programs are urgently needed in countries deeply affected by HIV. Methods This parallel-group RCT was conducted in four secondary schools in Mbarara, Uganda. Participants were 12 years and older, reported past-year computer or Internet use, and provided informed caregiver permission and youth assent. The intervention, CyberSenga, was a five-hour online healthy sexuality program. Half of the intervention group was further randomized to receive a booster at four-months post-intervention. The control arm received ‘treatment as usual’ (i.e., school-delivered sexuality programming). The main outcome measures were: 1) condom use and 2) abstinence in the past three months at six-months' post-intervention. Secondary outcomes were: 1) condom use and 2) abstinence at three-month's post-intervention; and 6-month outcomes by booster exposure. Analyses were intention to treat. Results All 416 eligible youth were invited to participate, 88% (n = 366) of whom enrolled. Participants were randomized to the intervention (n = 183) or control (n = 183) arm; 91 intervention participants were further randomized to the booster. No statistically significant results were noted among the main outcomes. Among the secondary outcomes: At three-month follow-up, trends suggested that intervention participants (81%) were more likely to be abstinent than control participants (74%; p = 0.08), and this was particularly true among youth who were abstinent at baseline (88% vs. 77%; p = 0.02). At six-month follow-up, those in the booster group (80%) reported higher rates of abstinence than youth in the intervention, no booster (57%) and control (55%) groups (p = 0.15); they also reported lower rates of unprotected sex (5%) compared to youth in the intervention, no booster (24%) and control (21%) groups (p = 0.21) among youth sexually active at baseline. Conclusions The CyberSenga program may affect HIV preventive behavior among abstinent

  9. Evaluating HIV Prevention: A Framework for National, State, and Local Levels.

    ERIC Educational Resources Information Center

    Rugg, Deborah; Buehler, Jim; Renaud, Michelle; Gilliam, Aisha; Heitgerd, Janet; Westover, Bonita; Wright-De Aguero, Linda; Bartholow, Kelly; Swanson, Sue

    1999-01-01

    Describes the 1995-1997 evaluation framework and activities of an evaluation of HIV-prevention efforts. This framework is offered as a platform for future efforts to determine the most effective ways to prevent HIV transmission, and it may be generalizable to other disease-prevention and health-promotion programs. (SLD)

  10. HIV prevention among female sex workers in Africa.

    PubMed

    Scheibe, A; Drame, F M; Shannon, K

    2012-01-01

    Sex work occurs to meet the demand for sexual services and is a universal phenomenon. In Africa sex work takes many forms and is an important source of income for many women. Yet sex worker reproductive health needs remain largely unmet. The criminalisation of sex work; community and service provider stigma; violence; substance use and limited access to health services and prevention commodities contribute to the high HIV burden evident among female sex workers in Africa. Following UNAIDS' three pillar approach to HIV prevention and sex work we present an overview of current opportunities, barriers and suggestions to improve HIV prevention policy and programming for sex work in Africa. Universal access to a comprehensive package of HIV services is the first pillar. Reproductive health commodities; voluntary and anonymous HIV counselling and testing; treatment of sexually transmitted infections, HIV and opportunistic infections; harm reduction for substance use and psychosocial support services make up the recommended package of services. The second pillar is a sex worker-supportive environment. The inclusion of sex worker programmes within national HIV strategic planning; sex worker-led community mobilisation and the establishment of sex work community networks (comprised of sex workers, health service providers, law enforcers and other stakeholders) enable effective programme implementation and are recommended. The reduction of sex worker vulnerability and addressing structural issues form the final pillar. The decriminalisation of sex work; development of supportive policy; gender equality and economic development are key factors that need to be addressed to increase sex worker resilience. Evidence supports the public health benefit of human rights based approaches to HIV prevention; moralistic and restrictive policy and laws towards sex work are harmful and should be removed. The establishment of these pillars will increase sex worker safety and enhance the

  11. Youth Suicide Prevention Programs

    ERIC Educational Resources Information Center

    Kalafat, John

    2006-01-01

    Youth suicide prevention programs are described that promote the identification and referral of at-risk youth, address risk factors, and promote protective factors. Emphasis is on programs that are both effective and sustainable in applied settings.

  12. Transgender HIV prevention: a qualitative needs assessment.

    PubMed

    Bockting, W O; Robinson, B E; Rosser, B R

    1998-08-01

    Although clinical experience and preliminary research suggest that some transgender people are at significant risk for HIV, this stigmatized group has so far been largely ignored in HIV prevention. As part of the development of HIV prevention education targeting the transgender population, focus groups of selected transgender individuals assessed their HIV risks and prevention needs. Data were gathered in the following four areas: (1) the impact of HIV/AIDS on transgender persons; (2) risk factors; (3) information and services needed; and (4) recruitment strategies. Findings indicated that HIV/AIDS compounds stigmatization related to transgender identity, interferes with sexual experimentation during the transgender 'coming out' process, and may interfere with obtaining sex reassignment. Identified transgender-specific risk factors include: sexual identity conflict, shame and isolation, secrecy, search for affirmation, compulsive sexual behaviour, prostitution, and sharing needles while injecting hormones. Community involvement, peer education and affirmation of transgender identity were stressed as integral components of a successful intervention. Education of health professionals about transgender identity and sexuality and support groups for transgender people with HIV/AIDS are urgently needed.

  13. A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings.

    PubMed

    Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald

    2013-04-16

    Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

  14. Nowhere to Run: HIV Prevention for Runaway and Homeless Youth.

    ERIC Educational Resources Information Center

    Posner, Marc

    This volume is a guide to providing effective Human Immunodeficiency Virus (HIV) and substance abuse prevention services to runaway and homeless youth. The guide is based on current research and the best programs in this field. Chapters 1 and 2 summarize what is known about runaway and homeless youth, the services these youth require if they are…

  15. Storytelling for Empowerment for Latino Teens: Increasing HIV Prevention Knowledge and Attitudes

    ERIC Educational Resources Information Center

    Nelson, Annabelle; Cordova, David; Walters, Andrew S.; Szecsy, Elsie

    2016-01-01

    Latino adolescents are disproportionately impacted by HIV, but researchers have documented few programs to prevent and reduce HIV risk. The Storytelling for Empowerment (SFE) "HIV StoryBook" was designed with an innovative ecodevelopment approach combining empowerment, family communication, and positive cultural identity. A mixed method…

  16. Pediatric HIV: School-Based Sequelae and Curricular Interventions for Infection Prevention and Social Acceptance.

    ERIC Educational Resources Information Center

    Landau, Steven; Pryor, John B.; Haefli, Katrine

    1995-01-01

    In response to the rising number of adolescents and infants who are infected with HIV, school psychologists must become experts in issues pertaining to pediatric HIV/AIDS. This article describes medical consequences of HIV and psychosocial sequalea. Discusses recommendations for school-based AIDS-education programs designed to prevent HIV…

  17. Expanding the partnership. The private sector's role in HIV / AIDS prevention.

    PubMed

    Lamptey, P

    1996-07-01

    The public sector supports most HIV/AIDS prevention and care activities in developing countries, with significant funding provided by the US Agency for International Development, the Overseas Development Authority, the European Community, and international banking institutions such as the World Bank. Local nongovernmental organizations (NGOs) and international private voluntary organizations (PVOs) implement many of the grassroots prevention and care efforts in developing countries, but often require support from donor agencies. While the private commercial sector has played a minor role in supporting HIV/AIDS prevention and care efforts, a number of local and multinational companies are beginning to recognize the importance of protecting their workers from HIV infection. These companies are motivated by a sense of moral obligation and/or view HIV/AIDS prevention as a cost-effective investment. Mainly affecting the most economically productive age groups, the HIV/AIDS epidemic will have a significant impact upon private industry. Workplace-based prevention programs and policies, private sector resources for HIV/AIDS prevention and care, how HIV/AIDS programs can benefit from the private sector's experience in commercial service delivery, research and development, and corporate direct cash and in-kind contributions to government and NGO HIV/AIDS prevention activities are discussed. The AIDS Control and Prevention (AIDSCAP) Project's Businesses Managing AIDS Project helps owners and managers understand the potential impact of HIV/AIDS upon their businesses and the benefits of HIV/AIDS prevention. PMID:12347592

  18. Approaches to preventative and therapeutic HIV vaccines.

    PubMed

    Gray, Glenda E; Laher, Fatima; Lazarus, Erica; Ensoli, Barbara; Corey, Lawrence

    2016-04-01

    Novel strategies are being researched to discover vaccines to prevent and treat HIV-1. Non-efficacious preventative vaccine approaches include bivalent recombinant gp120 alone, HIV gene insertion into an Adenovirus 5 (Ad5) virus vector and the DNA prime/Ad5 boost vaccine regimen. However, the ALVAC-HIV prime/AIDSVAX® B/E gp120 boost regimen showed 31.2% efficacy at 3.5 years, and is being investigated as clade C constructs with an additional boost. Likewise, although multiple therapeutic vaccines have failed in the past, in a non-placebo controlled trial, a Tat vaccine demonstrated immune cell restoration, reduction of immune activation, and reduced HIV-1 DNA viral load. Monoclonal antibodies for passive immunization or treatment show promise, with VRC01 entering advanced clinical trials.

  19. Research shows targeted HIV prevention succeeds.

    PubMed

    2002-03-01

    Systematic reviews of HIV prevention intervention literature for the target populations of African-Americans, Latinos, youths, and men who have sex with men in the United States shows that targeted interventions work in reducing HIV risk behaviors. Interventions that succeeded were culturally sensitive, of longer duration, and included skills training, according to a project supported by the Surgeon General's Leadership Campaign on AIDS and teh California HealthCare Foundation in Oakland. PMID:12206092

  20. Economics of antiretroviral treatment vs. circumcision for HIV prevention.

    PubMed

    Bärnighausen, Till; Bloom, David E; Humair, Salal

    2012-12-26

    The HIV Prevention Trials Network (HPTN) 052 study, which showed the effectiveness of antiretroviral treatment in reducing HIV transmission, has been hailed as a "game changer" in the fight against HIV, prompting calls for scaling up treatment as prevention (TasP). However, it is unclear how TasP can be financed, given flat-lining support for global HIV programs. We assess whether TasP is indeed a game changer or if comparable benefits are obtainable at similar or lower cost by increasing coverage of medical male circumcision (MMC) and antiretroviral treatment (ART) at CD4 <350/μL. We develop a new mathematical model and apply it to South Africa, finding that high ART coverage combined with high MMC coverage provides approximately the same HIV incidence reduction as TasP, for $5 billion less over 2009-2020. MMC outperforms ART significantly in cost per infection averted ($1,096 vs. $6,790) and performs comparably in cost per death averted ($5,198 vs. $5,604). TasP is substantially less cost effective at $8,375 per infection and $7,739 per death averted. The prevention benefits of HIV treatment are largely reaped with high ART coverage. The most cost-effective HIV prevention strategy is to expand MMC coverage and then scale up ART, but the most cost-effective HIV-mortality reduction strategy is to scale up MMC and ART jointly. TasP is cost effective by commonly used absolute benchmarks but it is far less cost effective than MMC and ART. Given South Africa's current annual ART spending, the $5 billion in savings offered by MMC and ART over TasP in the next decade, for similar health benefits, challenges the widely hailed status of TasP as a game changer.

  1. People who inject drugs in prison: HIV prevalence, transmission and prevention.

    PubMed

    Dolan, Kate; Moazen, Babak; Noori, Atefeh; Rahimzadeh, Shadi; Farzadfar, Farshad; Hariga, Fabienne

    2015-02-01

    In 2011, over 10.1 million people were held in prisons around the world. HIV prevalence is elevated in prison and this is due to the over representation of people who inject drugs (PWID). Yet HIV prevention programs for PWID are scarce in the prison setting. With a high proportion of drug users and few prevention programs, HIV transmission occurs and sometimes at an alarming rate. This commentary focuses primarily on drug users in prison; their risk behaviours and levels of infection. It also comments on the transmission of HIV including outbreaks and the efforts to prevent transmission within the prison setting. The spread of HIV in prison has substantial public health implications as virtually all prisoners return to the community. HIV prevention and treatment strategies known to be effective in community settings, such as methadone maintenance treatment, needle and syringe programs, condoms and antiretroviral therapy should be provided to prisoners as a matter of urgency.

  2. A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings

    PubMed Central

    Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H.Y.; Cole, Donald

    2013-01-01

    Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages. PMID:23594416

  3. Engaging Community Businesses in HIV Prevention: A Feasibility Study

    PubMed Central

    Rovniak, Liza S.; Hovell, Melbourne F.; Hofstetter, C. Richard; Blumberg, Elaine J.; Sipan, Carol L.; Batista, Marcia F.; Martinez-Donate, Ana P.; Mulvihill, Mary M.; Ayala, Guadalupe X.

    2009-01-01

    Purpose To explore the feasibility of engaging community businesses in HIV prevention. Design Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-, and post-program. Customer feedback was obtained through an online survey. Setting San Diego, California neighborhood with a high rate of AIDS. Subjects Fifty-one business owners/managers representing 10 retail categories, and 52 customers. Measures Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction and willingness to provide future support for HIV prevention. Analysis Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. Results The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or refused to participate (41%), p <.05. Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures, p < .05. More than 90% of customers supported distributing condoms and brochures in businesses and 96% of business owners/managers described their program experience as “positive.” Conclusion Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested. PMID:20465150

  4. A Cluster Randomized Controlled Trial of an Adolescent HIV Prevention Program among Bahamian Youth: Effect at 12 Months Post-Intervention

    PubMed Central

    Chen, Xinguang; Lunn, Sonya; Deveaux, Lynette; Li, Xioaming; Brathwaite, Nanika; Cottrell, Lesley; Stanton, Bonita

    2014-01-01

    Background Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. Objective To determine 1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program “Focus on Youth in the Caribbean” (FOYC) and 2) the role of the targeted PMT constructs in intervention effect. Methods 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, six and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from “1” = “a virgin without intention to have sex” to” 5″ = “having sex without a condom”. Group-based trajectory analysis was utilized in assessing the program effect. Results Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. Conclusion FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity. PMID:19116781

  5. Preventing HIV among Latino and African American Gay and Bisexual Men in a Context of HIV-Related Stigma, Discrimination, and Homophobia: Perspectives of Providers

    PubMed Central

    Brooks, Ronald A.; Etzel, Mark A.; Hinojos, Ernesto; Henry, Charles L.; Perez, Mario

    2005-01-01

    HIV-related stigma, discrimination, and homophobia impede community based efforts to combat HIV disease among Latino and African American gay and bisexual men. This commentary highlights ways to address these social biases in communities of color in Los Angeles from the perspectives of staff from HIV prevention programs. Information was collected from HIV prevention program staff participating in a two-day symposium. The outcomes from the symposium offer strategies for developing and implementing HIV prevention services for Latino and African American gay and bisexual men, which include: 1) addressing social biases present in a community that can hinder, and even prohibit, utilization of effective HIV prevention programs; 2) recasting HIV prevention messages in a broader social or health context; 3) developing culturally appropriate HIV prevention messages; 4) exploring new modalities and venues for delivering HIV prevention messages that are appropriate for gay and bisexual men of color and the communities in which they live; and 5) broadening the target of HIV prevention services to include service providers, local institutions and agencies, and the community at-large. These strategies underscore the need to consider the social and contextual factors of a community when designing and implementing HIV prevention programs. PMID:16283834

  6. Sociocultural and Behavioral Contexts of Condom Use in Heterosexual Married Couples in India: Challenges to the HIV Prevention Program

    ERIC Educational Resources Information Center

    Bhattacharya, Gauri

    2004-01-01

    This article examines sociocultural expectations of sexual behavior and the reasons why not using condoms may be logical to married heterosexual couples in India. Married women who report monogamous sexual relationships with their husbands are a high-risk group for HIV infection in India. Based on the public health model and a population-based…

  7. The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

    PubMed Central

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

    2010-01-01

    In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

  8. The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention.

    PubMed

    Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

    2009-01-01

    In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male- and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

  9. Using HIV Networks to Inform Real Time Prevention Interventions

    PubMed Central

    Little, Susan J.; Kosakovsky Pond, Sergei L.; Anderson, Christy M.; Young, Jason A.; Wertheim, Joel O.; Mehta, Sanjay R.; May, Susanne; Smith, Davey M.

    2014-01-01

    Objective To reconstruct the local HIV-1 transmission network from 1996 to 2011 and use network data to evaluate and guide efforts to interrupt transmission. Design HIV-1 pol sequence data were analyzed to infer the local transmission network. Methods We analyzed HIV-1 pol sequence data to infer a partial local transmission network among 478 recently HIV-1 infected persons and 170 of their sexual and social contacts in San Diego, California. A transmission network score (TNS) was developed to estimate the risk of HIV transmission from a newly diagnosed individual to a new partner and target prevention interventions. Results HIV-1 pol sequences from 339 individuals (52.3%) were highly similar to sequences from at least one other participant (i.e., clustered). A high TNS (top 25%) was significantly correlated with baseline risk behaviors (number of unique sexual partners and insertive unprotected anal intercourse (p = 0.014 and p = 0.0455, respectively) and predicted risk of transmission (p<0.0001). Retrospective analysis of antiretroviral therapy (ART) use, and simulations of ART targeted to individuals with the highest TNS, showed significantly reduced network level HIV transmission (p<0.05). Conclusions Sequence data from an HIV-1 screening program focused on recently infected persons and their social and sexual contacts enabled the characterization of a highly connected transmission network. The network-based risk score (TNS) was highly correlated with transmission risk behaviors and outcomes, and can be used identify and target effective prevention interventions, like ART, to those at a greater risk for HIV-1 transmission. PMID:24901437

  10. HIV Treatment as Prevention: Issues in Economic Evaluation

    PubMed Central

    Bärnighausen, Till; Salomon, Joshua A.; Sangrujee, Nalinee

    2012-01-01

    Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, “Investigating the Impact of Treatment on New HIV Infections”, that economic evaluations of antiretroviral therapy (ART) in currently existing programs and in HIV treatment as prevention (TasP) programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope of delivery, health states, ART regimens, health workers' experience, patients' time on treatment, and the distribution of delivery across public and private sectors. We argue that for particular evaluation purposes (e.g., to establish the social value of TasP) and from particular perspectives (e.g., national health policy makers) less detailed cost functions may be sufficient. We then extend the discussion of economic evaluation of TasP, describing why ART outcomes and costs assessed in currently existing programs are unlikely to be generalizable to TasP programs for several fundamental reasons. First, to achieve frequent, widespread HIV testing and high uptake of ART immediately following an HIV diagnosis, TasP programs will require components that are not present in current ART programs and whose costs are not included in current estimates. Second, the early initiation of ART under TasP will change not only patients' disease courses and treatment experiences—which can affect behaviors that determine clinical treatment success, such as ART adherence and retention—but also quality of life and economic outcomes for HIV-infected individuals. Third, the preventive effects of TasP are likely to alter the composition of the HIV-infected population over time, changing its biological and behavioral characteristics and leading to different costs and outcomes for ART. PMID:22802743

  11. HIV treatment as prevention: issues in economic evaluation.

    PubMed

    Bärnighausen, Till; Salomon, Joshua A; Sangrujee, Nalinee

    2012-01-01

    Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, "Investigating the Impact of Treatment on New HIV Infections", that economic evaluations of antiretroviral therapy (ART) in currently existing programs and in HIV treatment as prevention (TasP) programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope of delivery, health states, ART regimens, health workers' experience, patients' time on treatment, and the distribution of delivery across public and private sectors. We argue that for particular evaluation purposes (e.g., to establish the social value of TasP) and from particular perspectives (e.g., national health policy makers) less detailed cost functions may be sufficient. We then extend the discussion of economic evaluation of TasP, describing why ART outcomes and costs assessed in currently existing programs are unlikely to be generalizable to TasP programs for several fundamental reasons. First, to achieve frequent, widespread HIV testing and high uptake of ART immediately following an HIV diagnosis, TasP programs will require components that are not present in current ART programs and whose costs are not included in current estimates. Second, the early initiation of ART under TasP will change not only patients' disease courses and treatment experiences--which can affect behaviors that determine clinical treatment success, such as ART adherence and retention--but also quality of life and economic outcomes for HIV-infected individuals. Third, the preventive effects of TasP are likely to alter the composition of the HIV-infected population over time, changing its biological and behavioral characteristics and leading to different costs and outcomes for ART.

  12. CROI 2016: Hot Spots in HIV Infection and Advances in HIV Prevention.

    PubMed

    Buchbinder, Susan P; Liu, Albert Y

    2016-01-01

    The 2016 Conference on Retroviruses and Opportunistic Infections (CROI) highlighted hot spots in HIV infection. Men who have sex with men (MSM), transgender populations, people who inject drugs, fisherfolk, migrants, adolescents, and older adults are heavily impacted in a number of regions. Stigma contributes to risk behaviors and HIV acquisition across populations. HIV testing is a crucial first step in the HIV care continuum, and several large community-based surveys are underway in Africa to increase HIV testing, linkage to care, and uptake of antiretroviral treatment. Advances in preexposure prophylaxis (PrEP) featured prominently at CROI 2016. Two large efficacy trials of a vaginal ring containing the investigational drug dapivirine demonstrated efficacy and safety in preventing HIV infections in women in Africa. Data on the safety of long-acting injectable PrEP and several investigational PrEP drugs and formulations were also presented. Knowledge and use of PrEP among MSM in the United States appears to be increasing, and high uptake was seen among black MSM when provided as part of a culturally tailored support program. The use of broadly neutralizing antibodies for HIV prevention is a novel and promising approach to be evaluated in efficacy trials. PMID:27398859

  13. Diabetes Prevention Program (DPP)

    MedlinePlus

    ... Recruiting Patients & Families Consortia, Networks & Centers Reports & Planning Diabetes Prevention Program (DPP) Page Content On this page: ... increased risk of developing diabetes. [ Top ] Type 2 Diabetes and Prediabetes Type 2 diabetes is a disorder ...

  14. Residual Injection Risk Behavior, HIV Infection, and the Evaluation of Syringe Exchange Programs

    ERIC Educational Resources Information Center

    Des Jarlais, Don C.; Braine, Naomi; Yi, Huso; Turner, Charles

    2007-01-01

    This study assessed relationships between residual risk behavior (risk behavior among persons participating in effective HIV prevention programs) and HIV infection. Structured interviews and HIV tests were obtained from participants in six large U.S. syringe exchange programs. Program characteristics were obtained through interviews with the…

  15. Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?

    PubMed

    Kohler, Hans-Peter; Thornton, Rebecca

    2012-06-01

    Conditional cash transfers (CCT) have recently received considerable attention as a potentially innovative and effective approach to the prevention of HIV/AIDS. We evaluate a conditional cash transfer program in rural Malawi which offered financial incentives to men and women to maintain their HIV status for approximately one year. The amounts of the reward ranged from zero to approximately 3-4 months wage. We find no effect of the offered incentives on HIV status or on reported sexual behavior. However, shortly after receiving the reward, men who received the cash transfer were 9 percentage points more likely and women were 6.7 percentage points less likely to engage in risky sex. Our analyses therefore question the "unconditional effectiveness" of CCT program for HIV prevention: CCT Programs that aim to motivate safe sexual behavior in Africa should take into account that money given in the present may have much stronger effects than rewards offered in the future, and any effect of these programs may be fairly sensitive to the specific design of the program, the local and/or cultural context, and the degree of agency an individual has with respect to sexual behaviors.

  16. Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?

    PubMed Central

    Kohler, Hans-Peter; Thornton, Rebecca

    2013-01-01

    Conditional cash transfers (CCT) have recently received considerable attention as a potentially innovative and effective approach to the prevention of HIV/AIDS. We evaluate a conditional cash transfer program in rural Malawi which offered financial incentives to men and women to maintain their HIV status for approximately one year. The amounts of the reward ranged from zero to approximately 3–4 months wage. We find no effect of the offered incentives on HIV status or on reported sexual behavior. However, shortly after receiving the reward, men who received the cash transfer were 9 percentage points more likely and women were 6.7 percentage points less likely to engage in risky sex. Our analyses therefore question the “unconditional effectiveness” of CCT program for HIV prevention: CCT Programs that aim to motivate safe sexual behavior in Africa should take into account that money given in the present may have much stronger effects than rewards offered in the future, and any effect of these programs may be fairly sensitive to the specific design of the program, the local and/or cultural context, and the degree of agency an individual has with respect to sexual behaviors. PMID:24319306

  17. Young people and HIV prevention in Australian schools.

    PubMed

    Jones, Tiffany; Mitchell, Anne

    2014-06-01

    Australia has not seen a Human Immunodeficiency Virus (HIV) epidemic among young people. However, early research in the Australian context had indicated that the degree of unprotected sexual activity, partner change, and STI infection in this cohort would fuel a young people's epidemic if HIV ever reached a tipping point in the country. The difficulty of reaching young people outside school for HIV prevention has been no more successfully addressed in Australia than elsewhere. Therefore, the investment of Australian HIV prevention funds for youth has had an emphasis on school-based programs. This emphasis on formal schooling has led to a history of engagement with the ad hoc and unreliable nature of sexuality education in Australian schools. It has particularly been the catalyst for a struggle to construct young people as sexually active and as possessing a right to appropriate education, against tides of both secular and religiously-motivated resistance. The eight state and territory education sectors, along with the independent sectors, have had differing and sometimes troubled histories with HIV prevention. This paper discusses the differing HIV education policies and programs that have emerged in Australian schooling historically, and in some cases been abandoned altogether, amid strong public debates. It also considers current approaches, the new national curriculum, and future challenges. Additionally, the particular case of same sex attracted young men, who have a heightened level of vulnerability to HIV, is explored. Australian schools have struggled to address both the imperative for relevant sexuality education for same-sex-attracted young people and the broader issue of combating homophobia, which research has linked directly to this vulnerability. PMID:24846485

  18. Young people and HIV prevention in Australian schools.

    PubMed

    Jones, Tiffany; Mitchell, Anne

    2014-06-01

    Australia has not seen a Human Immunodeficiency Virus (HIV) epidemic among young people. However, early research in the Australian context had indicated that the degree of unprotected sexual activity, partner change, and STI infection in this cohort would fuel a young people's epidemic if HIV ever reached a tipping point in the country. The difficulty of reaching young people outside school for HIV prevention has been no more successfully addressed in Australia than elsewhere. Therefore, the investment of Australian HIV prevention funds for youth has had an emphasis on school-based programs. This emphasis on formal schooling has led to a history of engagement with the ad hoc and unreliable nature of sexuality education in Australian schools. It has particularly been the catalyst for a struggle to construct young people as sexually active and as possessing a right to appropriate education, against tides of both secular and religiously-motivated resistance. The eight state and territory education sectors, along with the independent sectors, have had differing and sometimes troubled histories with HIV prevention. This paper discusses the differing HIV education policies and programs that have emerged in Australian schooling historically, and in some cases been abandoned altogether, amid strong public debates. It also considers current approaches, the new national curriculum, and future challenges. Additionally, the particular case of same sex attracted young men, who have a heightened level of vulnerability to HIV, is explored. Australian schools have struggled to address both the imperative for relevant sexuality education for same-sex-attracted young people and the broader issue of combating homophobia, which research has linked directly to this vulnerability.

  19. 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.

  20. HIV/AIDS Prevention among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

    ERIC Educational Resources Information Center

    Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

    2005-01-01

    This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the…

  1. An exploration of faith leaders' beliefs concerning HIV prevention: thirty years into the epidemic.

    PubMed

    Pichon, Latrice C; Williams, Terrinieka T; Campbell, Bettina

    2013-01-01

    Despite the growing body of research on faith-based human immunodeficiency virus (HIV) initiatives, there are few studies exploring the perspective of faith leaders involved in HIV prevention efforts. This exploratory study examined how 29 faith leaders conceptualized key aspects of HIV prevention. Sexual health beliefs, perspectives on condom distribution, and facilitating factors and barriers to implementing an HIV program were explored. Seventy-six percent of participants agreed with the statement "they would be willing to make condoms available to adolescents." These findings highlight the importance of reconciling any differences between religious doctrine, leadership role, and beliefs of faith leaders in addressing HIV in churches. PMID:23718961

  2. Predictors of the Existence of Congregational HIV Programs: Similarities and Differences Compared with Other Health Programs

    PubMed Central

    Williams, Malcolm V.; Haas, Ann; Griffin, Beth Ann; Fulton, Brad; Kanouse, David E.; Bogart, Laura M.; Derose, Kathryn Pitkin

    2014-01-01

    Purpose Identify and compare predictors of the existence of congregational HIV and other health programs. Design Cross-sectional study. Setting United States. Participants A nationally-representative sample of 1,506 U.S. congregations surveyed in the National Congregations Study (2006-07). Measures Key informants at each congregation completed in-person and telephone interviews on congregational HIV and other health programs and various congregation characteristics (response rate = 78%). County-level HIV prevalence and population health data from the Robert Wood Johnson Foundation's 2007 County Health Rankings were linked to the congregational data. Analysis Multinomial logistic regression was used to assess factors that predict congregational health programs relative to no health programs; and of HIV programs relative to other health activities. Results Most congregations (57.5%) had at least one health-related program; many fewer (5.7%) had an HIV program. Predictors of health vs. HIV programs differed. The number of adults in the congregation was a key predictor of health programs, while having an official statement welcoming gay persons was a significant predictor of HIV programs (p<.05). Other significant characteristics varied by size of congregation and type of program (HIV vs. other health). Conclusion Organizations interested in partnering with congregations to promote health or prevent HIV should consider congregational size as well as other factors that predict involvement. Results of this study can inform policy interventions to increase the capacity of religious congregations to address HIV and health. PMID:25162322

  3. Negotiating Risk: Knowledge and Use of HIV Prevention by Persons With Serious Mental Illness Living in Supportive Housing

    PubMed Central

    Kloos, Bret; Gross, Steven M.; Meese, Katharine J.; Meade, Christina S.; Doughty, Jhan D.; Hawkins, Dietra D.; Zimmerman, Susan O.; Snow, David L.; Sikkema, Kathleen J.

    2008-01-01

    As a population, persons with serious mental illness (SMI) have an elevated risk for HIV infection. However, relatively little is known about how the risk of HIV has affected their lives, how persons with SMI evaluate their HIV risk, and what preventive measures they undertake. Furthermore, relatively little is known about community-based HIV prevention for persons with SMI as most interventions have been restricted to clinical settings. This report presents findings on the HIV-related experiences of persons with SMI living in supportive housing programs, one possible setting for implementing community-based HIV prevention with this population. The qualitative investigation interviewed 41 men and women living in five supportive housing programs. In-depth, qualitative interviews elicited discussion of research participants’ (a) experiences with HIV, (b) knowledge about HIV and HIV prevention, (c) assessments of their own risk, (d) descriptions of how they apply their prevention knowledge, and (e) reports of barriers for HIV prevention. Research participants describe social networks that have substantial contact with persons affected by HIV. However, contrary to some expectations of persons with SMI, research participants report using HIV prevention knowledge in negotiating their risk of contracting HIV. The implications of these findings are discussed in terms of their relevance for implementing community-based HIV prevention for persons with SMI. PMID:16389505

  4. Training Manual for HIV/AIDS Prevention.

    ERIC Educational Resources Information Center

    Epps, Patricia H.; Vallenari, Allison

    This manual includes all necessary information for implementing the Champs program, which trains older elementary school students or middle/high school students to operate puppets to deliver an HIV/AIDS message to kindergarten through sixth graders. Relying on a peer approach, the Program provides scripted, prerecorded lessons intended to reach…

  5. A Quasi-Experimental Evaluation of a Community-Based HIV Prevention Intervention for Mexican American Female Adolescents: The SHERO's Program

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  6. Social and Structural HIV Prevention in Alcohol-Serving Establishments

    PubMed Central

    Kalichman, Seth C.

    2010-01-01

    Alcohol use is associated with risks for sexually transmitted infections (STIs), including HIV/AIDS. People meet new sex partners at bars and other places where alcohol is served, and drinking venues facilitate STI transmission through sexual relationships within closely knit sexual networks. This paper reviews HIV prevention interventions conducted in bars, taverns, and informal drinking venues. Interventions designed to reduce HIV risk by altering the social interactions within drinking environments have demonstrated mixed results. Specifically, venue-based social influence models have reduced community-level risk in U.S. gay bars, but these effects have not generalized to gay bars elsewhere or to other populations. Few interventions have sought to alter the structural and physical environments of drinking places for HIV prevention. Uncontrolled program evaluations have reported promising approaches to bar-based structural interventions with gay men and female sex workers. Finally, a small number of studies have examined multilevel approaches that simultaneously intervene at both social and structural levels with encouraging results. Multilevel interventions that take environmental factors into account are needed to guide future HIV prevention efforts delivered within alcohol-serving establishments. PMID:23584060

  7. All Individuals Deserve Support: Collaborating To Prevent HIV/AIDS among Homeless Youth.

    ERIC Educational Resources Information Center

    Sherman, Nancy E.

    All Individuals Deserve Support (AIDS) is a collaborative prevention program between graduate students in a Community/Agency Counseling program and the Children's Home Homeless Youth Program in Peoria, Illinois. Graduate students developed a comprehensive HIV/AIDS prevention program for homeless youth as a class project. Project design involved:…

  8. 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

  9. Adapting an HIV Prevention Intervention for High-Risk, Incarcerated Adolescents

    ERIC Educational Resources Information Center

    Hurd, Noelle M.; Valerio, Melissa A.; Garcia, Nicole M.; Scott, Anthony A.

    2010-01-01

    This study examined the effectiveness of an adapted 4-session HIV prevention program. Participants included 490 adolescents who participated in either the 8- or the adapted 4-session HIVEd program. Analyses to identify mean changes in HIV-related knowledge, attitudes, self-efficacy, and behavioral intentions between participants in either the 4-…

  10. 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

  11. Effectiveness of condoms in preventing HIV transmission.

    PubMed

    Pinkerton, S D; Abramson, P R

    1997-05-01

    The consistent use of latex condoms continues to be advocated for primary prevention of HIV infection despite limited quantitative evidence regarding the effectiveness of condoms in blocking the sexual transmission of HIV. Although recent meta-analyses of condom effectiveness suggest that condoms are 60 to 70% effective when used for HIV prophylaxis, these studies do not isolate consistent condom use, and therefore provide only a lower bound on the true effectiveness of correct and consistent condom use. A reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently, i.e. consistent condom users are 10 to 20 times less likely to become infected when exposed to the virus than are inconsistent or non-users. Similar results are obtained utilizing model-based estimation techniques, which indicate that condoms decrease the per-contact probability of male-to-female transmission of HIV by about 95%. Though imperfect, condoms provide substantial protection against HIV infection. Condom promotion therefore remains an important international priority in the fight against AIDS.

  12. Combination HIV prevention options for young women in Africa.

    PubMed

    Baxter, Cheryl; Abdool Karim, Salim

    2016-07-01

    Although the number of new HIV infections has declined by over 30% in the past decade, the number of people who acquire HIV each year remains unacceptably high. In 2014 the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that there were about 2 million new HIV infections. The virus continues to spread, particularly in key populations, such as men who have sex with men (MSM), transgender individuals, sex workers and people who inject drugs. In Africa, young women have the highest HIV incidence rates. Scaling up known efficacious HIV prevention strategies for these groups at high risk is therefore a high priority. HIV prevention has generally been targeted at HIV-negative individuals or in some instances, entire communities. Prevention efforts are, however, shifting from a narrow focus on HIV-uninfected persons to a continuum of prevention that includes both HIV-negative and HIV-positive individuals. Given that a single HIV prevention intervention is unlikely to be able to alter the epidemic trajectory as HIV epidemics in communities are complex and comprise a mosaic of different risk factors and different routes of transmission, there is need to provide combination prevention. Hence, a mix of behavioural, biomedical and structural HIV prevention options is likely to be needed to alter the course of the HIV epidemic. The combination of HIV prevention interventions needed will vary depending on cultural context, the population targeted and the stage of the epidemic. This paper reviews the available HIV prevention strategies for young women and discusses new HIV prevention approaches in development. PMID:27399041

  13. Faith-Based HIV Care and Prevention in Chinese Immigrant Communities: Rhetoric or Reality?

    PubMed Central

    Kang, Ezer; Chin, John J.; Behar, Elana

    2012-01-01

    Ethnic churches attended by first generation Chinese immigrants are uniquely positioned to address emerging HIV prevention and care needs within the Chinese community at-large. Efforts to develop faith-based HIV programs necessitate identifying how HIV intersects with the sinicization of Christianity within Chinese churches. This paper will review the process of contextualizing HIV within theological and cultural frameworks that are meaningful for ethnic Chinese church leaders and members. The authors specifically propose two points of integration between public health and ecclesial functions: (1) HIV stigma-mitigation initiatives as informed by Christo-centric teachings of compassion and justice, and (2) HIV prevention and care reframed as social responsibility and informed by the Christian tradition of evangelism. Systems and practices that hinder and promote the involvement of Chinese churches in HIV prevention, care, and stigma-reduction will be discussed. PMID:23483037

  14. Can a pill prevent HIV? Negotiating the biomedicalisation of HIV prevention.

    PubMed

    Young, Ingrid; Flowers, Paul; McDaid, Lisa

    2016-03-01

    This article examines how biomedicalisation is encountered, responded to and negotiated within and in relation to new biomedical forms of HIV prevention. We draw on exploratory focus group discussions on pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) to examine how the processes of biomedicalisation are affected by and affect the diverse experiences of communities who have been epidemiologically framed as 'vulnerable' to HIV and towards whom PrEP and TasP will most likely be targeted. We found that participants were largely critical of the perceived commodification of HIV prevention as seen through PrEP, although this was in tension with the construction of being medical consumers by potential PrEP candidates. We also found how deeply entrenched forms of HIV stigma and homophobia can shape and obfuscate the consumption and management of HIV-related knowledge. Finally, we found that rather than seeing TasP or PrEP as 'liberating' through reduced levels of infectiousness or risk of transmission, social and legal requirements of responsibility in relation to HIV risk reinforced unequal forms of biomedical self-governance. Overall, we found that the stratifying processes of biomedicalisation will have significant implications in how TasP, PrEP and HIV prevention more generally are negotiated. PMID:26498141

  15. Outcomes and linkage to chronic care of HIV exposed infants among health centers and hospitals in Amhara Region, Ethiopia: implications to prevention of mother-to-child transmission of HIV program: a cross sectional study

    PubMed Central

    Kebede, Zemene Tigabu; Taye, Belaynew Wasie

    2016-01-01

    Introduction Numerous challenges exist in provision of prevention of mother-to-child transmission of HIV (PMTCT) such as linking HIV exposed infants (HEI) and their mothers to chronic cares services, and tackling loss to follow up. Limited evidence exists in Ethiopian setting that explains the persisting high HIV infection rate among HEIs and extent of linkage to chronic care. The study assessed the proportion of HIV infection; children linked to chronic care and determinants of HIV infection among HEI in Northern Ethiopia. Methods This institution-based cross-sectional study was conducted in health centers and hospitals of Amhara Region. A total of 484 HEI-mother pairs selected by multistage random sampling were included in the study. Data were collected from PMTCT and anti-retroviral therapy (ART) clinics using pre-tested and structured questionnaires. Quantitative data were entered in Epi Info version 7.0 and exported to SPSS 20.0 for analysis. Results A total of 484 mother-infant pairs with a response rate of 92.4% were included in the analysis. About 94.2% of infants and women were linked to chronic care follow-up sometime after the diagnosis. The proportion of HIV infection was 12.4%. Antenatal care attendance had a significant association with HIV infection among HEI (p < 0.0001). Delivering in health institution (p < 0.005), mode of delivery (p < 0.032), and provision of both infant (p < 0.0001) and maternal (p < 0.0001) prophylaxis showed a highly significant association with HIV infection among HIV exposed infants. Conclusion Health facilities shall encourage antenatal care that increased institutional delivery, leads to timely initiation and high uptake of PMTCT to reduce the vertical transmission of HIV infection and meet national targets. PMID:27642402

  16. Primary prevention lessons learned from those with HIV in Chennai, India

    PubMed Central

    Hendriksen, Ellen Setsuko; Sri Krishnan, A. K.; Vallabhaneni, Snigda; Johnson, Sethu; Raminani, Sudha; Kumarasamy, N.; Solomon, Suniti; Mayer, Kenneth K. H.; Safren, Steven S.

    2013-01-01

    Background As each HIV-infected individual represents a breakdown of HIV primary prevention measures, formative data from representative individuals living with HIV can help shape future primary prevention interventions. Little is known about sexual behaviours and other transmission risk factors of high-risk group members who are already HIV-infected in Chennai, India. Methods Semi-structured qualitative interviews were conducted with 27 HIV-infected individuals representing each high-risk group in Chennai (five men who have sex with men (MSM), five female commercial sex workers (CSW), four truckers and other men who travel for business, four injecting drug users (IDU), five married male clients of CSW, and four wives of CSW clients, MSM, truckers, and IDU). Results Themes relevant to HIV primary prevention included: (1) HIV diagnosis as the entry into HIV education and risk reduction, (2) reluctance to undergo voluntary counselling and testing, (3) gender and sexual roles as determinants of condom use, (4) misconceptions about HIV transmission, and (5) framing and accessibility of HIV education messages. Conclusions These qualitative data can be used to develop hypotheses about sexual risk taking in HIV-infected individuals in South India, inform primary prevention intervention programs, and improve primary prevention efforts overall. PMID:21592434

  17. Protegiendo Nuestra Comunidad: empowerment participatory education for HIV prevention.

    PubMed

    McQuiston, C; Choi-Hevel, S; Clawson, M

    2001-10-01

    To be effective, HIV/AIDS interventions must be culturally and linguistically appropriate and must occur within the context of the specific community in which they are delivered. In this article, the development of a culture-specific lay health advisor (LHA) program, Protegiendo Nuestra Comunidad, for recently immigrated Mexicans is described. This program is one component of a collaborative inquiry research project involving community participants and researchers working as partners in carrying out and assessing a program for the prevention of HIV/AIDS. The collaborative inquiry process was applied as an empowerment philosophy and methodology of Paulo Freire and an ecological framework was used for the development of Protegiendo Nuestra Comunidad. The use of principles of empowerment for curriculum development, teaching methodology, and program delivery are described.

  18. Voluntary medical male circumcision: an HIV prevention priority for PEPFAR.

    PubMed

    Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

    2012-08-15

    As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President's Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya's Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods-such as medical devices that remove the foreskin without injected anesthesia and/or sutures-are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all. PMID:22797745

  19. Voluntary medical male circumcision: an HIV prevention priority for PEPFAR.

    PubMed

    Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

    2012-08-15

    As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President's Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya's Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods-such as medical devices that remove the foreskin without injected anesthesia and/or sutures-are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all.

  20. Voluntary Medical Male Circumcision: An HIV Prevention Priority for PEPFAR

    PubMed Central

    Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C.; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

    2013-01-01

    As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President’s Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya’s Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods—such as medical devices that remove the foreskin without injected anesthesia and/or sutures—are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all. PMID:22797745

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

    PubMed

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

    2016-06-01

    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 perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of "common factors," or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency's program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources. PMID:27178497

  2. The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care.

    PubMed

    McKernan McKay, Mary; Alicea, Stacey; Elwyn, Laura; McClain, Zachary R B; Parker, Gary; Small, Latoya A; Mellins, Claude Ann

    2014-01-01

    This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers. PMID:24787707

  3. Preventing HIV transmission in "priority" countries.

    PubMed

    Finger, W R

    1993-05-01

    A recent $168 million 5-year cooperative agreement funded by the US Agency for International Development combines elements of its earlier AIDSTECH and AIDSCOM projects under the AIDS Control and Prevention Project (AIDSCAP). Instead of working to effect broad-scale behavior change toward the prevention of HIV transmission, AIDSCAP strategically targets locations for condom distribution, behavior change messages, and the treatment of sexually transmitted diseases. In Lagos and the states of Cross River and Jigawa where the AIDS epidemic is firmly established, for example, AIDSCAP is intervening to increase condom demand and accessibility; alter sexual behaviors which carry a high risk for HIV transmission; and reduce the prevalence of STDs which enhance the transmission of HIV. The project began in fall of 1991 and has expanded to include Ethiopia, Kenya, Malawi, Nigeria, Rwanda, Senegal, Brazil, Haiti, Jamaica, India, and Thailand; limited assistance is also provided to 7 other African countries, 4 Latin America countries, and 1 in Asia. 4 more countries are in the final stages of negotiations to be included in the project. The USAID mission in the host country and the government must invite AIDSCAP involvement in order for the country to attain priority status. Countries are selected based on the HIV prevalence rate, population size and distribution, level of commitment to HIV prevention/control, capacity to respond to the AIDSCAP plan of action, level of other donor support, the USAID Mission's development priorities, and the Mission's commitment of substantial funds from its own budget. Once involved, AIDSCAP is mandated to implement interventions through in-country agencies. PMID:12344871

  4. The couple approach to HIV / AIDS prevention.

    PubMed

    Alvarez, R O

    1995-01-01

    In 1995, the Philippine Overseas Employment Administration reported that there were 360,000 documented contract workers deployed to various international destinations, 33.1% of whom were sea-based contract workers. It is accepted in Philippine society that seamen stationed abroad for several months remain sexually active. They often have unprotected sexual intercourse with several male and female sex partners, exposing themselves and their partners to the risk of acquiring sexually transmitted infections. The Department of Health has therefore given some priority to involve overseas workers in AIDS education efforts. Seamen, in particular, have been found to engage in high-risk behaviors based upon the recognized routes of HIV transmission. The ISSA developed and implemented a project to address the HIV/AIDS education needs of this group of men and their partners. ISSA's HIV/AIDS Education and Prevention project used the couple approach in its activities, noting that couples and partners must work together to practice safer sex measures. The project involved 60 seamen and 60 women who were either wives or girlfriends of the seamen; more than half of the participants were husband-wife couples. The project functioned upon the premise that both partners have to be well-informed about HIV/AIDS in order to practice effective prevention measures.

  5. Reducing HIV and AIDS through Prevention (RHAP): a theoretically based approach for teaching HIV prevention to adolescents through an exploration of popular music.

    PubMed

    Boutin-Foster, Carla; McLaughlin, Nadine; Gray, Angela; Ogedegbe, Anthony; Hageman, Ivan; Knowlton, Courtney; Rodriguez, Anna; Beeder, Ann

    2010-05-01

    Using popular culture to engage students in discussions of HIV prevention is a nontraditional approach that may complement current prevention efforts and enhance the ability to reach youth who are at high risk of contracting HIV and other sexually transmitted infections. Hip-hop or rap music is the dominant genre of music among adolescents, especially Black and Latino youth who are disproportionately impacted by HIV and AIDS. This paper describes the rationale and development of the Reducing HIV and AIDS through Prevention (RHAP) program, a school-based program that uses hip-hop/rap music as a vehicle for raising awareness among adolescents about HIV/AIDS. Constructs from the Social Cognitive Theory and the Sexual Script Theory were used in developing the program. It was piloted and evaluated among 26 middle school students in East Harlem, New York. The lessons learned from a formative evaluation of the program and the implications for developing other programs targeting public health problems are discussed. The RHAP program challenges the traditional pedagogue-student paradigm and provides an alternative approach to teaching about HIV prevention and awareness.

  6. Reducing HIV and AIDS through Prevention (RHAP): A Theoretically Based Approach for Teaching HIV Prevention to Adolescents through an Exploration of Popular Music

    PubMed Central

    McLaughlin, Nadine; Gray, Angela; Ogedegbe, Anthony; Hageman, Ivan; Knowlton, Courtney; Rodriguez, Anna; Beeder, Ann

    2010-01-01

    Using popular culture to engage students in discussions of HIV prevention is a nontraditional approach that may complement current prevention efforts and enhance the ability to reach youth who are at high risk of contracting HIV and other sexually transmitted infections. Hip-hop or rap music is the dominant genre of music among adolescents, especially Black and Latino youth who are disproportionately impacted by HIV and AIDS. This paper describes the rationale and development of the Reducing HIV and AIDS through Prevention (RHAP) program, a school-based program that uses hip-hop/rap music as a vehicle for raising awareness among adolescents about HIV/AIDS. Constructs from the Social Cognitive Theory and the Sexual Script Theory were used in developing the program. It was piloted and evaluated among 26 middle school students in East Harlem, New York. The lessons learned from a formative evaluation of the program and the implications for developing other programs targeting public health problems are discussed. The RHAP program challenges the traditional pedagogue–student paradigm and provides an alternative approach to teaching about HIV prevention and awareness. PMID:20195778

  7. Prevention of HIV/AIDS Education in Rural Communities II.

    ERIC Educational Resources Information Center

    Torabi, Mohammad R., Ed.

    1997-01-01

    This second special issue of the Health Education Monograph Series on HIV/AIDS Prevention in Rural Communities presents seven articles: (1) "Preventing Maternal-Infant Transmission of HIV: Social and Ethical Issues" (James G. Anderson, Marilyn M. Anderson, and Tara Booth); (2) "HIV Infection in Diverse Rural Population: Migrant Farm Workers in…

  8. A Five Step Process for Interactive Parent-Adolescent Communication About HIV Prevention: Advice from Parents Living With HIV/AIDS

    PubMed Central

    Edwards, Laura L.; Reis, Janet S.

    2014-01-01

    AIM This study investigated how parents living with HIV communicated about HIV prevention with their 10–18 year old children. METHODS Interviews with 76 mothers and fathers were analyzed for (1) their experiences discussing HIV prevention with adolescents, and (2) advice on how to best broach HIV-related topics. RESULTS Interactive conversations, where both parents and adolescents participated, were regarded as effective. Parents emphasized that adolescents should have a “voice” (be able to voice their concerns) and a “choice” (have a variety of effective prevention strategies to choose from) during HIV-related talks. DISCUSSION A five step process for interactive communication emerged as a result of these discussions. IMPLICATIONS Health care professionals can facilitate adolescent sexual health by encouraging parents to actively involve their children in discussions about HIV prevention. CONCLUSION Future HIV prevention programs could benefit by providing parents with appropriate tools to foster interactive discussions about sexual health with adolescents. PMID:24683366

  9. Evaluating the Impact of Zimbabwe’s Prevention of Mother-to-Child HIV Transmission Program: Population-Level Estimates of HIV-Free Infant Survival Pre-Option A

    PubMed Central

    Buzdugan, Raluca; McCoy, Sandra I.; Watadzaushe, Constancia; Kang Dufour, Mi-Suk; Petersen, Maya; Dirawo, Jeffrey; Mushavi, Angela; Mujuru, Hilda Angela; Mahomva, Agnes; Musarandega, Reuben; Hakobyan, Anna; Mugurungi, Owen; Cowan, Frances M.; Padian, Nancy S.

    2015-01-01

    Objective We estimated HIV-free infant survival and mother-to-child HIV transmission (MTCT) rates in Zimbabwe, some of the first community-based estimates from a UNAIDS priority country. Methods In 2012 we surveyed mother-infant pairs residing in the catchment areas of 157 health facilities randomly selected from 5 of 10 provinces in Zimbabwe. Enrolled infants were born 9–18 months before the survey. We collected questionnaires, blood samples for HIV testing, and verbal autopsies for deceased mothers/infants. Estimates were assessed among i) all HIV-exposed infants, as part of an impact evaluation of Option A of the 2010 WHO guidelines (rolled out in Zimbabwe in 2011), and ii) the subgroup of infants unexposed to Option A. We compared province-level MTCT rates measured among women in the community with MTCT rates measured using program monitoring data from facilities serving those communities. Findings Among 8568 women with known HIV serostatus, 1107 (12.9%) were HIV-infected. Among all HIV-exposed infants, HIV-free infant survival was 90.9% (95% confidence interval (CI): 88.7–92.7) and MTCT was 8.8% (95% CI: 6.9–11.1). Sixty-six percent of HIV-exposed infants were still breastfeeding. Among the 762 infants born before Option A was implemented, 90.5% (95% CI: 88.1–92.5) were alive and HIV-uninfected at 9–18 months of age, and 9.1% (95%CI: 7.1–11.7) were HIV-infected. In four provinces, the community-based MTCT rate was higher than the facility-based MTCT rate. In Harare, the community and facility-based rates were 6.0% and 9.1%, respectively. Conclusion By 2012 Zimbabwe had made substantial progress towards the elimination of MTCT. Our HIV-free infant survival and MTCT estimates capture HIV transmissions during pregnancy, delivery and breastfeeding regardless of whether or not mothers accessed health services. These estimates also provide a baseline against which to measure the impact of Option A guidelines (and subsequently Option B+). PMID:26248197

  10. 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.

  11. HIV prevention service utilization in the Los Angeles House and Ball communities: past experiences and recommendations for the future.

    PubMed

    Holloway, Ian W; Traube, Dorian E; Kubicek, Katrina; Supan, Jocelyn; Weiss, George; Kipke, Michele D

    2012-10-01

    African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however, little research exists on effective approaches to HIV prevention within these communities. Using a mixed-methods approach, the present study sought to document participation in HIV prevention activities of a sample from the Los Angeles House and Ball communities (n = 263) in order to inform future service development. While 80% of participants were tested for HIV within the past 6 months, only 26% report HIV prevention program attendance. House leaders recommend a holistic approach to HIV prevention, one that incorporates attention to social problems beyond HIV, including poverty, housing difficulties, and lack of job training. PMID:23016504

  12. Exploring the use of mobile phone technology for the enhancement of the prevention of mother-to-child transmission of HIV program in Nyanza, Kenya: a qualitative study

    PubMed Central

    2013-01-01

    Background Community-based mobile phone programs can complement gaps in clinical services for prevention of mother-to-child transmission (PMTCT) of HIV in areas with poor infrastructure and personnel shortages. However, community and health worker perceptions on optimal mobile phone communication for PMTCT are underexplored. This study examined what specific content and forms of mobile communication are acceptable to support PMTCT. Methods Qualitative methods using focus groups and in-depth interviews were conducted in two district hospitals in Nyanza Province, Kenya. A total of 45 participants were purposefully selected, including HIV-positive women enrolled in PMTCT, their male partners, community health workers, and nurses. Semi-structured discussion guides were used to elicit participants’ current mobile phone uses for PMTCT and their perceived benefits and challenges. We also examined participants’ views on platform design and gender-tailored short message service (SMS) messages designed to improve PMTCT communication and male involvement. Results Most participants had access to a mobile phone and prior experience receiving and sending SMS, although phone sharing was common among couples. Mobile phones were used for several health-related purposes, primarily as voice calls rather than texts. The perceived benefits of mobile phones for PMTCT included linking with health workers, protecting confidentiality, and receiving information and reminders. Men and women considered the gender-tailored SMS as a catalyst for improving PMTCT male involvement and couples’ communication. However, informative messaging relayed safely to the intended recipient was critical. In addition, health workers emphasized the continual need for in-person counseling coupled with, rather than replaced by, mobile phone reinforcement. For all participants, integrated and neutral text messaging provided antenatally and postnatally was most preferred, although not all topics or text

  13. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention.

    PubMed

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff's spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15-19 years), adults aged 30-34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff's spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.

  14. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention.

    PubMed

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff's spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15-19 years), adults aged 30-34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff's spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed. PMID:26862764

  15. Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

    PubMed Central

    Hoshi, Tomonori; Fuji, Yoshito; Nzou, Samson Muuo; Tanigawa, Chihiro; Kiche, Ibrahim; Mwau, Matilu; Mwangi, Anne Wanjiru; Karama, Mohamed; Hirayama, Kenji; Goto, Kensuke; Kaneko, Satoshi

    2016-01-01

    HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff’s spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15–19 years), adults aged 30–34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff’s spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed. PMID:26862764

  16. Abstinence Promotion Under PEPFAR: The Shifting Focus of HIV Prevention For Youth

    PubMed Central

    Santelli, John S.; Speizer, Ilene S.; Edelstein, Zoe R.

    2013-01-01

    Abstinence-until-marriage (AUM) – strongly supported by religious conservatives in the U.S. - became a key element of initial HIV prevention efforts under the President’s Emergency Plan for AIDS Relief (PEPFAR). AUM programs have demonstrated limited efficacy in changing behaviors, promoted medically inaccurate information, and withheld life-saving information about risk reduction. A focus on AUM also undermined national efforts in Africa to create integrated youth HIV prevention programs. PEPFAR prevention efforts after 2008 shifted to science-based programming, however vestiges of AUM remain. Primary prevention programs within PEPFAR are essential and nations must be able to design HIV prevention based on local needs and prevention science. PMID:23327516

  17. An empiric risk scoring tool for identifying high-risk heterosexual HIV-1 serodiscordant couples for targeted HIV-1 prevention

    PubMed Central

    KAHLE, Erin M.; HUGHES, James P.; LINGAPPA, Jairam R.; JOHN-STEWART, Grace; CELUM, Connie; NAKKU-JOLOBA, Edith; NJUGUNA, Stella; MUGO, Nelly; BUKUSI, Elizabeth; MANONGI, Rachel; BAETEN, Jared M.

    2012-01-01

    Background and objectives Heterosexual HIV-1 serodiscordant couples are increasingly recognized as an important source of new HIV-1 infections in sub-Saharan Africa. A simple risk assessment tool could be useful for identifying couples at highest risk for HIV-1 transmission. Methods Using data from three prospective studies of HIV-1 serodiscordant couples from seven African countries and standard methods for development of clinical prediction rules, we derived and validated a risk scoring tool developed from multivariate modeling and composed of key predictors for HIV-1 risk that could be measured in standard research and clinical settings. Results The final risk score included age of the HIV-1 uninfected partner, married and/or cohabiting partnership, number of children, unprotected sex, uncircumcised male HIV-1 uninfected partner, and plasma HIV-1 RNA in the HIV-1 infected partner. The maximum risk score was 12, scores ≥5 were associated with an annual HIV-1 incidence of >3%, and couples with a score ≥6 accounted for only 28% of the population but 67% of HIV-1 transmissions. The area under the curve for predictive ability of the score was 0.74 (95% CI 0.70–0.78). Internal and external validation showed similar predictive ability of the risk score, even when plasma viral load was excluded from the risk score. Conclusions A discrete combination of clinical and behavioral characteristics defines highest-risk HIV-1 serodiscordant couples. Discriminating highest-risk couples for HIV-1 prevention programs and clinical trials using a validated risk score could improve research efficiency and maximize the impact of prevention strategies for reducing HIV-1 transmission. PMID:23187945

  18. HIV Education for Adult Literacy Programs.

    ERIC Educational Resources Information Center

    Smith, Barbara E.

    This staff development package is designed to inform adult literacy practitioners about Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus (AIDS/HIV) and to facilitate implementation of HIV education in adult literacy programs. It is intended to teach them to plan and implement HIV education for their adult literacy students and to…

  19. Responsibility for HIV prevention: patterns of attribution among HIV-seropositive gay and bisexual men.

    PubMed

    Offer, Claudine; Grinstead, Olga; Goldstein, Ellen; Mamary, Edward; Alvarado, Nicholas; Euren, Jason; Woods, William J

    2007-02-01

    The Seroconversion Narratives for AIDS Prevention (SNAP) study elicited narratives from recently infected seropositive gay and bisexual men that described the circumstances of their own seroconversion. This analysis of the narratives explored participants' attributions of responsibility for HIV prevention before and after they became infected. Before becoming infected with HIV, responsibility for prevention was often attributed to HIV-negative individuals themselves. These retrospective attributions revealed themes that included feelings of negligence, a sense of consequences, followed by regret. After seroconversion, responsibility for HIV prevention was primarily attributed to HIV-positive individuals themselves. Themes within these attributions included pledges to avoid HIV transmission, a strong sense of burden related to the possibility of infecting someone, and risk reduction strategies that they implemented in an attempt to avoid HIV transmission. Greater understanding of ideas related to responsibility has the potential to increase the effectiveness of HIV prevention interventions. PMID:17411387

  20. Guy Talk: Contesting Masculinities in HIV Prevention Education with Canadian Youth

    ERIC Educational Resources Information Center

    Larkin, June; Andrews, Amy; Mitchell, Claudia

    2006-01-01

    This paper takes up the concern that sexual health programs targeting adolescents may actually increase HIV risk among youth by reinforcing dominant versions of masculinity that portray males as sexually irresponsible and unconcerned about their health. If a key aim in HIV prevention education is a renegotiation of high-risk behavioral norms, an…

  1. Non-Antiretroviral Microbicides for HIV Prevention

    PubMed Central

    Scott, Yanille; Dezzutti, Charlene S.

    2016-01-01

    Non-antiretroviral microbicide candidates were previously explored as a female-controlled method of preventing sexual transmission of HIV. These products contained non-HIV specific active compounds that were ultimately found to disrupt the vaginal epithelium, cause increased immune activation in the female genital tract, disturb vaginal flora, and/or cause other irritation that precluded their use as vaginal microbicides. Due to the failure of these first-generation candidates, there was a shift in focus to developing HIV pre-exposure prophylaxis and microbicides containing small-molecule antiretrovirals. Even with the limited success of the antiretroviral-based microbicides in clinical evaluations and no commercially available products, there has been significant progress in microbicide research. The lessons learned from previous trials have given rise to more rigorous preclinical evaluation that aims to be better at predicting microbicide efficacy and safety and to novel formulation and delivery technologies. These advances have resulted in renewed interest in developing non-antiretroviral-based microbicides, such as broadly neutralizing antibodies (for example, VRC01) and anti-viral proteins (for example, Griffithsin), as options for persons not wanting to use antiretroviral drugs, and for their potential to prevent multiple sexually transmitted infections. PMID:27438574

  2. Effectiveness and Cost Effectiveness of Oral Pre-Exposure Prophylaxis in a Portfolio of Prevention Programs for Injection Drug Users in Mixed HIV Epidemics

    PubMed Central

    Alistar, Sabina S.; Owens, Douglas K.; Brandeau, Margaret L.

    2014-01-01

    Background Pre-exposure prophylaxis with oral antiretroviral treatment (oral PrEP) for HIV-uninfected injection drug users (IDUs) is potentially useful in controlling HIV epidemics with a significant injection drug use component. We estimated the effectiveness and cost effectiveness of strategies for using oral PrEP in various combinations with methadone maintenance treatment (MMT) and antiretroviral treatment (ART) in Ukraine, a representative case for mixed HIV epidemics. Methods and Findings We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs who inject opiates, and IDUs in MMT, adding an oral PrEP program (tenofovir/emtricitabine, 49% susceptibility reduction) for uninfected IDUs. We analyzed intervention portfolios consisting of oral PrEP (25% or 50% of uninfected IDUs), MMT (25% of IDUs), and ART (80% of all eligible patients). We measured health care costs, quality-adjusted life years (QALYs), HIV prevalence, HIV infections averted, and incremental cost effectiveness. A combination of PrEP for 50% of IDUs and MMT lowered HIV prevalence the most in both IDUs and the general population. ART combined with MMT and PrEP (50% access) averted the most infections (14,267). For a PrEP cost of $950, the most cost-effective strategy was MMT, at $520/QALY gained versus no intervention. The next most cost-effective strategy consisted of MMT and ART, costing $1,000/QALY gained compared to MMT alone. Further adding PrEP (25% access) was also cost effective by World Health Organization standards, at $1,700/QALY gained. PrEP alone became as cost effective as MMT at a cost of $650, and cost saving at $370 or less. Conclusions Oral PrEP for IDUs can be part of an effective and cost-effective strategy to control HIV in regions where injection drug use is a significant driver of the epidemic. Where budgets are limited, focusing on MMT and ART access should be the priority, unless PrEP has low cost. PMID:24489747

  3. Placing contraception at the centre of the HIV prevention agenda.

    PubMed

    Crankshaw, Tamaryn L; Smit, Jennifer A; Beksinska, Mags E

    2016-07-01

    Over the past decade, the global response to the HIV epidemic has been unprecedented, and enormous progress has been made. Significant investment in the roll out of antiretroviral treatment (ART) and efforts to increase treatment coverage have greatly reduced the number of AIDS-related deaths worldwide. There are a growing number of promising innovations to expand the HIV prevention mix. However, the reach of these interventions is still very limited in adolescent girls and young women (15-24 years) and the full realisation of the intervention mandates has not yet been achieved. The HIV prevention field has been criticised for the tendency to adopt a narrow focus. The Fast-Track Strategy offers a unique opportunity for the HIV prevention field to broaden its gaze and to begin to identify synergies (and efficiencies) with prevention approaches from other global development priorities, namely sexual and reproductive health and rights (SRHR). This paper applies a SRHR lens to HIV prevention by highlighting the critical relationship between unintended pregnancy and HIV, and seeks to expand on earlier debates that prevention of HIV and prevention of unintended pregnancy are inextricably linked, complementary activities with interrelated and common goals. We call for the prioritisation of prevention of unintended pregnancy amongst two overlapping population groups - girls and young women (15-24 years old) and women living with HIV - as a key tactic to accomplish the Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast-Track Strategy and as a way to fully realise existing HIV prevention efforts. We discuss the intersecting pathways between HIV prevention and unintended pregnancy prevention and build a case for contraception to be placed at the centre of the HIV prevention agenda. PMID:27399045

  4. The Potential Impact of Preventive HIV Vaccines in China: Results and Benefits of a Multi-Province Modeling Collaboration.

    PubMed

    Harmon, Thomas; Guo, Wei; Stover, John; Wu, Zunyou; Kaufman, Joan; Schneider, Kammerle; Liu, Li; Feng, Liao; Schwartländer, Bernard

    2015-01-01

    China's commitment to implementing established and emerging HIV/AIDS prevention and control strategies has led to substantial gains in terms of access to antiretroviral treatment and prevention services, but the evolving and multifaceted HIV/AIDS epidemic in China highlights the challenges of maintaining that response. This study presents modeling results exploring the potential impact of HIV vaccines in the Chinese context at varying efficacy and coverage rates, while further exploring the potential implications of vaccination programs aimed at reaching populations at highest risk of HIV infection. A preventive HIV vaccine would add a powerful tool to China's response, even if not 100% efficacious or available to the full population.

  5. Antiretroviral Therapy as HIV Prevention: Status and Prospects

    PubMed Central

    Venkatesh, Kartik K.

    2010-01-01

    As antiretroviral treatment of HIV infection has become increasingly accessible, attention has focused on whether these drugs can used for prevention because of increased tolerability of newer medications, decreased cost, and the limitations of other approaches. We review the status of antiretroviral HIV prevention, including chemoprophylaxis, as well as the effects of treatment of infected individuals on prevention. It is possible that the life-saving agents that have transformed the natural history of AIDS can be a critical component of HIV prevention efforts, but their ultimate role in affecting HIV transmission dynamics remains to be defined. PMID:20724682

  6. Microfinance and HIV/AIDS Prevention: Assessing its Promise and Limitations

    PubMed Central

    Dworkin, Shari L.; Blankenship, Kim

    2013-01-01

    Researchers increasingly argue that poverty and gender inequality exacerbate the spread of HIV/AIDS and that economic empowerment can therefore assist in the prevention and mitigation of the disease, particularly for women. This paper critically evaluates such claims. First, we examine the promises and limits of integrated HIV/AIDS prevention and microfinance programs by examining the available evidence base. We then propose future research agendas and next steps that may help to clear current ambiguities about the potential for economic programs to contribute to HIV/AIDS risk reduction efforts. PMID:19294500

  7. Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm

    PubMed Central

    Haberer, Jessica E.; Bangsberg, David R.; Baeten, Jared M.; Curran, Kathryn; Koechlin, Florence; Amico, K. Rivet; Anderson, Peter; Mugo, Nelly; Venter, Francois; Goicochea, Pedro; Caceres, Carlos; O’Reilly, Kevin

    2015-01-01

    Clinical trial data have shown that oral pre-exposure prophylaxis (PrEP) is efficacious when taken as prescribed; however, PrEP adherence is complex and must be understood within the context of variable risk for HIV infection and use of other HIV prevention methods. Different levels of adherence may be needed in different populations to achieve HIV prevention, and the optimal methods for achieving the necessary adherence for both individual and public health benefits are unknown. Guidance for PrEP use must consider these questions to determine the success of PrEP-based HIV prevention programs. In this article, we propose a new paradigm for understanding and measuring PrEP adherence, termed prevention-effective adherence, which incorporates dynamic HIV acquisition risk behaviors and the use of HIV alternative prevention strategies. We discuss the need for daily PrEP use only during periods of risk for HIV exposure, describe key issues for measuring and understanding relevant behaviors, review lessons from another health prevention field (i.e., family planning), and provide guidance for prevention-effective PrEP use. Moreover, we challenge emerging calls for sustained, near perfect PrEP adherence regardless of risk exposure and offer a more practical and public health-focused vision for this prevention intervention. PMID:26103095

  8. AIDS and promiscuity: muddles in the models of HIV prevention.

    PubMed

    Bolton, R

    1992-05-01

    AIDS has been blamed on promiscuity and the promiscuous, and a major goal of many HIV-prevention programs has been to induce people to reduce the number of their sexual partners. Despite the salience of this concept in the AIDS discourse of scientists, policymakers, the media, religious leaders, and the gay community, critical analysis of the role of promiscuity in this epidemic has been lacking. Following a review of promiscuity in various genres of AIDS discourse, this article discusses promiscuity in American society and in HIV-prevention campaigns. The relative risks associated with monogamy, abstinence and promiscuity are examined, and the author concludes that the partner-reduction strategy, instead of contributing to a reduction in HIV transmission has been an impediment to AIDS prevention efforts, exacerbating the problem by undermining the sex-positive approaches to risk reduction that have proven effective. Responsibility for this misguided strategy is attributed to a moralistic approach to AIDS and to the misapplication of epidemiological concepts and inappropriate social science models to the task of promoting healthy forms of sexuality.

  9. Efficacy of a Preventive Intervention for Youths Living with HIV.

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane; Lee, Martha B.; Murphy, Debra A.; Futterman, Donna; Duan, Naihua; Birnbaum, Jeffrey M.; Lightfoot, Marguerita

    2001-01-01

    Examined HIV transmission behaviors and health practices among HIV-infected youths over 15 months following participation in a preventive intervention that emphasized coping with HIV and reducing risky behaviors. The intervention resulted in increases in social support coping and reductions in risky sexual and lifestyle behaviors specifically…

  10. Acceptability of Smartphone Application-Based HIV Prevention Among Young Men Who Have Sex With Men

    PubMed Central

    Holloway, Ian W.; Rice, Eric; Gibbs, Jeremy; Winetrobe, Hailey; Dunlap, Shannon; Rhoades, Harmony

    2014-01-01

    Young men who have sex with men (YMSM) are increasingly using mobile smartphone applications (“apps”), such as Grindr, to meet sex partners. A probability sample of 195 Grindrusing YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone-based HIV prevention for YMSM. The number one reason for using Grindr (29%) was to meet “hook ups.” Among those participants who used both Grindr and online dating sites, a statistically significantly greater percentage used online dating sites for “hook ups” (42%) compared to Grindr (30%). Seventy percent of YMSM expressed a willingness to participate in a smartphone app-based HIV prevention program. Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use. PMID:24292281

  11. Acceptability of smartphone application-based HIV prevention among young men who have sex with men.

    PubMed

    Holloway, Ian W; Rice, Eric; Gibbs, Jeremy; Winetrobe, Hailey; Dunlap, Shannon; Rhoades, Harmony

    2014-02-01

    Young men who have sex with men (YMSM) are increasingly using mobile smartphone applications ("apps"), such as Grindr, to meet sex partners. A probability sample of 195 Grindr-using YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone-based HIV prevention for YMSM. The number one reason for using Grindr (29 %) was to meet "hook ups." Among those participants who used both Grindr and online dating sites, a statistically significantly greater percentage used online dating sites for "hook ups" (42 %) compared to Grindr (30 %). Seventy percent of YMSM expressed a willingness to participate in a smartphone app-based HIV prevention program. Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use. PMID:24292281

  12. Acceptability of smartphone application-based HIV prevention among young men who have sex with men.

    PubMed

    Holloway, Ian W; Rice, Eric; Gibbs, Jeremy; Winetrobe, Hailey; Dunlap, Shannon; Rhoades, Harmony

    2014-02-01

    Young men who have sex with men (YMSM) are increasingly using mobile smartphone applications ("apps"), such as Grindr, to meet sex partners. A probability sample of 195 Grindr-using YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone-based HIV prevention for YMSM. The number one reason for using Grindr (29 %) was to meet "hook ups." Among those participants who used both Grindr and online dating sites, a statistically significantly greater percentage used online dating sites for "hook ups" (42 %) compared to Grindr (30 %). Seventy percent of YMSM expressed a willingness to participate in a smartphone app-based HIV prevention program. Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use.

  13. PrEP as Peri-conception HIV Prevention for Women and Men.

    PubMed

    Heffron, Renee; Pintye, Jillian; Matthews, Lynn T; Weber, Shannon; Mugo, Nelly

    2016-06-01

    Daily oral tenofovir (TDF)-based pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy and recommended for men and women with substantial risk of HIV acquisition. The peri-conception period, the stage prior to pregnancy when condom use is necessarily reduced, has elevated HIV risk that can be mitigated by PrEP use. Data from a randomized trial suggest that peri-conception PrEP use by HIV-seronegative women does not increase the risk of pregnancy loss, birth defects or congenital anomalies, preterm birth, or infant growth faltering. Women considering PrEP use throughout pregnancy must weigh the known increased risk of HIV acquisition with unknown risks of drug effects on infant growth. PrEP has been used safely by HIV-seronegative men with HIV-seropositive female partners who have become pregnant. As an effective user-controlled HIV prevention strategy, PrEP offers autonomy and empowerment for HIV prevention and can be recommended alongside antiretroviral therapy, fertility screening, vaginal self-insemination, intercourse timed to peak fertility, medically assisted reproduction, and other safer conception strategies to provide multiple options. The integration of PrEP into safer conception programs is warranted and will safely reduce HIV transmission to women, men, and children during the peri-conception period.

  14. Teen pregnancy prevention: do any programs work?

    PubMed

    Card, J J

    1999-01-01

    This paper begins with a review of the problem of teen pregnancy in the United States. Domestic trends are compared with those of other developed countries. Antecedents of the problem are discussed. New developments in addressing the problem are then described, including the following: (a) a renewed emphasis on abstinence on the one hand; (b) a move toward a more positive view of teen sexuality on the other; (c) the development of new prevention initiatives such as STD/HIV/AIDS prevention programs, community-wide teen pregnancy prevention collaboratives, broad-based youth development programs, and state and local government initiatives; and (d) the lauching of the National Campaign to Prevent Teen Pregnancy. An analysis of the different ways in which the problem can be framed and the implications for solutions of the problem follow. Examples of promising teen pregnancy and STD/HIV/AIDS prevention programs are provided. The paper ends with a recommendation for an eclectic approach to framing the problem and possible solutions. PMID:10352859

  15. Evaluation of a substance abuse, HIV and hepatitis prevention initiative for urban Native Americans: the Native Voices program.

    PubMed

    Nelson, Kyle; Tom, Nazbah

    2011-01-01

    Although many community-based prevention interventions are conducted in American Indian and Alaska Native (AI/AN) communities, few studies report the outcomes. This article is a mixed methods outcome evaluation of an HIV/AIDS, hepatitis, and substance abuse prevention intervention for an urban AI/AN community, Native Voices. The study group wascomposed of 100youth (ages 13 to 18) who lived in the San Francisco Bay Area. The outcome measures of interest were knowledge, perception of risk, sexual self-efficacy, ethnic identity, and sexual risk behavior. The findings indicate that knowledge, perception of risk, and sexual self-efficacy increased, while no change was shown in measures of ethnic identity and behavior. Findings extended prior research by evaluating the Gathering of Native Americans (GONA) curriculum, a promising intervention designed for AI/AN people. PMID:22400468

  16. Prevention for positives: challenges and opportunities for integrating prevention into HIV case management.

    PubMed

    Mitchell, C G; Linsk, N L

    2001-10-01

    Despite nearly 20 years of HIV prevention efforts, rates of new HIV infection persist at an alarming rate. As successful antiretroviral medications enable many HIV infected persons to live longer, healthier lives, interventions are necessary to support ongoing prevention and reduced risk behaviors. This article describes a survey that was used to assess the opportunities and challenges related to the integration of prevention screening into the work of HIV/AIDS case managers. The article describes the survey, reports the findings (N = 101), and concludes with a discussion of issues that must be addressed prior to incorporating prevention screening into HIV/AIDS case management.

  17. Chemoprophylaxis for HIV Prevention: New Opportunities and New Questions

    PubMed Central

    Mayer, Kenneth H.; Venkatesh, Kartik K.

    2010-01-01

    Growing data suggest that antiretrovirals can be used as an effective means of HIV prevention. This paper reviews the current status and future clinical prospects of utilizing antiretroviral chemoprophylaxis before and after high-risk HIV exposure to prevent HIV transmission. The discussion about using antiretrovirals as a means of primary HIV prevention has moved to the forefront of public health discourse because of a growing evidence base, the increased tolerability of the medications, the decreased cost, the ever expanding formulary, and the limitations of other approaches. PMID:21406981

  18. Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography

    PubMed Central

    Kripke, Katharine; Chimbwandira, Frank; Mwandi, Zebedee; Matchere, Faustin; Schnure, Melissa; Reed, Jason; Castor, Delivette; Sgaier, Sema

    2016-01-01

    Background In 2007, the World Health Organization (WHO) recommended scaling up voluntary medical male circumcision (VMMC) in priority countries with high HIV prevalence and low male circumcision (MC) prevalence. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), an estimated 5.8 million males had undergone VMMC by the end of 2013. Implementation experience has raised questions about the need to refocus VMMC programs on specific subpopulations for the greatest epidemiological impact and programmatic effectiveness. As Malawi prepared its national operational plan for VMMC, it sought to examine the impacts of focusing on specific subpopulations by age and region. Methods We used the Decision Makers’ Program Planning Toolkit, Version 2.0, to study the impact of scaling up VMMC to different target populations of Malawi. National MC prevalence by age group from the 2010 Demographic and Health Survey was scaled according to the MC prevalence for each district and then halved, to adjust for over-reporting of circumcision. In-country stakeholders advised a VMMC unit cost of $100, based on implementation experience. We derived a cost of $451 per patient-year for antiretroviral therapy from costs collected as part of a strategic planning exercise previously conducted in- country by UNAIDS. Results Over a fifteen-year period, circumcising males ages 10–29 would avert 75% of HIV infections, and circumcising males ages 10–34 would avert 88% of infections, compared to the current strategy of circumcising males ages 15–49. The Ministry of Health’s South West and South East health zones had the lowest cost per HIV infection averted. Moreover, VMMC met WHO’s definition of cost-effectiveness (that is, the cost per disability-adjusted life-year [DALY] saved was less than three times the per capita gross domestic product) in all health zones except Central East. Comparing urban versus rural areas in the country, we found that circumcising men in urban

  19. Effectiveness of HIV prevention social marketing with injecting drug users.

    PubMed

    Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

    2010-10-01

    Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

  20. A "big data" approach to HIV epidemiology and prevention.

    PubMed

    Young, Sean D

    2015-01-01

    The recent availability of "big data" from social media and mobile technologies provides promise for development of new tools and methods to address the HIV epidemic. This manuscript presents recent work in this growing area of bioinformatics, digital epidemiology, and disease modeling, describes how it can be applied to address HIV prevention, and presents issues that need to be addressed prior to implementing a mobile technology big-data approach to HIV prevention. PMID:25449693

  1. Predictors of Success in Implementing HIV Prevention in Rural America: A State-Level Structural Factor Analysis of HIV Prevention Targeting Men who have Sex with Men

    PubMed Central

    Horvath, Keith J.

    2013-01-01

    Relatively few studies have examined the impact of modifying structural factors on HIV prevention efforts in the United States despite their high potential for lowering HIV prevalence rates. The aim of this study was to identify state-level characteristics of successful HIV prevention implementation. Structured interviews with 73 key informants in 13 rural states identified ‘more successful’ and ‘less successful’ states in HIV prevention. States were compared on demographic, religious, gay community, and funding variables. The 7 more successful states had both a wider variety and more MSM-targeted interventions. Overall funding, degree of epidemic, and “ruralness” were not significantly associated with success. Rather, successful states had less religious and Evangelical Protestant adherents and more ‘gay community’ infrastructure. They also spent a greater proportion of funds contracting community-based organizations and on MSMtargeted programming. Success in HIV prevention varies across rural states. Key demographic, social and economic indicators distinguish success in HIV prevention. PMID:17440806

  2. Highly active antiretroviral treatment for the prevention of HIV transmission

    PubMed Central

    2010-01-01

    In 2007 an estimated 33 million people were living with HIV; 67% resided in sub-Saharan Africa, with 35% in eight countries alone. In 2007, there were about 1.4 million HIV-positive tuberculosis cases. Globally, approximately 4 million people had been given highly active antiretroviral therapy (HAART) by the end of 2008, but in 2007, an estimated 6.7 million were still in need of HAART and 2.7 million more became infected with HIV. Although there has been unprecedented investment in confronting HIV/AIDS - the Joint United Nations Programme on HIV/AIDS estimates $13.8 billion was spent in 2008 - a key challenge is how to address the HIV/AIDS epidemic given limited and potentially shrinking resources. Economic disparities may further exacerbate human rights issues and widen the increasingly divergent approaches to HIV prevention, care and treatment. HIV transmission only occurs from people with HIV, and viral load is the single greatest risk factor for all modes of transmission. HAART can lower viral load to nearly undetectable levels. Prevention of mother to child transmission offers proof of the concept of HAART interrupting transmission, and observational studies and previous modelling work support using HAART for prevention. Although knowing one's HIV status is key for prevention efforts, it is not known with certainty when to start HAART. Building on previous modelling work, we used an HIV/AIDS epidemic of South African intensity to explore the impact of testing all adults annually and starting persons on HAART immediately after they are diagnosed as HIV positive. This theoretical strategy would reduce annual HIV incidence and mortality to less than one case per 1000 people within 10 years and it would reduce the prevalence of HIV to less than 1% within 50 years. To explore HAART as a prevention strategy, we recommend further discussions to explore human rights and ethical considerations, clarify research priorities and review feasibility and acceptability

  3. Getting Personal: Progress and Pitfalls in HIV Prevention among Latinas

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Raj, Anita; Reed, Elizabeth; Ulibarri, Monica

    2011-01-01

    This article first presents the political, personal, and epidemiological context of Hortensia Amaro's 1988 publication in "Psychology of Women Quarterly" ("PWQ"), "Considerations for Prevention of HIV Infection Among Hispanic Women" (Amaro, 1988). Second, it provides a brief summary of progress in HIV prevention with Latinas. The third section…

  4. Evaluation of the Positive Prevention HIV/STD Curriculum

    ERIC Educational Resources Information Center

    LaChausse, Robert G.

    2006-01-01

    This study evaluated the effectiveness of Positive Prevention, a theory-based, HIV/STD prevention education curriculum for high school youth. Three hundred fifty-three students participated in a longitudinal experimental design to determine the impact of the curriculum on HIV/AIDS knowledge, self-efficacy to abstain from sex, self-efficacy of…

  5. Making the Connections: Why Literacy Matters for HIV Prevention

    ERIC Educational Resources Information Center

    Medel-Anonuevo, Carolyn; Cheick, Diarra Mahamadou

    2007-01-01

    This issue in the "Literacy Matters" looks at the relationship between literacy and HIV prevention education. It is the result of the UNESCO Institute for Lifelong Learning's work on examining the contribution of non-formal education (NFE) to HIV prevention, carried out in collaboration with the Association for the Development of Education in…

  6. Antiviral agents and HIV prevention: controversies, conflicts, and consensus

    PubMed Central

    Cohen, Myron S.; Muessig, Kathryn E.; Smith, M. Kumi; Powers, Kimberly A.; Kashuba, Angela D.M.

    2013-01-01

    Antiviral agents can be used to prevent HIV transmission before exposure as preexpo-sure prophylaxis (PrEP), after exposure as postexposure prophylaxis, and as treatment of infected people for secondary prevention. Considerable research has shed new light on antiviral agents for PrEP and for prevention of secondary HIV transmission. While promising results have emerged from several PrEP trials, the challenges of poor adherence among HIV-negative clients and possible increase in sexual risk behaviors remain a concern. In addition, a broader pipeline of antiviral agents for PrEP that focuses on genital tract pharmacology and safety and resistance issues must be developed. Antiretroviral drugs have also been used to prevent HIV transmission from HIV-infected patients to their HIV-discordant sexual partners. The HIV Prevention Trials Network 052 trial demonstrated nearly complete prevention of HIV transmission by early treatment of infection, but the generalizability of the results to other risk groups – including intravenous drug users and MSM – has not been determined. Most importantly, the best strategy for use of antiretroviral agents to reduce the spread of HIV at either the individual level or the population level has not been developed, and remains the ultimate goal of this area of investigation. PMID:22507927

  7. The Diabetes Prevention Program

    PubMed Central

    2005-01-01

    The Diabetes Prevention Program is a randomized clinical trial testing strategies to prevent or delay the development of type 2 diabetes in high-risk individuals with elevated fasting plasma glucose concentrations and impaired glucose tolerance. The 27 clinical centers in the U.S. are recruiting at least 3,000 participants of both sexes, ~50% of whom are minority patients and 20% of whom are ≥65 years old, to be assigned at random to one of three intervention groups: an intensive lifestyle intervention focusing on a healthy diet and exercise and two masked medication treatment groups—metformin or placebo—combined with standard diet and exercise recommendations. Participants are being recruited during a 2 2/3-year period, and all will be followed for an additional 3 1/3 to 5 years after the close of recruitment to a common closing date in 2002. The primary outcome is the development of diabetes, diagnosed by fasting or post-challenge plasma glucose concentrations meeting the 1997 American Diabetes Association criteria. The 3,000 participants will provide 90% power to detect a 33% reduction in an expected diabetes incidence rate of at least 6.5% per year in the placebo group. Secondary outcomes include cardiovascular disease and its risk factors; changes in glycemia, β-cell function, insulin sensitivity, obesity, diet, physical activity, and health-related quality of life; and occurrence of adverse events. A fourth treatment group—troglilazone combined with standard diet and exercise recommendations—was included initially but discontinued because of the liver toxicity of the drug. This randomized clinical trial will test the possibility of preventing or delaying the onset of type 2 diabetes in individuals at high risk. PMID:10189543

  8. Gender Differences in HIV/AIDS Preventive Self-Efficacy Among Taiwanese Adolescents.

    PubMed

    Lee, Yi-Hui; Salman, Ali; Cooksey-James, Tawna

    2016-02-01

    The aim of the cross-sectional study was to understand gender differences in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Self-administered questionnaires were used to measure HIV/AIDS preventive self-efficacy and covariates (age, substance use, and sexual experiences). Data were collected from 734 Taiwanese high school adolescents aged 16 to 18 years. Descriptive statistic analyses, t-test, and ANCOVA were utilized to analyze data. The results indicate significant differences exist between genders in HIV/AIDS preventive self-efficacy among Taiwanese adolescents. Compared to the males, female adolescents were found having significantly higher HIV/AIDS preventive self-efficacy related to refusing sexual intercourse, condom use, and questioning potential sexual partners than those who are males. While controlling age, sexual experience, and substance use, female Taiwanese adolescents also had higher HIV/AIDS preventive self-efficacy than those who are males. The findings suggest the importance of addressing gender differences in HIV/AIDS preventive self-efficacy when developing HIV reduction programs for Taiwanese adolescents.

  9. Current and (Potential) Future Effects of the Affordable Care Act on HIV Prevention.

    PubMed

    Viall, Abigail H; McCray, Eugene; Mermin, Jonathan; Wortley, Pascale

    2016-04-01

    Recent advances in science, program, and policy could better position the nation to achieve its vision of the USA as a place where new HIV infections are rare. Among these developments, passage of the Patient Protection and Affordable Care Act (ACA) in 2010 may prove particularly important, as the health system transformations it has launched offer a supportive foundation for realizing the potential of other advances, both within and beyond the clinical arena. This article summarizes opportunities to expand access to high-impact HIV prevention interventions under the ACA, examines whether available evidence indicates that these opportunities are being realized, and considers potential challenges to further gains for HIV prevention in an era of health reform. This article also highlights the new roles that HIV prevention programs and providers may assume in a health system no longer defined by fragmentation among public health, medical care, and community service providers.

  10. Feasibility of Delivering Evidence-Based HIV/STI Prevention Programming to A Community Sample of African-American Teen Girls via the Internet

    PubMed Central

    Danielson, Carla Kmett; McCauley, Jenna L.; Jones, Andrea; Borkman, April O.; Miller, Stephanie; Ruggiero, Kenneth J.

    2014-01-01

    The current study examined the feasibility of an HIV/STI prevention intervention for African American female adolescents. The intervention, SiHLEWeb, is a web-based adaptation of the evidence-based intervention, Sistas, Informing, Healing, Living, and Empowering (SiHLE). Participants were 41 African-American girls aged 13 to 18 years, recruited in collaboration with community partners (local high schools, Department of Juvenile Justice, child advocacy center, medical university). Results support the feasibility of recruitment, screening, and follow-up retention methods. The majority (63.4%) of recruited participants completed the intervention, taking an average of 4.5 site visits. Completers of SiHLEWeb demonstrated increases in knowledge regarding HIV/STI risks and risk reduction behavior, as well as significant increases in condom use self-efficacy. Findings provide preliminary support for the large-scale, randomized-controlled trial of the efficacy of SiHLEWeb to reduce high-risk sexual behavior among female African-American adolescents. PMID:24059877

  11. Feasibility of delivering evidence-based HIV/STI prevention programming to a community sample of African American teen girls via the internet.

    PubMed

    Danielson, Carla Kmett; McCauley, Jenna L; Jones, Andrea M; Borkman, April L; Miller, Stephanie; Ruggiero, Kenneth J

    2013-10-01

    The current study examined the feasibility of an HIV/STI prevention intervention for African American female adolescents. The intervention SiHLEWeb is a web-based adaptation of the evidence-based intervention, Sistas, Informing, Healing, Living, and Empowering (SiHLE). Participants were 41 African American girls aged 13 to 18 years, recruited in collaboration with community partners (local high schools, Department of Juvenile Justice, child advocacy center, medical university). Results support the feasibility of recruitment, screening, and follow-up retention methods. The majority (63.4%) of recruited participants completed the intervention, taking an average of 4.5 (SD = 3.63) site visits. Completers of SiHLEWeb demonstrated increases in knowledge regarding HIV/STI risks and risk reduction behavior [t(18) = 4.74, p < .001], as well as significant increases in condom use self-efficacy [t(16) = 2.41, p = .03]. Findings provide preliminary support for the large-scale, randomized-controlled trial of the efficacy of SiHLEWeb to reduce high-risk sexual behavior among female African American adolescents.

  12. Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era.

    PubMed

    Mutchler, Matt G; McDavitt, Bryce; Ghani, Mansur A; Nogg, Kelsey; Winder, Terrell J A; Soto, Juliana K

    2015-09-01

    Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options.

  13. Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era

    PubMed Central

    McDavitt, Bryce; Ghani, Mansur A.; Nogg, Kelsey; Winder, Terrell J.A.; Soto, Juliana K.

    2015-01-01

    Abstract Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded “tool kit” of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and “spreading the word” about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such “prevention navigation” could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options. PMID:26121564

  14. Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era.

    PubMed

    Mutchler, Matt G; McDavitt, Bryce; Ghani, Mansur A; Nogg, Kelsey; Winder, Terrell J A; Soto, Juliana K

    2015-09-01

    Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options. PMID:26121564

  15. Barriers to accessing HIV-prevention in clinic settings: Higher alcohol use and more sex partners predict decreased exposure to HIV-prevention counseling.

    PubMed

    Wilson, Kristina; Albarracín, Dolores

    2015-01-01

    Understanding barriers to accepting HIV-prevention counseling among vulnerable populations is of critical importance, as prevention efforts can only have a public health impact if high-risk populations are willing to enroll. A correlational field study was conducted in a health care setting with a high-risk community sample (N = 350) to determine if number of sex partners and alcohol consumption predict acceptance of an invitation to take part in HIV-prevention counseling. Findings indicated that participants engaging in the least risky behavior (i.e. individuals reporting no alcohol consumption and few sex partners) were more likely to accept an offer to receive HIV-prevention counseling. Moreover, heavy drinking was associated with decreased exposure to HIV-prevention counseling, regardless of the number of sex partners reported (b = .12, p > .05). Given associations between heavy drinking and sexual risk taking, finding ways to increase exposure to HIV-prevention counseling programs among heavy drinkers could serve a vital public health function. PMID:24684497

  16. Prevention Program Management. Participant Manual.

    ERIC Educational Resources Information Center

    University Research Corp., Bethesda, MD.

    This training package, which centers on effective management and the operation of valid prevention programs, presents a five-day training experience designed to help managers of substance-abuse prevention programs. In this participant manual, the introduction includes a list of program goals and objectives and a summary of the ten individual…

  17. 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…

  18. HIV Prevention Strategies for Community Colleges: Lessons Learned from Bridges to Healthy Communities. AACC Project Brief.

    ERIC Educational Resources Information Center

    Ottenritter, Nan; Barnett, Lynn

    The American Association of Community Colleges (AACC) instituted the Bridges to Healthy Communities project in 1995 as part of a 5-year strategy to develop campus-based programs for preventing HIV infection and related health problems among college students. The Centers for Disease Control and Prevention (CDC) sponsored the national effort through…

  19. 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.

  20. Targeting Structural Change for HIV Prevention: A Process and Tool for Community Application.

    PubMed

    Willard, Nancy; Chutuape, Kate; Stewart-Campbell, Rachel; Boyer, Cherrie B; Ellen, Jonathan

    2015-11-01

    To address the persistent HIV epidemic in the United States, prevention efforts are focusing on social determinants related to HIV risk by targeting systems and structures, such as organizational and institutional policies, practices and programs, and legislative and regulatory approaches to modify features of the environment that influence HIV risk. With limited evidenced-based examples, communities can benefit from strategic planning resources that help them consider developing structural-level changes that target root causes of HIV risk. In this article, we present the Connect to Protect® project that outlines a process and a tool to move from general ideas to specific structural changes. Examples from 14 coalitions are also provided. Using the process and tools presented here can provide a launching pad for other coalitions seeking to build an HIV prevention agenda and for practitioners seeking to incorporate structural changes for community health promotion. PMID:25776019

  1. Targeting Structural Change for HIV Prevention: A Process and Tool for Community Application

    PubMed Central

    Willard, Nancy; Chutuape, Kate; Stewart-Campbell, Rachel; Boyer, Cherrie B.; Ellen, Jonathan

    2015-01-01

    To address the persistent HIV epidemic in the United States, prevention efforts are focusing on social determinants related to HIV risk by targeting systems and structures, such as organizational and institutional policies, practices and programs, and legislative and regulatory approaches to modify features of the environment that influence HIV risk. With limited evidenced-based examples, communities can benefit from strategic planning resources that help them consider developing structural-level changes that target root causes of HIV risk. In this article, we present the Connect to Protect® project that outlines a process and a tool to move from general ideas to specific structural changes. Examples from 14 coalitions are also provided. Using the process and tools presented here can provide a launching pad for other coalitions seeking to build an HIV prevention agenda and for practitioners seeking to incorporate structural changes for community health promotion. PMID:25776019

  2. Targeting Structural Change for HIV Prevention: A Process and Tool for Community Application.

    PubMed

    Willard, Nancy; Chutuape, Kate; Stewart-Campbell, Rachel; Boyer, Cherrie B; Ellen, Jonathan

    2015-11-01

    To address the persistent HIV epidemic in the United States, prevention efforts are focusing on social determinants related to HIV risk by targeting systems and structures, such as organizational and institutional policies, practices and programs, and legislative and regulatory approaches to modify features of the environment that influence HIV risk. With limited evidenced-based examples, communities can benefit from strategic planning resources that help them consider developing structural-level changes that target root causes of HIV risk. In this article, we present the Connect to Protect® project that outlines a process and a tool to move from general ideas to specific structural changes. Examples from 14 coalitions are also provided. Using the process and tools presented here can provide a launching pad for other coalitions seeking to build an HIV prevention agenda and for practitioners seeking to incorporate structural changes for community health promotion.

  3. HIV-prevention science at a crossroads: advances in reducing sexual risk

    PubMed Central

    Vermund, Sten H.; Allen, Katherine L.; Karim, Quarraisha Abdool

    2010-01-01

    Purpose of review We review the current state of evidence-based prevention strategies for reducing sexual transmission of HIV. The combined programmatic and scientific efforts through 2008 to reduce sexual transmission of HIV have failed to reduce substantially the global pandemic. Recent findings Prevention interventions to reduce HIV infection target behavioral, biomedical, and structural risk factors. Some of these prevention strategies have been evaluated in randomized clinical trials (RCTs) with HIV seroincidence endpoints. When RCTs are not feasible, a variety of observational and quasiexperimental research approaches can provide insight as to program effectiveness of specific strategies. Only five RCTs have demonstrated a notable decrease in sexually acquired HIV incidence. These include the Mwanza study of syndromic management of sexually transmitted diseases and three male circumcision trials in East Africa; a microbicide trial reported in 2009 shows substantial promise for the efficacy of PRO 2000 (0.5% gel). Summary The combined programmatic and scientific efforts to reduce sexual transmission of HIV have made incremental progress. New prevention tools are needed to stem the continued spread of HIV, though microbicides and vaccines will take many more years to develop, test, and deploy. Combination strategies of existing modalities should be tested to evaluate the potential for more proximate prevention benefits. PMID:19532063

  4. Developing family interventions for adolescent HIV prevention in South Africa

    PubMed Central

    Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J.; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K. Brown, Larry

    2016-01-01

    ABSTRACT Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent–child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent–adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352). PMID

  5. Developing family interventions for adolescent HIV prevention in South Africa.

    PubMed

    Kuo, Caroline; Atujuna, Millicent; Mathews, Catherine; Stein, Dan J; Hoare, Jacqueline; Beardslee, William; Operario, Don; Cluver, Lucie; K Brown, Larry

    2016-01-01

    Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352). PMID:26916841

  6. Regional Differences in Prevalence of HIV-1 Discordance in Africa and Enrollment of HIV-1 Discordant Couples into an HIV-1 Prevention Trial

    PubMed Central

    Lingappa, Jairam R.; Lambdin, Barrot; Bukusi, Elizabeth Ann; Ngure, Kenneth; Kavuma, Linda; Inambao, Mubiana; Kanweka, William; Allen, Susan; Kiarie, James N.; Makhema, Joseph; Were, Edwin; Manongi, Rachel; Coetzee, David; de Bruyn, Guy; Delany-Moretlwe, Sinead; Magaret, Amalia; Mugo, Nelly; Mujugira, Andrew; Ndase, Patrick; Celum, Connie

    2008-01-01

    Background Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regional differences in HIV-1 discordance among African couples, has not previously been reported. Methodology/Principal Findings The Partners in Prevention HSV-2/HIV-1 Transmission Trial (“Partners HSV-2 Study”), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 2007. Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8–31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r = 0.74, p = 0.09). Conclusions/Significance HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials. PMID

  7. Is Sex Like Driving? HIV Prevention and Risk Compensation*

    PubMed Central

    Wilson, Nicholas L.; Xiong, Wentao; Mattson, Christine L.

    2015-01-01

    Risk compensation has been called the “Achilles’ heel” of HIV prevention policies (Cassell et al 2006). This paper examines the behavioral response to male circumcision, a major HIV prevention policy currently being implemented throughout much of Sub-Saharan Africa. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision may reduce fatalism about acquiring HIV/AIDS and increase the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient’s belief about the reduction in the risk of acquiring HIV. PMID:26997745

  8. A role for businesses in HIV prevention in Asia.

    PubMed

    Kimball, A M; Thant, M

    1996-06-15

    The estimated number of HIV cases in Asia now exceeds the "worst case" scenario envisioned by the World Bank in 1993. While prevention efforts have failed to contain the epidemic in other parts of the world, Asia's private sector has the resources to contain the epidemic if it acts quickly. In parts of Asia, work place-based medical and health services already exist, but, to date, efforts to gain the cooperation of business and industry in HIV prevention programs have led to disappointment. Businesses in Thailand, on the other hand, have begun a vigorous prevention campaign led by the Thailand Business Coalition on AIDS. The countries where the epidemic has not yet made a big impact (Japan, Korea, Hong Kong, Indonesia, Viet Nam, and the Philippines) are those where intervention could be most effective. Unfortunately, little corporate cooperation is occurring in these areas. Asian companies seem to fear contamination from the disease if they engage in prevention activities. Businesses in Asia have not faced the reality of the costs of AIDS which will rob companies of highly skilled workers who are expensive to replace, drive away foreign capital, and shrink the home market as people dedicate their resources to health care. While the impact of AIDS on businesses follows a tiered approach, all enterprises will eventually be affected adversely. The interrelated nature of Asia economies will also mean that even nations which are not experiencing the epidemic will feel its economic impact (for example, Japan will see its gross national product decrease because of trade losses caused by the epidemic in Thailand). Prevention efforts by businesses must be supported and encouraged by governments with financial and other incentives. Multinational corporations can have an effect on national companies as well as organize programs for their own employees. Because they depend upon longterm strategic thinking, Asian financial institutions are beginning to understand the role that

  9. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen

    PubMed Central

    Salazar, Ximena; Núnez-Curto, Arón; Villayzán, Jana; Castillo, Regina; Benites, Carlos; Caballero, Patricia; Cáceres, Carlos F

    2016-01-01

    Introduction As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a “Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen.” Discussion A policy dialogue between key stakeholders – Peru's Ministry of Health, academic scientists, civil society, transgender leaders and international agencies – created the conditions for a change in Peru's national HIV policy for transwomen. Supported by the effective engagement of all sectors, the Ministry of Health launched a plan to provide comprehensive HIV prevention and care for transwomen. The five-year plan includes new national guidelines for HIV prevention, care and support, and country-level investments in infrastructure and equipment. In addition to new biomedical strategies, the plan also incorporates several strategies to address structural factors that contribute to the vulnerability of transwomen. We identified three key factors that created the right conditions for this change in Peru's HIV policy. These factors include (1) the availability of solid evidence, based on scientific research; (2) ongoing efforts within the transwomen community to become better advocates of their own rights; and (3) a dialogue involving honest discussions between stakeholders about possibilities of changing the nation's HIV policy. Conclusions The creation of Peru's national plan for HIV prevention and care for transwomen shows that long-term processes, focused on human rights for transwomen in Peru, can lead to organizational and public-policy change. PMID:27431469

  10. Integrating Infrastructure Building with Peer-Focused Approaches to HIV Prevention Education.

    ERIC Educational Resources Information Center

    Fairfax, Johnnie L.; Clark, Marc D.; Wright, Linda S.; Ford, Denyce S.; Shepperd, Billie T.

    1997-01-01

    Discusses the District of Columbia Public Schools' collaborative approach to HIV/AIDS prevention education centered on peer education. The program is part of a broader school health project that addresses many health risk areas. It links peer programs to local networks, training teachers and peer educators and offering special community training…

  11. Masculine ideology, norms, and HIV prevention among young Black men

    PubMed Central

    Hall, Naomi M.; Applewhite, Sheldon

    2014-01-01

    This study examines the relationship between masculine ideology, adherence to norms, and HIV prevention among young Black heterosexual and gay men on the campus of a historically Black college/university. The data from four focus groups and nine individual interviews (N = 35) were aggregated and two recurring themes emerged: sexual communication, and mate availability. Additional themes related to HIV prevention were stigma, protection, and testing. The importance of investigating masculinity with young men is highlighted and implications for professionals working with college students to prevent the transmission of HIV are included. PMID:25525415

  12. Modeling HIV-1 Mucosal Transmission and Prevention in Humanized Mice.

    PubMed

    Veselinovic, Milena; Charlins, Paige; Akkina, Ramesh

    2016-01-01

    The new generation humanized mice (hu-mice) that permit continuous de novo generation of human hematopoietic cells have led to novel strategies in studying HIV-1 pathogenesis, prevention and therapies. HIV-1 infection of hu-mice results in chronic viremia and CD4+ T cell loss, thus mimicking key aspects of the disease progression. In addition, the new generation hu-mice are permissive for HIV-1 sexual transmission by vaginal and rectal routes thus allowing in vivo efficacy testing of new anti-HIV-1 drugs for prevention. Two leading models are currently being used, namely the hu-HSC mice and the BLT mice. Here we describe the methodology for generating both hu-HSC and BLT mice and their use in the study of HIV-1 transmission and prevention of infection by topical and oral administration of anti-retroviral drugs. Practical aspects of the methodologies are emphasized.

  13. HIV Prevention Messages Targeting Young Latino Immigrant MSM.

    PubMed

    Solorio, Rosa; Norton-Shelpuk, Pamela; Forehand, Mark; Martinez, Marcos; Aguirre, Joel

    2014-01-01

    Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.

  14. HIV Prevention Messages Targeting Young Latino Immigrant MSM

    PubMed Central

    Solorio, Rosa; Forehand, Mark; Aguirre, Joel

    2014-01-01

    Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay. PMID:24864201

  15. HIV Prevention Messages Targeting Young Latino Immigrant MSM.

    PubMed

    Solorio, Rosa; Norton-Shelpuk, Pamela; Forehand, Mark; Martinez, Marcos; Aguirre, Joel

    2014-01-01

    Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay. PMID:24864201

  16. A typology of structural approaches to HIV prevention

    PubMed Central

    Tsai, Alexander C.

    2012-01-01

    Renewed enthusiasm for biomedical HIV prevention strategies has followed the recent publication of several high-profile HIV antiretroviral therapy-based HIV prevention trials. In a recent article, Roberts & Matthews (2012) accurately note some of the shortcomings of these individually targeted approaches to HIV prevention and advocate for increased emphasis on structural interventions that have more fundamental effects on the population distribution of HIV. However, they make some implicit assumptions about the extent to which structural interventions are user-independent and more sustainable than biomedical or behavioral interventions. In this article, I elaborate a simple typology of structural interventions along these two axes and suggest that they may be neither user-independent nor sustainable and therefore subject to the same sustainability concerns, costs, and potential unintended consequences as biomedical and behavioral interventions. PMID:22877933

  17. 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.

  18. HIV risk and preventive interventions in transgender women sex workers

    PubMed Central

    Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

    2015-01-01

    Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

  19. Prevention Program Management. Trainer Manual.

    ERIC Educational Resources Information Center

    University Research Corp., Bethesda, MD.

    This training package, which centers on effective management and the operation of valid prevention programs, presents a five-day training experience designed to help managers of substance-abuse prevention programs. In this trainer manual, the introduction includes a list of course goals and objectives, a summary of the ten individual training…

  20. Just Say Maybe: Working with Uncertainties in HIV Prevention Education

    ERIC Educational Resources Information Center

    Frankham, Jo

    2003-01-01

    The article focuses on a key aspect of the experiences of young gay men and considers how their responses might inform HIV prevention education for all young people. The article first outlines key representations of same-sex desire and of HIV/AIDS through which young gay men learn various certainties about gay men, gay sex and AIDS. As a…

  1. HIV Prevention for Adolescents: Where Do We Go from Here?

    ERIC Educational Resources Information Center

    Lightfoot, Marguerita

    2012-01-01

    The World Health Organization estimates that 50% of the 30 million HIV infections worldwide occurred in young people between the ages of 15 and 24 years. In the United States, national statistics estimate that almost 40% of new HIV cases occur in youth ages 13-29 (Centers for Disease Control and Prevention, 2011). Therefore, a focus on preventing…

  2. 78 FR 43055 - Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... July 18, 2013 Part III The President Executive Order 13649--Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative #0; #0; #0; Presidential... Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative By...

  3. Nosocomial HIV infection: epidemiology and prevention--a global perspective.

    PubMed

    Ganczak, Maria; Barss, Peter

    2008-01-01

    Because, globally, HIV is transmitted mainly by sexual practices and intravenous drug use and because of a long asymptomatic period, healthcare-associated HIV transmission receives little attention even though an estimated 5.4% of global HIV infections result from contaminated injections alone. It is an important personal issue for healthcare workers, especially those who work with unsafe equipment or have insufficient training. They may acquire HIV occupationally or find themselves before courts, facing severe penalties for causing HIV infections. Prevention of blood-borne nosocomial infections such as HIV differs from traditional infection control measures such as hand washing and isolation and requires a multidisciplinary approach. Since there has not been a review of healthcare-associated HIV contrasting circumstances in poor and rich regions of the world, the aim of this article is to review and compare the epidemiology of HIV in healthcare facilities in such settings, followed by a consideration of general approaches to prevention, specific countermeasures, and a synthesis of approaches used in infection control, injury prevention, and occupational safety. These actions concentrated on identifying research on specific modes of healthcare-associated HIV transmission and on methods of prevention. Searches included studies in English and Russian cited in PubMed and citations in Google Scholar in any language. MeSH keywords such as nosocomial, hospital-acquired, iatrogenic, healthcare associated, occupationally acquired infection and HIV were used together with mode of transmission, such as "HIV and hemodialysis". References of relevant articles were also reviewed. The evidence indicates that while occasional incidents of healthcare-related HIV infection in high-income countries continue to be reported, the situation in many low-income countries is alarming, with transmission ranging from frequent to endemic. Viral transmission in health facilities occurs by

  4. Automated preventive maintenance program

    NASA Technical Reports Server (NTRS)

    Cea, E. J.; Grieger, T. H.

    1971-01-01

    Maintenance program which is concise and inexpensive to operate adapts to almost any system that has a FORTRAN compiler. Program operates on a stored data base with an output consisting of scheduling information and various management reports.

  5. Broadly Neutralizing Anti-HIV Antibodies Prevent HIV Infection of Mucosal Tissue Ex Vivo

    PubMed Central

    Scott, Yanille M.; Park, Seo Young

    2015-01-01

    Broadly neutralizing monoclonal antibodies (nAbs) specific for HIV are being investigated for use in HIV prevention. Due to their ability to inhibit HIV attachment to and entry into target cells, nAbs may be suitable for use as topical HIV microbicides. As such, they would present an alternative intervention for individuals who may not benefit from using antiretroviral-based products for HIV prevention. We theorize that nAbs can inhibit viral transmission through mucosal tissue, thus reducing the incidence of HIV infection. The efficacy of the PG9, PG16, VRC01, and 4E10 antibodies was evaluated in an ex vivo human model of mucosal HIV transmission. nAbs reduced HIV transmission, causing 1.5- to 2-log10 reductions in HIV replication in ectocervical tissues and ≈3-log10 reductions in HIV replication in colonic tissues over 21 days. These antibodies demonstrated greater potency in colonic tissues, with a 50-fold higher dose being required to reduce transmission in ectocervical tissues. Importantly, nAbs retained their potency and reduced viral transmission in the presence of whole semen. No changes in tissue viability or immune activation were observed in colonic or ectocervical tissue after nAb exposure. Our data suggest that topically applied nAbs are safe and effective against HIV infection of mucosal tissue and support further development of nAbs as a topical microbicide that could be used for anal as well as vaginal protection. PMID:26596954

  6. 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. PMID:22871481

  7. An exploratory study of HIV-prevention advocacy by persons in HIV care in Uganda

    PubMed Central

    Tumwine, Christopher; Nannungi, Annet; Ssegujja, Eric; Nekesa, Nicolate; Ssali, Sarah; Atuyambe, Lynn; Ryan, Gery; Wagner, Glenn

    2013-01-01

    To explore how people living with HIV (PLHIV) and in care encourage others to adopt HIV-protective behaviours, we conducted in-depth interviews with a purposive sample of 40 HIV clinic patients in Kampala, Uganda. Content analysis was used to examine the message content, trigger events, and outcomes of HIV-prevention advocacy events initiated by the HIV clients with members of their social networks. The content themes included encouraging specific behaviours, such as HIV testing and treatment, condom use and non-promiscuity, as well as more general cautionary messages about protecting oneself from HIV infection. Common triggers for bringing up HIV-prevention advocacy information in a discussion or conversation included: wanting to prevent the targeted person from ‘falling into the same problems,’ wanting to benefit oneself with regard to avoiding re-infection, out of concern that the target would engage in higher-risk behaviour, due to observed changes in the target’s health, and to convey information after receiving treatment at the clinic. The participants mostly reported positive or neutral responses to these advocacy events; negative responses were rare. Interventions to empower PLHIV to be agents of change could represent a new frontier for HIV prevention. PMID:24910590

  8. Developing community networks to deliver HIV prevention interventions.

    PubMed

    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.

  9. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

    PubMed Central

    Jaiantilal, Prafulta; Gutin, Sarah A.; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Abstract Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges

  10. Reducing HIV Risks in the Places Where People Drink: Prevention Interventions in Alcohol Venues.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C

    2016-01-01

    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

  11. 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. PMID:22778344

  12. Equity monitoring for social marketing: use of wealth quintiles and the concentration index for decision making in HIV prevention, family planning, and malaria programs

    PubMed Central

    2013-01-01

    Background The majority of social marketing programs are intended to reach the poor. It is therefore essential that social marketing organizations monitor the health equity of their programs and improve targeting when the poor are not being reached. Current measurement approaches are often insufficient for decision making because they fail to show a program's ability to reach the poor and demonstrate progress over time. Further, effective program equity metrics should be benchmarked against a national reference population and consider exposure, not just health outcomes, to measure direct results of implementation. This study compares two measures of health equity, concentration indices and wealth quintiles, using a defined reference population, and considers benefits of both measures together to inform programmatic decision making. Methods Three datasets from recent cross-sectional behavioral surveys on malaria, HIV, and family planning from Nepal and Burkina Faso were used to calculate concentration indices and wealth quintiles. Each sample was standardized to national wealth distributions based on recent Demographic and Health Surveys. Wealth quintiles were generated and concentration indices calculated for health outcomes and program exposure in each sample. Chi-square and t-tests were used to assess statistical significance of results. Results Reporting wealth quintiles showed that recipients of Population Services International (PSI) interventions were wealthier than national populations. Both measures indicated that desirable health outcomes were usually concentrated among wealthier populations. Positive and significant concentration indices in all three surveys indicated that wealth and program exposure were correlated; however this relationship was not necessarily linear. In analyzing the equity of modern contraceptive use stratified by exposure to family planning messages in Nepal, the outcome was equitable (concentration index = 0.006, p = 0.68) among the

  13. The obligation to provide antiretroviral treatment in HIV prevention trials.

    PubMed

    Lo, Bernard; Padian, Nancy; Barnes, Mark

    2007-06-19

    Providing antiretroviral therapy (ART) to participants who seroconvert during HIV prevention trials in developing countries is an ethical expectation. Promising treatment to the few seroconverters widens disparities within a resource-poor country and would be unjust. Such an assurance should be done in a way that also improves access to ART for others in the country. US funds for ART in poor countries from the PEPFAR should be available to all countries that host HIV prevention and clinical trials. PMID:17545698

  14. Behavioral and Biomedical Combination Strategies for HIV Prevention

    PubMed Central

    Bekker, Linda-Gail; Beyrer, Chris; Quinn, Thomas C.

    2012-01-01

    Around 2.5 million people become infected with HIV each year. This extraordinary toll on human life and public health worldwide will only be reversed with effective prevention. What’s more, in the next few years, it is likely at least, that no single prevention strategy will be sufficient to contain the spread of the disease. There is a need for combination prevention as there is for combination treatment, including biomedical, behavioral, and structural interventions. Expanded HIV prevention must be grounded in a systematic analysis of the epidemic’s dynamics in local contexts. Although 85% of HIV is transmitted sexually, effective combinations of prevention have been shown for people who inject drugs. Combination prevention should be based on scientifically derived evidence, with input and engagement from local communities that fosters the successful integration of care and treatment. PMID:22908192

  15. AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research.

    PubMed

    Fisher, William A; Kohut, Taylor; Fisher, Jeffrey D

    2009-12-01

    The current analysis considers the HIV prevention research record in the social sciences. We do so with special reference to what has been termed "AIDS Exceptionalism"- departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for "Prevention for Positives," supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to addresses effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior. At the first quarter century of the AIDS epidemic, it is important to weigh our accomplishments against our failures in the fight against AIDS…Future historians will conclude that we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven "prevention" that only served a particular political agenda.Editorial: A Quarter Century of AIDS. American Journal of Public Health. (Stall & Mills, 2006, p. 961).

  16. Setting up an HIV screening program.

    PubMed

    Williams, A; Dodd, R Y

    1989-01-01

    Human immunodeficiency virus-1 (HIV-1) screening programs currently are based primarily on the detection of specific HIV-1 antibodies by the commercially available enzyme immunoassay (EIA) combined with highly specific confirmation procedures. Factors to be considered in establishing a screening program include test performance characteristics, economy, confidentiality and notification procedures, legal and regulatory issues, proficiency and quality control measures, and laboratory safety. Commercial EIA screening in conjunction with a licensed Western blot assay permits the classification of all but a few serum samples into HIV-1-positive and HIV-1-negative categories. The occasional indeterminate results often can be resolved by following a defined retesting/resampling algorithm or by using research-level test procedures that may become available for diagnostic use in the future. Although screening of patient populations with an increased risk of HIV-1 exposure will improve the predictive accuracy of an initial screening assay, confirmation testing should nonetheless be performed for all EIA reactive sera regardless of the source. Local HIV-1 screening programs that meet minimum-volume requirements can result in considerable savings and flexibility for a moderate-size institution. However, before this type of program is undertaken, numerous technical and ethical considerations need to be addressed.

  17. HIV-1 transmission linkage in an HIV-1 prevention clinical trial

    SciTech Connect

    Leitner, Thomas; Campbell, Mary S; Mullins, James I; Hughes, James P; Wong, Kim G; Raugi, Dana N; Scrensen, Stefanie

    2009-01-01

    HIV-1 sequencing has been used extensively in epidemiologic and forensic studies to investigate patterns of HIV-1 transmission. However, the criteria for establishing genetic linkage between HIV-1 strains in HIV-1 prevention trials have not been formalized. The Partners in Prevention HSV/HIV Transmission Study (ClinicaITrials.gov NCT00194519) enrolled 3408 HIV-1 serodiscordant heterosexual African couples to determine the efficacy of genital herpes suppression with acyclovir in reducing HIV-1 transmission. The trial analysis required laboratory confirmation of HIV-1 linkage between enrolled partners in couples in which seroconversion occurred. Here we describe the process and results from HIV-1 sequencing studies used to perform transmission linkage determination in this clinical trial. Consensus Sanger sequencing of env (C2-V3-C3) and gag (p17-p24) genes was performed on plasma HIV-1 RNA from both partners within 3 months of seroconversion; env single molecule or pyrosequencing was also performed in some cases. For linkage, we required monophyletic clustering between HIV-1 sequences in the transmitting and seroconverting partners, and developed a Bayesian algorithm using genetic distances to evaluate the posterior probability of linkage of participants sequences. Adjudicators classified transmissions as linked, unlinked, or indeterminate. Among 151 seroconversion events, we found 108 (71.5%) linked, 40 (26.5%) unlinked, and 3 (2.0%) to have indeterminate transmissions. Nine (8.3%) were linked by consensus gag sequencing only and 8 (7.4%) required deep sequencing of env. In this first use of HIV-1 sequencing to establish endpoints in a large clinical trial, more than one-fourth of transmissions were unlinked to the enrolled partner, illustrating the relevance of these methods in the design of future HIV-1 prevention trials in serodiscordant couples. A hierarchy of sequencing techniques, analysis methods, and expert adjudication contributed to the linkage

  18. 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

  19. The evolution of the CDC HIV prevention capacity-building assistance initiative.

    PubMed

    Taveras, Samuel; Duncan, Ted; Gentry, Daniel; Gilliam, Aisha; Kimbrough, Ivory; Minaya, Jasmin

    2007-01-01

    As the HIV/AIDS epidemic neared the end of its first decade in the late 1980s, the US Centers for Disease Control and Prevention (CDC) recognized the disparate impact on racial and ethnic minority communities. In response, a program was initiated to build capacity to prevent the further spread of HIV and other STDs in these communities. Since that time, the program has expanded in scope, intensity of efforts, and funding. Today, the CDC's Capacity Building Assistance (CBA) Initiative serves communities across the nation by building community, organizational, and HIV prevention program/intervention capacity designed to reduce the number of new HIV infections among at-risk populations. This article focuses on the history and evolution of these efforts, lessons learned, and how these were used to develop the current, more responsive system. A conceptual framework is presented that describes the taxonomy of CBA services designed to (1) enhance organizational infrastructure; (2) enhance HIV prevention interventions; (3) strengthen community capacity; and (4) strengthen community planning. It includes language and definitions, approaches and mechanisms for delivering capacity-building services, and a Web-based request-and-referral system that serves as the foundation for tracking, monitoring, and ensuring the delivery of appropriate, efficient, and culturally competent CBA.

  20. AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research

    PubMed Central

    Fisher, William A.; Kohut, Taylor; Fisher, Jeffrey D.

    2013-01-01

    The current analysis considers the HIV prevention research record in the social sciences. We do so with special reference to what has been termed “AIDS Exceptionalism”— departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for “Prevention for Positives,” supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to addresses effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior. At the first quarter century of the AIDS epidemic, it is important to weigh our accomplishments against our failures in the fight against AIDS…Future historians will conclude that we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven “prevention” that only served a particular political agenda. Editorial: A Quarter Century of AIDS. American Journal of Public Health. (Stall & Mills, 2006, p. 961) PMID:23667386

  1. HIV prevention interventions in Chennai, India: are men who have sex with men being reached?

    PubMed

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

    2009-11-01

    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 in the prior 3 months were less likely to have participated in

  2. Improving community support for HIV and AIDS prevention through national partnerships.

    PubMed

    Williams, K R; Scarlett, M I; Jimenez, R; Schwartz, B; Stokes-Nielson, P

    1991-01-01

    If the transmission of human immunodeficiency virus (HIV) is to be prevented, the environment in which people live should predispose them to engage in and sustain safe behaviors. Too often in public health, the range of organizations that make up that environment are overlooked, and prevention strategies are limited to familiar medical and public health institutions. Improvement in public health does not occur in isolation, apart from the other institutions of society--and so it is with the HIV-AIDS epidemic. Education; business and labor; religion; government; voluntary, civic, and social organizations; and the media can all serve as facilitators or as barriers to creating the environment--at the national, regional, State, or local level--that will prevent and control the spread of HIV infection and AIDS and support the needs of those already infected. Collectively, they become a comprehensive HIV prevention network with access to and influence on the total public. One of the most significant benefits of this network is the multiplier effect on the limited resources of public health. Therefore, as part of its HIV and AIDS prevention strategy, the Centers for Disease Control (CDC) has developed national partnerships to involve the leadership of business, labor and industry, religious institutions and organizations, and voluntary organizations in HIV and AIDS prevention and service. Some of these partnerships are federally funded, others are not. The national partnership program described in this paper has produced increased resources for HIV education and services and has demonstrated the synergistic benefits resulting from public and private cooperation in addressing the HIV epidemic.

  3. The Mpowerment Project: a community-level HIV prevention intervention for young gay men.

    PubMed Central

    Kegeles, S M; Hays, R B; Coates, T J

    1996-01-01

    OBJECTIVES. Since young gay men are engaging in alarmingly high rates of unsafe sex and few seek help for changing risky behaviors, community-level programs to prevent infection with the human immunodeficiency virus (HIV) among them are urgently needed. METHODS. We developed and implemented a community-level HIV prevention program in a midsized Oregon community. The peer-led program had three components: out-reach, small groups, and a publicity campaign. Independently from the prevention program, a cohort of young gay men (n = 300) was surveyed in this and in a similar comparison community pre- and postintervention. RESULTS. Following intervention, the proportion of men engaging in any unprotected anal intercourse decreased from 41.0% to 30.0% (-27% from baseline), decreased from 20.2% to 11.1% (-45% from baseline) with nonprimary partners, and decreased from 58.9% to 44.7% (-24% from baseline) with boyfriends. No significant changes occurred in the comparison community over the same period. CONCLUSIONS. This prevention approach effectively led to HIV risk reduction. To reach risk-taking young gay men, HIV prevention activities must be embedded in social activities and community life. PMID:8712273

  4. Do Peer Educators Make a Difference? An Evaluation of a Youth-Led HIV Prevention Model in Zambian Schools

    ERIC Educational Resources Information Center

    Denison, J. A.; Tsui, S.; Bratt, J.; Torpey, K.; Weaver, M. A.; Kabaso, M.

    2012-01-01

    Restless Development's youth-led model places trained Volunteer Peer Educators (VPEs), aged 18-25 years, in schools to teach HIV prevention and reproductive health (RH). VPEs also run youth centers, extracurricular and community-based activities. This evaluation assesses (i) program effects on students' HIV/RH knowledge, attitudes and behaviors…

  5. HIV Seropositivity and AIDS Prevention and Control: Report on a WHO Meeting (Moscow, USSR, March 14-17, 1989).

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    With the development of tests to detect infection with Human Immunodeficiency Virus (HIV), it has become possible to determine its prevalence and to monitor trends in populations. Such information is valuable in designing, implementing, and monitoring public health programs for the prevention and control of HIV and the Acquired Immune Deficiency…

  6. HIV prevention in prisons and jails: obstacles and opportunities.

    PubMed Central

    Polonsky, S; Kerr, S; Harris, B; Gaiter, J; Fichtner, R R; Kennedy, M G

    1994-01-01

    High rates of human immunodeficiency virus (HIV) infection among jail and prison inmates suggest that HIV prevention efforts should focus on incarcerated populations. Overcrowding, the high prevalence of injection drug use, and other high-risk behaviors among inmates create a prime opportunity for public health officials to affect the course of the HIV epidemic if they can remedy these problems. Yet, along with the opportunity, there are certain obstacles that correctional institutions present to public health efforts. The various jurisdictions have differing approaches to HIV prevention and control. Whether testing should be mandatory or voluntary, whether housing should be integrated or segregated by HIV serostatus, and whether condoms, bleach, or clean needles should be made available to the prisoners, are questions hotly debated by public health and correctional officials. Even accurate assessment of risk-taking within the institutions leads to controversy, as asking questions could imply acceptance of the very behaviors correctional officials are trying to prevent. Education and risk-reduction counseling are the least controversial and most widely employed modes of prevention, but the effectiveness of current prevention efforts in reducing HIV transmission in this high-risk population is largely undetermined. PMID:7938381

  7. 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

  8. HIV prevention research: taking stock and the way forward.

    PubMed

    Hayes, Richard; Kapiga, Saidi; Padian, Nancy; McCormack, Sheena; Wasserheit, Judith

    2010-10-01

    Previous papers in this supplement have reviewed the evidence of the effectiveness of alternative HIV prevention methods from randomized controlled trials and other studies. This paper draws together the main conclusions from these reviews. A conceptual framework is presented that maps the proximal and distal determinants of sexual HIV transmission and helps to identify the stages in the causal pathway at which each intervention approach acts. The advances, gaps and challenges emerging from the reviews of individual intervention methods are summarized and cross-cutting themes identified. Approximately 90% of HIV prevention trials have found no effect on HIV incidence and we explore the alternative explanations for the large number of 'flat' trials. We conclude that there is no single explanation for these flat results, which may be due to interventions that are ineffective or inappropriately targeted or implemented, or to factors related to the design or conduct of trials. We examine the lessons from these flat results and provide recommendations on what should be done differently in future trials. HIV prevention remains of critical importance in an era of expanded delivery of antiretroviral therapy. In future HIV prevention research, it is important that resources are used as efficiently as possible to provide rigorous evidence of the effectiveness of a wider array of complementary prevention tools. PMID:21042056

  9. HIV PREVENTION RESEARCH: TAKING STOCK AND THE WAY FORWARD

    PubMed Central

    Hayes, Richard; Kapiga, Saidi; Padian, Nancy; McCormack, Sheena; Wasserheit, Judith

    2011-01-01

    Previous papers in this supplement have reviewed the evidence of the effectiveness of alternative HIV prevention methods from randomised controlled trials and other studies. This paper draws together the main conclusions from these reviews. A conceptual framework is presented that maps the proximal and distal determinants of sexual HIV transmission and helps to identify the stages in the causal pathway at which each intervention approach acts. The advances, gaps and challenges emerging from the reviews of individual intervention methods are summarised and cross-cutting themes identified. Approximately 90% of HIV prevention trials have found no effect on HIV incidence and we explore the alternative explanations for the large number of “flat” trials. We conclude that there is no single explanation for these flat results which may be due to interventions that are ineffective or inappropriately targeted or implemented, or to factors related to the design or conduct of trials. We examine the lessons from these flat results and provide recommendations on what should be done differently in future trials. HIV prevention remains of critical importance in an era of expanded delivery of antiretroviral therapy. In future HIV prevention research, it is important that resources are used as efficiently as possible to provide rigorous evidence of the effectiveness of a wider array of complementary prevention tools. PMID:21042056

  10. Translation of biomedical prevention strategies for HIV: Prospects and pitfalls

    PubMed Central

    Vermund, Sten H.; Tique, José A.; Cassell, Holly M.; Johnson, Megan E.; Ciampa, Philip J.; Audet, Carolyn M.

    2013-01-01

    Early achievements in biomedical approaches for HIV prevention included physical barriers (condoms), clean injection equipment (both for medical use and for injection drug users), blood and blood product safety, and prevention of mother to child transmission. In recent years, antiretroviral drugs to reduce risk of transmission (when the infected person takes the medicines; treatment as prevention or TasP) or reduce risk of acquisition (when the seronegative person takes them; pre-exposure prophylaxis or PrEP) have proven efficacious. Circumcision of men has also been a major tool relevant for higher prevalence regions such as sub-Saharan Africa. Well-established prevention strategies in the control of sexually transmitted diseases and tuberculosis are highly relevant for HIV (i.e., screening, linkage to care, early treatment, and contact tracing). Unfortunately, only slow progress is being made in some available HIV prevention strategies such as family planning for HIV-infected women who do not want more children and prevention mother-to-child HIV transmission. Current studies seek to integrate strategies into approaches that combine biomedical, behavioral, and structural methods to achieve prevention synergies. This review identifies the major biomedical approaches demonstrated to be efficacious that are now available. We also highlight the need for behavioral risk reduction and adherence as essential components of any biomedical approach. PMID:23673881

  11. 77 FR 23733 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-20

    ...) Enhancing Hepatitis Prevention Treatment and Care in the United States; (2) Integrating HIV Prevention and..., CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Road,...

  12. Ecological factors influencing HIV sexual risk and resilience among young people in rural Kenya: implications for prevention.

    PubMed

    Harper, Gary W; Riplinger, Andrew J; Neubauer, Leah C; Murphy, Alexandra G; Velcoff, Jessica; Bangi, Audrey K

    2014-02-01

    Most new HIV infections in Kenya occur among young people. The purpose of this study was to understand ecological factors that influence HIV-related sexual risk and resilience among young people in rural Kenya and to elicit their ideas for HIV prevention interventions. Nine focus groups (N = 199) were conducted with both female (55%) and male (45%) participants (ages 14-24 years) living in rural communities in Kenya. Findings were organized into thematic areas related to the following systems of influence: (i) intrapersonal (substance use, HIV knowledge), (ii) interpersonal (peer pressure, lack of parent-child communication, interpersonal sexual violence), (iii) institutional/community (pornography, transactional sex, 'idleness', lack of role models) and (iv) socio-cultural/policy (Kikuyu culture, Western influence, religious beliefs, HIV-related stigma and gendered sexual scripts). Results regarding the types of HIV prevention programs that participants believed should be developed for young people in rural Kenya revealed seven primary themes, including (i) HIV prevention community/group workshops, (ii) condom distribution, (iii) job skills trainings, (iv) athletic and social clubs, (v) HIV-related stigma reduction campaigns, (vi) community-wide demonstrations and (vii) other HIV/AIDS activities led by young people. Implications for the development of culturally and developmentally appropriate HIV prevention interventions for young people in rural Kenya are discussed.

  13. Ecological factors influencing HIV sexual risk and resilience among young people in rural Kenya: implications for prevention.

    PubMed

    Harper, Gary W; Riplinger, Andrew J; Neubauer, Leah C; Murphy, Alexandra G; Velcoff, Jessica; Bangi, Audrey K

    2014-02-01

    Most new HIV infections in Kenya occur among young people. The purpose of this study was to understand ecological factors that influence HIV-related sexual risk and resilience among young people in rural Kenya and to elicit their ideas for HIV prevention interventions. Nine focus groups (N = 199) were conducted with both female (55%) and male (45%) participants (ages 14-24 years) living in rural communities in Kenya. Findings were organized into thematic areas related to the following systems of influence: (i) intrapersonal (substance use, HIV knowledge), (ii) interpersonal (peer pressure, lack of parent-child communication, interpersonal sexual violence), (iii) institutional/community (pornography, transactional sex, 'idleness', lack of role models) and (iv) socio-cultural/policy (Kikuyu culture, Western influence, religious beliefs, HIV-related stigma and gendered sexual scripts). Results regarding the types of HIV prevention programs that participants believed should be developed for young people in rural Kenya revealed seven primary themes, including (i) HIV prevention community/group workshops, (ii) condom distribution, (iii) job skills trainings, (iv) athletic and social clubs, (v) HIV-related stigma reduction campaigns, (vi) community-wide demonstrations and (vii) other HIV/AIDS activities led by young people. Implications for the development of culturally and developmentally appropriate HIV prevention interventions for young people in rural Kenya are discussed. PMID:23969629

  14. MTV's "Staying Alive" global campaign promoted interpersonal communication about HIV and positive beliefs about HIV prevention.

    PubMed

    Geary, Cynthia Waszak; Burke, Holly McClain; Castelnau, Laure; Neupane, Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

    2007-02-01

    In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household surveys. Using linear regression techniques, our evaluation examined the effects of campaign exposure on interpersonal communication about HIV and the effects of campaign exposure and interpersonal communication on beliefs about HIV prevention. We found a consistent positive effect of exposure on interpersonal communication across all sites, though there were differences among sites with regard to whom the respondent talked about HIV. We also found a consistent positive effect of exposure on HIV prevention beliefs across sites when interpersonal communication was simultaneously entered into the model. Finally, in two sites we found a relationship between interpersonal communication and HIV prevention beliefs, controlling for exposure, though again, the effects differed by the type of person the communication was with. These similar findings in three diverse sites provide ecological validity of the findings that "Staying Alive" promoted interpersonal communication and influenced young people's beliefs about HIV prevention in a positive way, evidence for the potential of a global media campaign to have an impact on social norms.

  15. MTV's "Staying Alive" global campaign promoted interpersonal communication about HIV and positive beliefs about HIV prevention.

    PubMed

    Geary, Cynthia Waszak; Burke, Holly McClain; Castelnau, Laure; Neupane, Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

    2007-02-01

    In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; São Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household surveys. Using linear regression techniques, our evaluation examined the effects of campaign exposure on interpersonal communication about HIV and the effects of campaign exposure and interpersonal communication on beliefs about HIV prevention. We found a consistent positive effect of exposure on interpersonal communication across all sites, though there were differences among sites with regard to whom the respondent talked about HIV. We also found a consistent positive effect of exposure on HIV prevention beliefs across sites when interpersonal communication was simultaneously entered into the model. Finally, in two sites we found a relationship between interpersonal communication and HIV prevention beliefs, controlling for exposure, though again, the effects differed by the type of person the communication was with. These similar findings in three diverse sites provide ecological validity of the findings that "Staying Alive" promoted interpersonal communication and influenced young people's beliefs about HIV prevention in a positive way, evidence for the potential of a global media campaign to have an impact on social norms. PMID:17411389

  16. Paediatric HIV: Progress on Prevention, Treatment and Cure

    PubMed Central

    Kim, Maria H; Ahmed, Saeed; Abrams, Elaine J.

    2015-01-01

    Purpose of review This review provides an update on current developments with prevention, treatment and cure strategies in the field of pediatric HIV. Recent findings/Summary There has been tremendous progress in the prevention and treatment of pediatric HIV infection. With new strategies for prevention of mother-to-child transmission, we are growing ever closer towards elimination of pediatric HIV, though challenges with retention of pregnant woman and their HIV-exposed infants remain. Ongoing vigilance regarding the potential hazards of in utero ART exposure to infants continues with no significant alarms yet identified. Though cure has not been achieved, evidence of the impact of early treatment on reducing HIV-1 reservoir size with subsequent prolonged remission has enlivened efforts to rapidly identify and treat HIV-infected newborns. There is an increasing array of treatment options for pediatric patients and reassuring evidence regarding long-term complications of ART. Unfortunately, despite evidence suggesting the benefit of early treatment, timely identification and treatment of children remains a challenge. Better strategies for effective case-finding and engagement in care are urgently needed in addition to an improved understanding of how to retain HIV-positive children and adolescents on treatment. However, further emboldened by recent international commitments and robust global support, the future is hopeful. PMID:26709366

  17. 30 Years on Selected Issues in the Prevention of HIV among Persons Who Inject Drugs

    PubMed Central

    Des Jarlais, D. C.; Pinkerton, S.; Hagan, H.; Guardino, V.; Feelemyer, J.; Cooper, H.; Hatzatkis, A.; Uuskula, A.

    2013-01-01

    After 30 years of extensive research on human immunodeficiency virus (HIV) among persons who inject drugs (PWID), we now have a good understanding of the critical issues involved. Following the discovery of HIV in 1981, epidemics among PWID were noted in many countries, and consensus recommendations for interventions for reducing injection related HIV transmission have been developed. While high-income countries have continued to develop and implement new Harm Reduction programs, most low-/middle-income countries have implemented Harm Reduction at very low levels. Modeling of combined prevention programming including needle exchange (NSP) and antiretroviral therapy (ARV) suggests that NSP be given the highest priority. Future HIV prevention programming should continue to provide Harm Reduction programs for PWID coupled with interventions aimed at reducing sexual transmission. As HIV continues to spread in low- and middle-income countries, it is important to achieve and maintain high coverage of Harm Reduction programs in these locations. As PWID almost always experience multiple health problems, it will be important to address these multiple problems within a comprehensive approach grounded in a human rights perspective. PMID:23840957

  18. A network-individual-resource model for HIV prevention.

    PubMed

    Johnson, Blair T; Redding, Colleen A; DiClemente, Ralph J; Mustanski, Brian S; Dodge, Brian; 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

    2010-12-01

    HIV is transmitted through dyadic exchanges of individuals linked in transitory or permanent networks of varying sizes. A theoretical perspective that bridges key individual level elements with important network elements can be a complementary 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

  19. A Mixed-Method Analysis of African-American Women's Attendance at an HIV Prevention Intervention

    ERIC Educational Resources Information Center

    Pinto, R. M.; McKay, M. M.

    2006-01-01

    Grounded in a model of service utilization, this study conceptualizes attendance of African-American women at an HIV prevention intervention as associated with influences across three ecological domains--individual, service (program), and social network. First, the texts of responses to semistructured, open-ended elicitation interviews were…

  20. Preventing Mother-to-Child HIV Transmission among South African Adolescents

    ERIC Educational Resources Information Center

    Varga, Christine; Brookes, Heather

    2008-01-01

    Although prevention of mother-to-child HIV transmission (PMTCT) programs are predicated on maternal behavior change, little is known about sociocultural factors affecting maternal-child care practices in this arena. The authors used narrative methods (key informant workshops, questionnaires, focus groups, and case study analysis) to explore how…

  1. 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…

  2. Cultural Strategies for Teaching HIV/AIDS Prevention to American Indians

    ERIC Educational Resources Information Center

    McIntosh, Dannette R.

    2012-01-01

    The purpose of this study was to describe what tools and strategies Native Americans who live in Oklahoma believe are important in learning about HIV/AIDS, to determine if culturally specific information is important in developing prevention programs, and to ascertain learning strategies. Data collection was a two-part process. First, the Cultural…

  3. Effectiveness of HIV prevention for women: what is working?

    PubMed

    Gil-Llario, María Dolores; Ballester-Arnal, Rafael; Giménez-García, Cristina; Salmerón-Sánchez, Pedro

    2014-10-01

    The HIV-AIDS remains a public health problem which disproportionally affects women. However, prevention strategies have rarely considered their specific efficacy for them. For this reason, this study examines the differential effectiveness of six intervention elements based on socio-cognitive theories addressing young women. A controlled between-groups design examined the change in risk profile among 167 young Spanish women (mean age 21.3 years old) involved in five sexual risk prevention interventions (informative talk, attitudinal discussion, role-play, fear induction and informative website) and one control non-intervening group (waiting list). Our findings support the differential efficacy of some HIV preventive intervention elements comparing others for women. In particular, the attitudinal discussion stands out followed by the informative talk and the role play. Contrarily, the fear induction component did not reveal relevant improvements. This study provides new evidence related to HIV prevention. Particularly, the higher efficacy of motivational components for these young Spanish women is revealed.

  4. Counseling for HIV Prevention: Clinical Interventions and HIV Antibody Testing.

    ERIC Educational Resources Information Center

    Craig, Donald H.; And Others

    1996-01-01

    Describes some developmental foundations for HIV counseling. Asserts that, in both formal sessions and moments of opportunity, educators, clinicians, and counselors can use the counseling relationship to promote healthy behavior change. This clinical process depends on careful self-appraisal, good counseling skills, and responsiveness to the…

  5. Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

    PubMed Central

    Armstrong, M. L.; LaPlante, A. M.; Altice, F. L.; Copenhaver, M.; Molina, P. E.

    2015-01-01

    Alcohol use disorders (AUDs) are highly prevalent among people living with HIV/AIDS (PLWHA) and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI), the Holistic Health Recovery Program (HHRP+), that focuses on secondary HIV prevention and antiretroviral therapy (ART) adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs) were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1) negative mood states contribute to heavy alcohol consumption in PLWHA; (2) high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3) local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4) healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5) misperceptions about the relationships between alcohol and HIV are common; (6) PLWHA are interested in learning about alcohol's impact on ART and HIV disease progression. These data were used to design the adapted EBI. PMID:26697216

  6. HIV risks and HIV prevention among female sex workers in two largest urban settings in Croatia, 2008-2014.

    PubMed

    Štulhofer, Aleksandar; Landripet, Ivan; Božić, Jasmina; Božičević, Ivana

    2015-01-01

    Harm reduction-based HIV prevention has been in place among female sex workers (FSWs) in Croatia for more than a decade. However, little is known about how well the existing programs meet the needs of FSWs in an environment where sex work remains criminalized and highly stigmatized. This study aims to assess changes in FSWs' vulnerability to HIV infection in the 2008-2014 period. Using convenience samples of FSWs in Croatia's two largest urban settings, behavioral data were collected in 2007-2008 and 2014. Outreach workers interviewed 154 FSWs in the first wave of the survey and 158 in the second. The period under observation was characterized by a stable prevalence of most HIV-relevant risk behaviors and experiences. Significant changes in client-based victimization and HIV knowledge were observed only among FSWs in the capital city. Substantial and mostly sustained levels of sexual and nonsexual victimization call for more research into the limits of the current behavior-based harm reduction approach to HIV prevention in the country.

  7. 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

  8. HIV prevention for adults with criminal justice involvement: a systematic review of HIV risk-reduction interventions in incarceration and community settings.

    PubMed

    Underhill, Kristen; Dumont, Dora; Operario, Don

    2014-11-01

    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

  9. Reframing HIV prevention for gay men in the United States.

    PubMed

    Halkitis, Perry N

    2010-11-01

    The HIV epidemic in the United States has affected at least two generations of gay men. Despite numerous efforts to intervene on this public health crisis, HIV infections continue to escalate, especially among young men. This condition is compounded by an ever-growing number of gay men who are aging and living with HIV. We must enact an innovative and proactive vision and framework for HIV prevention that moves us beyond the undertakings rooted in social-cognitive paradigms that have informed this work for the past 25 years. A new framework for HIV prevention must give voice to gay men; must consider the totality of their lives; must delineate the underlying logic, which directs their relation to sex and HIV; and must concurrently respect their diverse life experiences. This approach should be rooted in a biopsychosocial paradigm, should be informed by both theory and practice, and should be directed by three theoretical lenses--a theory of syndemics, developmental theories, and contextual understandings of HIV disease. Taken together, these elements are a call to action for research and practice psychologists who are working to improve the lives of gay men. PMID:21058777

  10. HIV prevention in the Hispanic community: sex, culture, and empowerment.

    PubMed

    Marín, Barbara VanOss

    2003-07-01

    To address the serious HIV epidemic in the Hispanic community in the United States, the underlying causes of the epidemic must be addressed. Marginalization, including homophobia, poverty, and racism, as well as cultural factors such as machismo and sexual silence disempower people, making HIV prevention difficult. This article reviews evidence for the impact of marginalization and cultural factors on HIV risk and proposes a cycle of disempowerment. Three examples of empowerment interventions developed specifically for Hispanics (targeting heterosexuals, women, and gay men) are presented, and how these interventions address disempowerment is discussed. One intervention is used to illustrate principles of developing culturally appropriate interventions.

  11. Compendium of HIV Prevention Interventions with Evidence of Effectiveness. From CDC's HIV/AIDS Prevention Research Synthesis Project.

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention (DHHS/PHS), Atlanta, GA.

    This publication was developed in response to requests by prevention service providers and planners, for science-based interventions that work in HIV/AIDS prevention. All interventions came from behavioral or social studies that had both intervention and control/comparison groups and positive results for behavioral or health outcomes. The document…

  12. The village/commune safety policy and HIV prevention efforts among key affected populations in Cambodia: finding a balance

    PubMed Central

    2012-01-01

    The Village/Commune Safety Policy was launched by the Ministry of Interior of the Kingdom of Cambodia in 2010 and, due to a priority focus on “cleaning the streets”, has created difficulties for HIV prevention programs attempting to implement programs that work with key affected populations including female sex workers and people who inject drugs. The implementation of the policy has forced HIV program implementers, the UN and various government counterparts to explore and develop collaborative ways of delivering HIV prevention services within this difficult environment. The following case study explores some of these efforts and highlights the promising development of a Police Community Partnership Initiative that it is hoped will find a meaningful balance between the Village/Commune Safety Policy and HIV prevention efforts with key affected populations in Cambodia. PMID:22770267

  13. Interventions to Prevent Sexually Transmitted Infections, Including HIV Infection

    PubMed Central

    Cates, Willard

    2011-01-01

    The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Disease (STD) Treatment Guidelines were last updated in 2006. To update the “Clinical Guide to Prevention Services” section of the 2010 CDC STD Treatment Guidelines, we reviewed the recent science with reference to interventions designed to prevent acquisition of STDs, including human immunodeficiency virus (HIV) infection. Major interval developments include (1) licensure and uptake of immunization against genital human papillomavirus, (2) validation of male circumcision as a potent prevention tool against acquisition of HIV and some other sexually transmitted infections (STIs), (3) failure of a promising HIV vaccine candidate to afford protection against HIV acquisition, (4) encouragement about the use of antiretroviral agents as preexposure prophylaxis to reduce risk of HIV and herpes simplex virus acquisition, (5) enhanced emphasis on expedited partner management and rescreening for persons infected with Chlamydia trachomatis and Neisseria gonorrhoeae, (6) recognition that behavioral interventions will be needed to address a new trend of sexually transmitted hepatitis C among men who have sex with men, and (7) the availability of a modified female condom. A range of preventive interventions is needed to reduce the risks of acquiring STI, including HIV infection, among sexually active people, and a flexible approach targeted to specific populations should integrate combinations of biomedical, behavioral, and structural interventions. These would ideally involve an array of prevention contexts, including (1) communications and practices among sexual partners, (2) transactions between individual clients and their healthcare providers, and (3) comprehensive population-level strategies for prioritizing prevention research, ensuring accurate outcome assessment, and formulating health policy. PMID:22080271

  14. Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy.

    PubMed

    Bowen, A M; Williams, M L; Daniel, C M; Clayton, S

    2008-12-01

    Internet delivered primary prevention interventions for HIV risk reduction present significant challenges. Changing lifestyle behaviors, such as beginning to use condoms, is difficult and men seeking dates on line may want to avoid thinking about HIV risk which may lead to low initiation and high dropout rates. Many Internet delivered HIV risk reduction programs have mimicked face-to-face outreach programs, failing to take advantage of the Internet's capabilities or did not conduct evaluation. This study focuses on examining the feasibility, acceptability, and efficacy of an Internet delivered HIV risk reduction program for rural men who have sex with men (MSM). The program included online recruiting, three intervention modules, each with two sessions, online questionnaires. The intervention was developed based on iterative research and the Information-Motivation-Behavioral skills model. Participants (N = 475) were randomly assigned to one of six module orders and data were collected automatically at pre-test and after each module. Data supports the feasibility and acceptability of the program as demonstrated by good retention and rapid program completion. Knowledge, self-efficacy, outcome expectancies and motivation increase in a dose response fashion. Post-intervention behavior changes included reduced anal sex and significant increases in condom use. Limitations include a short follow-up period, a predominantly young white rural sample, and the lack of an attention control. Overall the results of the study provide support for the efficacy of Internet-based interventions to reduce risk of HIV infection. Results also support traditional research methods to evaluate HIV prevention programs delivered exclusively through the Internet.

  15. Preventing HIV Transmission in Nigeria: Role of the Dentists

    PubMed Central

    Azodo, Clement Chinedu; Ehizele, Adebola Oluyemisi; Umoh, Agnes; Ogbebor, Gabriel

    2010-01-01

    Background: As healthcare providers, dentists are in a unique position to foster behavioural changes that are needed to stem the spread of HIV infection. This study was conducted to assess the role of dentists in the prevention of HIV transmission in Nigeria. Methods: This descriptive cross-sectional survey was conducted from June 2006 to January 2007. A multi-stage sampling technique was used to select 300 practising dentists from all parts of Nigeria. Data were collected through a self-administered questionnaire that focused on dentist demographic details, attitudes towards treating HIV-infected persons, involvement in public or clinic-based patient education on HIV and infection control. Results: Two hundred and fifty-seven questionnaires were returned completed, constituting an 86% response rate. The majority of respondents (77.8%) had their dental practice in the southern part of Nigeria, and 89% were in the age bracket of 21–40 years. HIV education by dentists was ranked as poor, as less than a quarter of respondents routinely educated patients on HIV in the clinic. Only a few dentists (33.3%) were involved in public enlightenment programme on HIV in the previous 12 months. Most of the respondents (93%) reported a willingness to treat HIV-infected patients while observing universal precautions. Good infection barrier practices were adopted by 89.9% of dentists, and disposable cartridges for local anaesthetic agents and dental needles were not reused by 93.4% of the respondents. Autoclaving was the most widely used sterilization method (73.2%), but less than half of the respondents knew how to ascertain whether sterilization was effective. Conclusion: This study revealed that efforts by Nigerian dentists to prevent HIV transmission are presently less than optimal. Therefore, there is a need for sensitisation and motivation through seminars, workshops and lectures. PMID:22135532

  16. Inhibition of Heat Shock Protein 90 Prevents HIV Rebound*

    PubMed Central

    Joshi, Pheroze; Maidji, Ekaterina; Stoddart, Cheryl A.

    2016-01-01

    HIV evades eradication because transcriptionally dormant proviral genomes persist in long-lived reservoirs of resting CD4+ T cells and myeloid cells, which are the source of viral rebound after cessation of antiretroviral therapy. Dormant HIV genomes readily produce infectious virus upon cellular activation because host transcription factors activated specifically by cell stress and heat shock mediate full-length HIV transcription. The molecular chaperone heat shock protein 90 (Hsp90) is overexpressed during heat shock and activates inducible cellular transcription factors. Here we show that heat shock accelerates HIV transcription through induction of Hsp90 activity, which activates essential HIV-specific cellular transcription factors (NF-κB, NFAT, and STAT5), and that inhibition of Hsp90 greatly reduces gene expression mediated by these factors. More importantly, we show that Hsp90 controls virus transcription in vivo by specific Hsp90 inhibitors in clinical development, tanespimycin (17-(allylamino)-17-demethoxygeldanamycin) and AUY922, which durably prevented viral rebound in HIV-infected humanized NOD scid IL-2Rγ−/− bone marrow-liver-thymus mice up to 11 weeks after treatment cessation. Despite the absence of rebound viremia, we were able to recover infectious HIV from PBMC with heat shock. Replication-competent virus was detected in spleen cells from these nonviremic Hsp90 inhibitor-treated mice, indicating the presence of a tissue reservoir of persistent infection. Our novel findings provide in vivo evidence that inhibition of Hsp90 activity prevents HIV gene expression in replication-competent cellular reservoirs that would typically cause rebound in plasma viremia after antiretroviral therapy cessation. Alternating or supplementing Hsp90 inhibitors with current antiretroviral therapy regimens could conceivably suppress rebound viremia from persistent HIV reservoirs. PMID:26957545

  17. HIV risk and prevention among Asian/Pacific Islander men who have sex with men: listen to our stories.

    PubMed

    Nemoto, Tooru; Operario, Don; Soma, Toho; Bao, Daniel; Vajrabukka, Alberto; Crisostomo, Vincent

    2003-02-01

    Despite increasing need for HIV prevention research and intervention programs, the voices and stories of Asian and Pacific Islander men who have sex with men (API MSM) have remained absent from HIV prevention literature. Five focus groups with API MSM (N = 38) were conducted to identify psychological, social, and cultural factors related to HIV risk and protection. Six themes were identified based on focus group discussion: (a) dual-identity status, (b) coming out and disclosure issues, (c) relationships and dating, (d) substance use, (e) sexual risk reduction strategies, and (f) health and social services. Narrative data indicate that multilevel HIV prevention intervention strategies are necessary for addressing the unique psychosocial and behavioral HIV risk factors among API MSM, such as dual stigma stemming from homophobia and racism, discomfort with sexuality, power dynamics and stereotypes in relationships with White men, substance use, and low utilization of health and social services.

  18. Couples-focused behavioral interventions for prevention of HIV: Systematic review of the state of evidence

    PubMed Central

    Burton, Jennifer; Darbes, Lynae A.; Operario, Don

    2009-01-01

    HIV is frequently transmitted in the context of partners in a committed relationship, thus couples-focused HIV prevention interventions are a potentially promising modality for reducing infection. We conducted a systematic review of studies testing whether couples-focused behavioral prevention interventions reduce HIV transmission and risk behavior. We included studies using randomized controlled trial designs, quasi-randomized controlled trials and nonrandomized controlled studies. We searched five electronic databases and screened 7628 records. Six studies enrolling 1,084 couples met inclusion criteria and were included in this review. Results across studies consistently indicated that couples-focused programs reduced unprotected sexual intercourse and increased condom use compared with control groups. However, studies were heterogeneous in population, type of intervention, comparison groups, and outcomes measures, and so meta-analysis to calculate pooled effects was inappropriate. Although couples-based approaches to HIV prevention appear initially promising, additional research is necessary to build a stronger theoretical and methodological basis for couples-based HIV prevention, and future interventions must pay closer attention to homosexual couples, adolescents and young people in relationships. PMID:18843530

  19. Components of Quality HIV/STD Prevention & Human Sexuality Education. Report of the HIV/STD Prevention & Human Sexuality Education Task Force.

    ERIC Educational Resources Information Center

    Florida State Dept. of Health and Rehabilitative Services, Tallahassee.

    This report sets forth the essential components of quality HIV/STD prevention and human sexuality education as determined by the HIV/STD Prevention and Human Sexuality Education Task Force. The first part of the report presents the purpose of the task force, background on Florida legislation on HIV/AIDS and sexuality education as part of…

  20. Congregation-based programs to address HIV/AIDS: elements of successful implementation.

    PubMed

    Williams, Malcolm V; Palar, Kartika; Derose, Kathryn Pitkin

    2011-06-01

    Religious organizations may be uniquely positioned to address HIV by offering prevention, treatment, or support services to affected populations, but models of effective congregation-based HIV programs in the literature are scarce. This systematic review distils lessons on successfully implementing congregation HIV efforts. Peer-reviewed articles on congregation-based HIV efforts were reviewed against criteria measuring the extent of collaboration, tailoring to the local context, and use of community-based participatory research (CBPR) methods. The effectiveness of congregations' efforts and their capacity to overcome barriers to addressing HIV is also assessed. We found that most congregational efforts focused primarily on HIV prevention, were developed in partnerships with outside organizations and tailored to target audiences, and used CBPR methods. A few more comprehensive programs also provided care and support to people with HIV and/or addressed substance use and mental health needs. We also found that congregational barriers such as HIV stigma and lack of understanding HIV's importance were overcome using various strategies including tailoring programs to be respectful of church doctrine and campaigns to inform clergy and congregations. However, efforts to confront stigma directly were rare, suggesting a need for further research.

  1. Prevention And Treatment Produced Large Decreases In HIV Incidence In A Model Of People Who Inject Drugs

    PubMed Central

    Marshall, Brandon D. L.; Friedman, Samuel R.; Monteiro, João F. G.; Paczkowski, Magdalena; Tempalski, Barbara; Pouget, Enrique R.; Lurie, Mark N.; Galea, Sandro

    2015-01-01

    People who inject drugs continue to be at greatly increased risk of HIV infection in the United States. We modeled HIV transmission in a dynamic network of drug users and non-drug users (representing the New York metropolitan statistical area population) to estimate the effectiveness of various combination prevention scenarios. We first assumed that current approaches continue (status quo), and then compared projected HIV incidence at 2020 and 2040 to those derived from hypothetical initiatives: (1) scale-up HIV testing, (2) increased access to substance abuse treatment, (3) improved coverage of needle and syringe programs, (4) scaling up Treatment as Prevention; and (5), “high-impact“ combination prevention, combining strategies (1) through (4). No strategy completely eliminated HIV transmission. High-impact prevention produced the largest decrease in HIV incidence, a 62% reduction compared to the status quo. Increased resources for and investment in multi-modality HIV prevention approaches will be required to eliminate HIV transmission among people who inject drugs. PMID:24590937

  2. Campus HIV Prevention Strategies: Planning for Success.

    ERIC Educational Resources Information Center

    Hoban, Mary T.; Ottenritter, Nan W.; Gascoigne, Jan L.; Kerr, Dianne L.

    This document presents the results of the National College Health Risk Behavior Survey (NCHRBS) conducted by the U.S. Centers for Disease Control (CDC) that pertain to HIV transmission. These results include sexual assault, alcohol and other drug use, and sexual behaviors. The survey was administered to a nationally representative random sample of…

  3. Paying for Prevention: Challenges to Health Insurance Coverage for Biomedical HIV Prevention in the United States

    PubMed Central

    Underhill, Kristen

    2014-01-01

    Reducing the incidence of HIV infection continues to be a crucial public health priority in the United States, especially among populations at elevated risk such as men who have sex with men, transgender women, people who inject drugs, and racial and ethnic minority communities. Although most HIV prevention efforts to date have focused on changing risky behaviors, the past decade has yielded efficacious new biomedical technologies designed to prevent infection, such as the prophylactic use of antiretroviral drugs and the first indications of an efficacious vaccine. Access to prevention technologies will be a significant part of the next decade’s response to HIV, and advocates are mobilizing to achieve more widespread use of these interventions. These breakthroughs, however, arrive at a time of escalating healthcare costs; health insurance coverage therefore raises pressing new questions about priority-setting and the allocation of responsibility for public health. The goals of this Article are to identify legal challenges and potential solutions for expanding access to biomedical HIV prevention through health insurance coverage. This Article discusses the public policy implications of HIV prevention coverage decisions, assesses possible legal grounds on which insurers may initially deny coverage for these technologies, and evaluates the extent to which these denials may survive external and judicial review. Because several of these legal grounds may be persuasive, particularly denials on the basis of medical necessity, this Article also explores alternative strategies for financing biomedical HIV prevention efforts. PMID:23356098

  4. Condoms "contain worms" and "cause HIV" in Tanzania: Negative Condom Beliefs Scale development and implications for HIV prevention.

    PubMed

    Siegler, Aaron J; Mbwambo, Jessie K; McCarty, Frances A; DiClemente, Ralph J

    2012-11-01

    Condom promotion remains a key component of HIV prevention programs, complimenting recent successes in biomedical HIV prevention. Although condom use has increased in much of East Africa, it remains substantially below optimal levels. Negative rumors about condoms have been documented in East Africa, yet the prevalence and effects of belief in the negative rumors have not been explored. This study evaluated levels of belief in negative rumors about condoms, developed a Negative Condom Beliefs Scale, and assessed its accuracy in predicting willingness to use condoms. A cross-sectional, cluster survey (n = 370) was conducted representing adults in two rural districts in Northern Tanzania in 2008. Item agreement ranged from 35 to 53% for the following rumors regarding condoms: causing cancer, having holes, containing HIV, having worms, and the worms causing HIV. Items loaded on a single latent factor and had high internal consistency and convergent validity. In a multivariate model, negative condom score (AOR = 0.67, 95% CI = 0.6, 0.8) was the strongest single predictor of willingness to use condoms, followed by greater perceived anonymity in acquiring condoms (AOR = 4.36, 95% CI = 2.2, 8.6) and higher condom self-efficacy (AOR = 4.24, 95% CI = 2.0, 8.9). Our findings indicate high levels of subscription to negative beliefs about condoms, with two out of three respondents affirming belief in at least one negative condom rumor. This study highlights the relation between condom rumor beliefs and willingness to use condoms, and indicates avenues for future research and means for improving the design of HIV prevention programs.

  5. Topical Microbicides and HIV Prevention in the Female Genital Tract

    PubMed Central

    Cottrell, Mackenzie L; Kashuba, Angela D. M.

    2014-01-01

    Worldwide, HIV disproportionately affects women who are often unable to negotiate traditional HIV preventive strategies such as condoms. In the absence of an effective vaccine or cure, chemoprophylaxis may be a valuable self-initiated alternative. Topical microbicides have been investigated as one such option. The first generation topical microbicides were non-specific, broad-spectrum antimicrobial agents, including surfactants, polyanions, and acid buffering gels, that generally exhibited contraceptive properties. After extensive clinical study, none prevented HIV infection, and their development was abandoned. Second generation topical microbicides include agents with selective mechanisms of antiviral activity. Most are currently being used for, or have previously been explored as, drugs for treatment of HIV. The most advanced of these is tenofovir 1% gel: the first topical agent shown to significantly reduce HIV infection by 39% compared to placebo. This review summarizes the evolution of topical microbicides for HIV chemoprophylaxis, highlights important concepts learned, and offers current and future considerations for this area of research. PMID:24664786

  6. All together now. An integrated approach to preventing adolescent pregnancy and STD/HIV infection.

    PubMed

    Fisher, W A

    1990-01-01

    2 outcomes of the high level of unprotected sexual activity among US adolescents--teenage pregnancy and infection with sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)--are produced by similar behavioral factors. Among these are an unwillingness to acknowledge in advance sexual activity, a failure to seek out necessary preventive knowledge, an unwillingness to engage in preventive behaviors such as use of condoms or other contraceptives, and a lack of communication about sexuality in adolescent relationships. Despite this overlap, health educators and service providers have failed to develop an integrated approach for dealing with adolescent pregnancy and STD/HIV risk. Proposed is a sequence of preventive behaviors and skills to be taught to teenagers, including acceptance of their sexuality, education regarding sex-related preventive options, an active commitment to engage in preventive behaviors, the negotiation of sex-related prevention with one's partner, performance of public preventive acts such as condom purchase, consistent practice and reinforcement of preventive behaviors, and the ability to shift preventive "scripts." At the same time, programs must address the potential psychological obstacles to the performance of sex-related preventive behaviors--e.g., negative feeling about sexuality, misinformation coupled with cognitive immaturity, and mass media images and fantasies. Program interventions can be delivered most efficiently through the public school system, with linkages to birth control clinics, STD clinics, HIV testing centers, and drug treatment programs. The type of sexuality education proposed--provision of relevant information that teenagers can actively translate into preventive behaviors--should be anticipated to produce more resistance from conservative community forces than traditional educational efforts.

  7. Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here?

    PubMed Central

    Cohen, Myron S; Smith, M Kumi; Muessig, Kathryn E; Hallett, Timothy B; Powers, Kimberly A; Kashuba, Angela D

    2013-01-01

    Antiretroviral drugs that inhibit viral replication were expected to reduce transmission of HIV by lowering the concentration of HIV in the genital tract. In 11 of 13 observational studies, antiretroviral therapy (ART) provided to an HIV-infected index case led to greatly reduced transmission of HIV to a sexual partner. In the HPTN 052 randomised controlled trial, ART used in combination with condoms and counselling reduced HIV transmission by 96·4%. Evidence is growing that wider, earlier initiation of ART could reduce population-level incidence of HIV. However, the full benefits of this strategy will probably need universal access to very early ART and excellent adherence to treatment. Challenges to this approach are substantial. First, not all HIV-infected individuals can be located, especially people with acute and early infection who are most contagious. Second, the ability of ART to prevent HIV transmission in men who have sex with men (MSM) and people who use intravenous drugs has not been shown. Indeed, the stable or increased incidence of HIV in MSM in some communities where widespread use of ART has been established emphasises the concern that not enough is known about treatment as prevention for this crucial population. Third, although US guidelines call for immediate use of ART, such guidelines have not been embraced worldwide. Some experts do not believe that immediate or early ART is justified by present evidence, or that health-care infrastructure for this approach is sufficient. These concerns are very difficult to resolve. Ongoing community-based prospective trials of early ART are likely to help to establish the population-level benefit of ART, and—if successful—to galvanise treatment as prevention. PMID:24152938

  8. HIV Treatment as Prevention: Considerations in the Design, Conduct, and Analysis of Cluster Randomized Controlled Trials of Combination HIV Prevention

    PubMed Central

    Boily, Marie-Claude; Mâsse, Benoît; Alsallaq, Ramzi; Padian, Nancy S.; Eaton, Jeffrey W.; Vesga, Juan F.; Hallett, Timothy B.

    2012-01-01

    The rigorous evaluation of the impact of combination HIV prevention packages at the population level will be critical for the future of HIV prevention. In this review, we discuss important considerations for the design and interpretation of cluster randomized controlled trials (C-RCTs) of combination prevention interventions. We focus on three large C-RCTs that will start soon and are designed to test the hypothesis that combination prevention packages, including expanded access to antiretroviral therapy, can substantially reduce HIV incidence. Using a general framework to integrate mathematical modelling analysis into the design, conduct, and analysis of C-RCTs will complement traditional statistical analyses and strengthen the evaluation of the interventions. Importantly, even with combination interventions, it may be challenging to substantially reduce HIV incidence over the 2- to 3-y duration of a C-RCT, unless interventions are scaled up rapidly and key populations are reached. Thus, we propose the innovative use of mathematical modelling to conduct interim analyses, when interim HIV incidence data are not available, to allow the ongoing trials to be modified or adapted to reduce the likelihood of inconclusive outcomes. The preplanned, interactive use of mathematical models during C-RCTs will also provide a valuable opportunity to validate and refine model projections. PMID:22807657

  9. HIV treatment as prevention: considerations in the design, conduct, and analysis of cluster randomized controlled trials of combination HIV prevention.

    PubMed

    Boily, Marie-Claude; Mâsse, Benoît; Alsallaq, Ramzi; Padian, Nancy S; Eaton, Jeffrey W; Vesga, Juan F; Hallett, Timothy B

    2012-01-01

    The rigorous evaluation of the impact of combination HIV prevention packages at the population level will be critical for the future of HIV prevention. In this review, we discuss important considerations for the design and interpretation of cluster randomized controlled trials (C-RCTs) of combination prevention interventions. We focus on three large C-RCTs that will start soon and are designed to test the hypothesis that combination prevention packages, including expanded access to antiretroviral therapy, can substantially reduce HIV incidence. Using a general framework to integrate mathematical modelling analysis into the design, conduct, and analysis of C-RCTs will complement traditional statistical analyses and strengthen the evaluation of the interventions. Importantly, even with combination interventions, it may be challenging to substantially reduce HIV incidence over the 2- to 3-y duration of a C-RCT, unless interventions are scaled up rapidly and key populations are reached. Thus, we propose the innovative use of mathematical modelling to conduct interim analyses, when interim HIV incidence data are not available, to allow the ongoing trials to be modified or adapted to reduce the likelihood of inconclusive outcomes. The preplanned, interactive use of mathematical models during C-RCTs will also provide a valuable opportunity to validate and refine model projections. PMID:22807657

  10. Automated System Programs Preventive Maintenance.

    ERIC Educational Resources Information Center

    Locke, Richard C.

    1987-01-01

    A preventive maintenance system provides for the monitoring and inspection of school building elements in a programmed way through an automatic checklist. Utility cost savings are expected along with reduction of travel and wait time, and measurable standards of performance for all maintenance and repair work. (MLF)

  11. 75 FR 70270 - Submission for OMB Review; Comment Request; Pretesting of NIAID's Biomedical HIV Prevention...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... NIAID's Biomedical HIV Prevention Research Communication Messages SUMMARY: In compliance with the... comment on proposed data collection projects, the National Institute of Allergy and Infectious Diseases... Collection: Title: Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages. Type...

  12. 76 FR 6484 - Submission for OMB Review; Comment Request; Pretesting of NIAID's Biomedical HIV Prevention...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... NIAID's Biomedical HIV Prevention Research Communication Messages SUMMARY: Under the provisions of... Infectious Diseases (NIAID), the National Institutes of Health (NIH) has submitted to the Office of...: Title: Pretesting of NIAID's Biomedical HIV Prevention Research Communication Messages. Type...

  13. Global prevention, funding, accountability debated in fight against HIV / AIDS.

    PubMed

    1999-10-18

    World leaders, physicians, economists, governmental health organizations, and pharmaceutical manufacturers attended the Third International Conference on Healthcare Resource Allocation for HIV/AIDS and Other Life-threatening Illnesses in Vienna, Austria. The conference participants discussed the economic, ethical, and human rights issues underlying health care resource allocation. Some highlights of the meeting included: the prevention strategies in fighting AIDS virus; the use of high medical ethical standards; the affordability and accessibility of essential therapies; the economic aspects affecting the medical assistance mechanisms; the need to improve the pharmaceutical industry; the need to improve HIV/AIDS care access in developing countries; promoting the development of HIV/AIDS vaccines; and developing rapid diagnosis of HIV.

  14. Future HIV Mentoring Programs to Enhance Diversity.

    PubMed

    Stoff, David M; Cargill, Victoria A

    2016-09-01

    This paper proposes a general template to guide future mentoring program development addressing: (i) considerations to ensure an adequate research workforce; (ii) key guidelines and principles of mentoring; and (iii) use of a logic model to develop program milestones, outcomes and evaluation. We focus on these areas to guide and inform the most effective mentoring program components, which we find to be more helpful than identifying specific features and ingredients. Although the focus is on the development of a new generation of investigators from diverse backgrounds, this template may also apply to mentoring programs for other investigators and for disciplines beyond HIV. PMID:27484059

  15. HIV prevention among injecting drug users: responses in developing and transitional countries.

    PubMed Central

    Ball, A L; Rana, S; Dehne, K L

    1998-01-01

    OBJECTIVE: Human immunodeficiency virus (HIV) infection associated with injecting drug use has been reported in at least 98 countries and territories worldwide. There is evidence that new epidemics are emerging in different regions, including Eastern Europe, Latin American, and the eastern Mediterranean. The authors provide a global overview of the situation of HIV infection associated with injecting drug use and responses that have been implemented in various developing and transitional countries. METHODS: Although there has been extensive documentation of the extent and nature of of HIV infection associated with injecting drug use in many developed countries and the various interventions implemented in those countries, there is very limited information on the situation in developing and transitional countries. This chapter brings together information from a broad range of sources, including published literature; "gray" or "fugitive" literature; data collected by the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations International Drug Control Programme (UNDCP); personal communications; and direct observation by the authors. The authors have traveled extensively to a wide range of developing and transitional countries and have accessed information not readily available to the international research community. RESULTS: A wide range of HIV prevention strategies targeting injecting drug users (IDUs) has been implemented in developing countries and countries in transition. Interventions include opioid substitution pharmacotherapy, needle syringe exchange and distribution, condom and bleach distribution, outreach to IDUs, peer education programs, and social network interventions. In some communities, completely new models of intervention and service delivery have developed in response to specific local needs and limitations. CONCLUSIONS: Although empirical data may currently be lacking to demonstrate the

  16. Combination implementation for HIV prevention: moving from evidence to population-level impact

    PubMed Central

    Chang, Larry W; Serwadda, David; Quinn, Thomas C; Wawer, Maria J; Gray, Ronald H; Reynolds, Steven J

    2013-01-01

    Summary The promise of combination HIV prevention—the application of multiple HIV prevention interventions to maximize population-level impact—has never been greater. However, to succeed in achieving significant reductions in HIV incidence, an additional concept needs to be considered—combination implementation. Combination implementation for HIV prevention is defined here as the pragmatic, localized application of evidence-based strategies to realize high sustained uptake and quality of HIV prevention interventions. This review explores diverse implementation strategies including HIV testing and counseling models, task shifting, linkage to and retention in care, antiretroviral therapy support, behavior change, demand creation, and structural interventions and discusses how they could be used in the provision of HIV prevention interventions such as medical male circumcision and treatment as prevention. Only through careful consideration of how to implement and operationalize HIV prevention interventions will the HIV community be able to move from clinical trial evidence to population-level impact. PMID:23257232

  17. Adaptation of an evidence-based HIV prevention intervention for women with incarcerated partners: expanding to community settings.

    PubMed

    Mahoney, Megan; Bien, Melanie; Comfort, Megan

    2013-02-01

    High rates of incarceration in urban, low income communities may exacerbate women's risk of HIV infection by decreasing the number of available male sexual partners and disrupting long-term partnerships. The Health Access Program for Prevention, Empowerment, and Networking for Women (HAPPEN) was established to address the HIV prevention needs of women partnered with incarcerated or recently released men in community settings. HAPPEN is an adaptation of the evidence-based HIV prevention intervention Health Options Mean Empowerment (HOME) project. HOME was designed specifically for women visiting their incarcerated male partners and was delivered at a prison visiting center. Recruitment and program implementation for HAPPEN occurred at community-based organizations serving women with histories of substance abuse, intimate partner violence and incarceration, and provided health education, HIV testing, and linkage to health care and social services. This paper describes the process of adapting HOME using input from target organization stakeholders and target population members. PMID:23387947

  18. Impact Evaluation of a Policy Intervention for HIV Prevention in Washington, DC.

    PubMed

    Ruiz, Monica S; O'Rourke, Allison; Allen, Sean T

    2016-01-01

    Syringe exchange programs (SEPs) lower HIV risk. From 1998 to 2007, Congress prohibited Washington, DC, from using municipal revenue for SEPs. We examined the impact of policy change on IDU-associated HIV cases. We used surveillance data for new IDU-associated HIV cases between September 1996 and December 2011 to build an ARIMA model and forecasted the expected number of IDU-associated cases in the 24 months following policy change. Interrupted time series analyses (ITSA) were used to assess epidemic impact of policy change. There were 176 IDU-associated HIV cases in the 2 years post-policy change; our model predicted 296 IDU-associated HIV cases had the policy remained in place, yielding a difference of 120 averted HIV cases. ITSA identified significant immediate (B = -6.0355, p = .0005) and slope changes (B = -.1241, p = .0427) attributed to policy change. Policy change is an effective structural intervention for HIV prevention when it facilitates the implementation of services needed by vulnerable populations. PMID:26336945

  19. HIV prevention in Mexican schools: prospective randomised evaluation of intervention

    PubMed Central

    Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M

    2006-01-01

    Objective To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. Design Cluster randomised controlled trial. Setting 40 public high schools in the state of Morelos, Mexico. Participants 10 954 first year high school students. Intervention Schools were randomised to one of three arms: an HIV prevention course that promoted condom use, the same course with emergency contraception as back-up, or the existing sex education course. Self administered anonymous questionnaires were completed at baseline, four months, and 16 months. Students at intervention schools received a 30 hour course (over 15 weeks) on HIV prevention and life skills, designed in accordance with guidelines of the joint United Nations programme on HIV/AIDS. Two extra hours of education on emergency contraception were given to students in the condom promotion with contraception arm. Main outcome measures Primary outcome measure was reported condom use. Other outcomes were reported sexual activity; knowledge and attitudes about HIV and emergency contraception; and attitudes and confidence about condom use. Results Intervention did not affect reported condom use. Knowledge of HIV improved in both intervention arms and knowledge of emergency contraception improved in the condom promotion with contraception arm. Reported sexual behaviour was similar in the intervention arms and the control group. Conclusion A rigorously designed, implemented, and evaluated HIV education course based in public high schools did not reduce risk behaviour, so such courses need to be redesigned and evaluated. Addition of emergency contraception did not decrease reported condom use or increase risky sexual behaviour but did increase reported use of emergency contraception. PMID:16682420

  20. Geography should not be destiny: focusing HIV/AIDS implementation research and programs on microepidemics in US neighborhoods.

    PubMed

    Nunn, Amy; Yolken, Annajane; Cutler, Blayne; Trooskin, Stacey; Wilson, Phill; Little, Susan; Mayer, Kenneth

    2014-05-01

    African Americans and Hispanics are disproportionately affected by the HIV/AIDS epidemic. Within the most heavily affected cities, a few neighborhoods account for a large share of new HIV infections. Addressing racial and economic disparities in HIV infection requires an implementation program and research agenda that assess the impact of HIV prevention interventions focused on increasing HIV testing, treatment, and retention in care in the most heavily affected neighborhoods in urban areas of the United States. Neighborhood-based implementation research should evaluate programs that focus on community mobilization, media campaigns, routine testing, linkage to and retention in care, and block-by-block outreach strategies.

  1. Preventing HIV: determinants of sexual behaviour.

    PubMed

    Donovan, B; Ross, M W

    2000-05-27

    AIDS has Invigorated and distorted the study of sexual behaviour. Because that study began so recently, there remain many unanswered questions about why we have sex at all, why we do sex one way rather than another, or even how we define sex. Yet in every instance in which well-designed and adequately resourced behavioural Interventions have been Implemented, these have netted success in the form of falling HIV incidences or prevalences. But, despite these successes, such interventions remain patchy and poorly supported. Perhaps humankind's traditional aversion for the public discussion of sexual matters underlies this reticence. Or maybe a new era of "creeping absolutism"--in which biomedical advances are given premature credit for what they can achieve in HIV control--has arrived.

  2. Preventing HIV: determinants of sexual behaviour.

    PubMed

    Donovan, B; Ross, M W

    2000-05-27

    AIDS has Invigorated and distorted the study of sexual behaviour. Because that study began so recently, there remain many unanswered questions about why we have sex at all, why we do sex one way rather than another, or even how we define sex. Yet in every instance in which well-designed and adequately resourced behavioural Interventions have been Implemented, these have netted success in the form of falling HIV incidences or prevalences. But, despite these successes, such interventions remain patchy and poorly supported. Perhaps humankind's traditional aversion for the public discussion of sexual matters underlies this reticence. Or maybe a new era of "creeping absolutism"--in which biomedical advances are given premature credit for what they can achieve in HIV control--has arrived. PMID:10866459

  3. The Intersection between Sex Work and Reproductive Health in Northern Karnataka, India: Identifying Gaps and Opportunities in the Context of HIV Prevention

    PubMed Central

    Becker, Marissa; Ramanaik, Satyanarayana; Halli, Shiva; Blanchard, James F.; Raghavendra, T.; Bhattacharjee, Parinita; Moses, Stephen; Avery, Lisa; Mishra, Sharmistha

    2012-01-01

    Objective. To examine the reproductive health practices of female sex workers (FSWs) in the context of an HIV prevention program in Karnataka, India. Methods. Data obtained from a survey of 1,011 FSWs registered with an HIV prevention program. We examined reproductive health indicators, and performed multivariate logistic regression among primiparous FSWs to assess sex work during pregnancy and antenatal HIV testing. Results. Among primiparous FSWs (N = 251), 92.0% continued sex work during pregnancy, and 55.4% received antenatal HIV testing. A longer duration in sex work (AOR 2.7, 95% CI: 1.0–7.5), rural residence (AOR 3.3, 95% CI: 1.2–8.9), and antenatal HIV testing (AOR 6.3, 95% CI: 2.0–20.1) were associated with continued sex work during pregnancy. Older FSWs (age >25 years, AOR 0.12, 95% CI: 0.05–0.33), who delivered at home (AOR 0.14, 95% CI: 0.09–0.34), were least likely to receive antenatal HIV testing. Antenatal HIV testing was associated with awareness of methods to prevent vertical HIV transmission (AOR 3.9, 95% CI: 1.9–14.1). Conclusions. Antenatal HIV testing remains low in the context of ongoing sex work during pregnancy. Existing HIV prevention programs are well positioned to immediately integrate reproductive health care with HIV interventions targeted to FSWs. PMID:23346390

  4. Integration of healthcare programs: a long-term policy perspective for a sustainable HIV program for India.

    PubMed

    Tanwar, Sukarma S S; Rewari, Bharat B

    2013-01-01

    With the Government of India's initiative to ensure Universal Access to health through its flagship program of National Rural Health Mission, the debate on the economic efficiency and sustainability of a 'stand-alone' over 'integrated' programs has become extremely relevant. This study was conducted with the aim to establish opinion on the issue of sustainability of 'stand-alone' HIV program in India. Experts working on health policy development and implementation at various were interviewed on this issue and majority of experts interviewed were of the opinion that a 'stand-alone' HIV program is not sustainable in the long run because of inefficient use of resources. Integration of HIV program with the general health system is essential but it needs extensive planning. Areas like HIV testing centers, prevention of parent to child transmission and sexually transmitted infection diagnosis and treatment can be integrated with the general health system immediately.

  5. Partnerships for HIV / AIDS prevention. Promoting collaboration in Ethiopia and Tanzania.

    PubMed

    Nwankwo, E; Takele, A

    1996-07-01

    In most parts of the world, nongovernmental organizations (NGO) have been at the forefront of HIV/AIDS prevention and care efforts. Many believe that the key to sustaining prevention and care efforts is giving such grassroots organizations the resources and skills they need to design, manage, and evaluate HIV/AIDS projects. Such capacity building is the central purpose of the programs carried out by the AIDS Control and Prevention (AIDSCAP) Project with US Agency for International Development funding in more than 40 countries. Capacity building involves training in technical skills, strengthening organizational and management skills, and improving the ability of NGOs to work together. Examples of mechanisms to help organizations coordinate prevention resources and activities include AIDSCAP-initiated focus site intervention teams (FSITs) in Ethiopia and NGO clusters in Tanzania. Forming NGO clusters, cluster management, lessons learned, FSITs at work, and FSIT results are discussed. PMID:12347591

  6. Multipurpose prevention technologies: the future of HIV and STI protection

    PubMed Central

    2015-01-01

    Every day, more than 1 million people are newly infected with sexually transmitted infections (STIs) that can lead to morbidity, mortality, and an increased risk of human immunodeficiency virus (HIV) acquisition. Existing prevention and management strategies, including behavior change, condom promotion, and therapy have not reduced the global incidence and prevalence, pointing to the need for novel innovative strategies. This review summarizes important issues raised during a satellite session at the first HIV R4P conference, held in Cape Town, on October 31, 2014. We explore key STIs that are challenging public health today; new biomedical prevention approaches including multipurpose prevention technologies (MPTs); and the scientific and regulatory hurdles that must be overcome to make combination prevention tools a reality. PMID:25759332

  7. SOMOS: evaluation of an HIV prevention intervention for Latino gay men.

    PubMed

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

    2011-06-01

    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 specific issues, a multilayered HIV intervention was designed to incorporate and integrate psychosocial and community factors through multiple session groups, social marketing and community presentations. Participants learned strategies for effective community leadership and were encouraged to provide HIV education and address internalized homophobia in their communities. There were a total of 113 Latino gay male participants. Pretests and post-tests at 90-day follow-up were administered to measure knowledge, attitudes and behaviors related to HIV infection, self-efficacy, internalized homophobia and connectedness (i.e. gay community affiliation and social provisions); a risk index was calculated to measure level of behavioral risk for HIV infection. Participants demonstrated lower risk indices and a decrease in partners at 3 and 6 months after the intervention. There was also an increase in reported social support resources, along with an increase in group identification. Connectedness was a strong predictor of the number of sexual partners at the 90-day follow-up. This homegrown program represents a culturally responsive, highly needed and relevant intervention that should be subjected to further rigorous testing.

  8. HIV Prevention in Schools: A Tool Kit for Education Leaders.

    ERIC Educational Resources Information Center

    Office of the Surgeon General (DHHS/PHS), Washington, DC.

    This packet of materials is Phase 1 of a toolkit designed to enlighten education leaders about the need for HIV prevention for youth, especially in communities of color. One element of the toolkit is a VHS videotape that features a brief message from former Surgeon General, Dr. David Satcher. The toolkit also includes a copy of a letter sent to…

  9. Adolescent Use of Two Types of HIV Prevention Agencies

    ERIC Educational Resources Information Center

    Hohman, Melinda; Shillington, Audrey M.; Min, Jong Won; Clapp, John D.; Mueller, Kristin; Hovell, Melbourne

    2008-01-01

    This study compared two groups of adolescents seeking help at HIV prevention drop-in agencies. The first group attended agencies in low-income Hispanic neighborhoods which recruited within the locale. The second group of youth attended agencies that recruited based upon a specific population--they targeted homeless and LGBQ youth. We explored the…

  10. What’s God got to do with it? Engaging African American faith-based institutions in HIV prevention

    PubMed Central

    Nunn, Amy; Cornwall, Alexandra; Thomas, Gladys; Waller, Pastor Alyn; Friend, Rafiyq; Broadnax, Pastor Jay; Flanigan, Timothy

    2013-01-01

    African Americans are disproportionately infected and affected by HIV/AIDS. Although faith-based institutions play critical leadership roles in the African American community, the faith-based response to HIV/AIDS has historically been lacking. We explore recent successful strategies of a citywide HIV/AIDS awareness and testing campaign developed in partnership with 40 African American faith-based institutions in Philadelphia, Pennsylvania, a city with some of the United State’s highest HIV infection rates. Drawing on important lessons from the campaign and subsequent efforts to sustain the campaign’s momentum with a citywide HIV testing, treatment and awareness program, we provide a roadmap for engaging African American faith communities in HIV prevention that include partnering with faith leaders; engaging the media to raise awareness, destigmatising HIV/AIDS and encouraging HIV testing; and conducting educational and HIV testing events at houses of worship. African American faith based institutions have a critical role to play in raising awareness about the HIV/AIDS epidemic and for reducing racial disparities in HIV infection. PMID:23379422

  11. Integrating HIV prevention into substance user treatment: current practices and challenges.

    PubMed

    Mitchell, Christopher G; Oltean, Anthony

    2007-01-01

    Despite well-organized prevention efforts, HIV continues to spread in the United States. Injection drug users (IDUs) and other substance users who engage in high-risk behaviors are at particularly high risk for contracting HIV. Substance abuse(dagger) counselors therefore are in a unique position to present HIV prevention messages to their clients. This article reports the results of a study that surveyed counselors in an urban setting (n = 116) to assess their knowledge of HIV, their current HIV prevention practices, and their attitudes about integrating HIV prevention more fully into their work. The article concludes with a discussion of the survey's limitations and its implications for training.

  12. Summary of comments and recommendations from the CDC consultation on the HIV/AIDS Epidemic and prevention in the Hispanic/Latino community.

    PubMed

    Alvarez, Maria E; Jakhmola, Priya; Painter, Thomas M; Taillepierre, Julio Dicent; Romaguera, Raúl A; Herbst, Jeffrey H; Wolitski, Richard J

    2009-10-01

    In April 2008, the U.S. Centers for Disease Control and Prevention (CDC) hosted a national consultation meeting of academic researchers, public health officials, service providers, and community leaders to examine the HIV/AIDS epidemic and prevention needs of Hispanics/Latinos in the United States and its territories. The consultation engaged key stakeholders to review available information on HIV-related behavioral research and prevention efforts, describe gaps in current HIV prevention programs and research on Hispanics/Latinos, and identify community and societal-level factors that can increase vulnerability of Hispanics/Latinos for acquiring or transmitting HIV infection. Recommendations were also made to CDC for future collaboration with the Hispanic/Latino community in areas of HIV prevention research and prevention programs. This article summarizes participants' recommendations for HIV prevention research, program and capacity building, policy and planning, and partnerships and communication. These recommendations will be used by CDC to inform the development of a National Plan of Action for HIV/AIDS prevention among Hispanics/Latinos, and can provide a framework for use by other federal and non-federal agencies, academic researchers, community-based organizations, and policymakers as they seek to curtail the HIV epidemic among Hispanics/Latinos. PMID:19824831

  13. Access for all: contextualising HIV treatment as prevention in Swaziland.

    PubMed

    Vernooij, Eva; Mehlo, Mandhla; Hardon, Anita; Reis, Ria

    2016-01-01

    This article explores how notions of the individual and population are evoked in two ongoing HIV treatment as prevention (TasP) implementation studies in Swaziland. By contrasting policy discourses with lived kinship experiences of people living with HIV, we seek to understand how TasP unfolds in the Swazi context. Data collection consisted of eight focus group discussions with people living with HIV who were members of support groups to examine their perspectives about TasP. In addition, 18 key informant interviews were conducted with study team members, national-level policy-makers and NGO representatives involved in the design of health communication messages about TasP in Swaziland. Thematic analysis was used to identify recurrent themes in transcripts and field notes. Policy-makers and people living with HIV actively resisted framing HIV treatment as a prevention technology but promoted it as (earlier) access to treatment for all. TasP was not conceptualised in terms of individual or societal benefits, which are characteristic of international public health debates; rather its locally situated meanings were embedded in kinship experiences, concerns about taking responsibility for one's own health and others, local biomedical knowledge about drug resistance, and secrecy. The findings from this study suggest that more attention is needed to understand how the global discourse of TasP becomes shaped in practice in different cultural contexts. PMID:27421047

  14. The effectiveness of HIV prevention and the epidemiological context.

    PubMed Central

    Grassly, N. C.; Garnett, G. P.; Schwartländer, B.; Gregson, S.; Anderson, R. M.

    2001-01-01

    Planning an intervention to prevent infections with the human immunodeficiency virus (HIV) should be guided by local epidemiological and socioeconomic conditions. The socioeconomic setting and existing public service capacity determine whether an intervention can have a significant outcome in terms of a reduction in a defined risk. The epidemiological context determines whether such risk reduction translates into a measurable impact on HIV incidence. Measurement of variables describing the epidemiological context can be used to determine the local suitability of interventions, thereby guiding planners and policy-makers in their choice of intervention. Such measurements also permit the retrospective analysis of the impact of interventions where HIV incidence was not recorded. The epidemiological context is defined for four different categories of intervention, shown to be effective in lower-income countries by randomized controlled trials. Appropriate indicators for the epidemiological context and methodological guidelines for their measurement are proposed. Their use in the transfer of a successful intervention from one context to another and in scaling up the effort to control HIV infection is explored. These indicators should provide a useful resource for those involved in planning HIV prevention interventions. PMID:11799444

  15. New ways of preventing HIV infection: thinking simply, simply thinking

    PubMed Central

    Short, R.V

    2006-01-01

    HIV infection is the greatest health crisis in human history. It continues to spread unchecked among the poor in the developing world because we have failed to design simple preventative methods that are available and affordable to those living on under $2 a day. Five new methods are discussed. (i) A natural microbicide. Intravaginal lime or lemon juice has been used for centuries as a traditional contraceptive. The juice can also kill HIV in the laboratory, but clinical trials are needed to see if vaginal application is acceptable, safe and effective. (ii) Intravaginal oestrogen. Monkeys can be protected from Simian immunodeficiency virus (SIV) infection by keratinizing the vagina with topical oestrogen. If women take the oral contraceptive pill vaginally it retains its contraceptive efficacy, and the oestrogen it contains should thicken the vagina and protect against HIV infection. Clinical trials are needed. (iii) Male circumcision. Removal of the inner foreskin removes the main site of HIV entry into the penis, resulting in a sevenfold reduction in susceptibility to infection. The practice needs to be promoted. (iv) Post-coital penile hygiene. Wiping the penis immediately after intercourse with lime or lemon juice or vinegar should kill the virus before it has had a chance to infect. A clinical trial of efficacy is needed. (v) PhotoVoice. Asking schoolchildren in developing countries to photograph their impressions of HIV/AIDS is a powerful way of getting them to discuss the subject openly, and develop their own preventative strategies. PMID:16627296

  16. Are MSM willing to SMS for HIV prevention?

    PubMed

    Khosropour, Christine M; Lake, Jason G; Sullivan, Patrick S

    2014-01-01

    Text messaging is a potential HIV-prevention tool for men who have sex with men (MSM), specifically young MSM and MSM of color. To determine the willingness of MSM to receive text messages as part of an HIV-prevention intervention, we administered an online survey to MSM recruited from MySpace.com, which included questions about mobile phone ownership and willingness to participate in a future text message-based HIV research study. Of participants, 85% (n = 5,378) reported owning a mobile phone and 49% (n = 2,483) of mobile phone owners reported being willing to receive text messages in a future HIV research study. Black and Hispanic men were more willing than White non-Hispanic men to receive text messages. Men with a college degree were less willing to receive texts than men with a high school level of education, and men >22 years old were less likely to be willing to receive texts than those younger than 22 years of age. The authors' findings demonstrate that willingness to receive text messages as part of an HIV research study is moderate, and mirrors patterns of text message use in age and race. Variations in willingness should be taken into account when designing and implementing future interventions.

  17. Kenya AIDS Indicator Surveys 2007 and 2012: implications for public health policies for HIV prevention and treatment.

    PubMed

    Maina, William K; Kim, Andrea A; Rutherford, George W; Harper, Malayah; K'Oyugi, Boniface O; Sharif, Shahnaaz; Kichamu, George; Muraguri, Nicholas M; Akhwale, Willis; De Cock, Kevin M

    2014-05-01

    AIDS Indicator Surveys are standardized surveillance tools used by countries with generalized HIV epidemics to provide, in a timely fashion, indicators for effective monitoring of HIV. Such data should guide responses to the HIV epidemic, meet program reporting requirements, and ensure comparability of findings across countries and over time. Kenya has conducted 2 AIDS Indicator Surveys, in 2007 (KAIS 2007) and 2012-2013 (KAIS 2012). These nationally representative surveys have provided essential epidemiologic, sociodemographic, behavioral, and biologic data on HIV and related indicators to evaluate the national HIV response and inform policies for prevention and treatment of the disease. We present a summary of findings from KAIS 2007 and KAIS 2012 and the impact that these data have had on changing HIV policies and practice.

  18. 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

  19. MOBILIZING COMMUNITIES AROUND HIV PREVENTION FOR YOUTH: HOW THREE COALITIONS APPLIED KEY STRATEGIES TO BRING ABOUT STRUCTURAL CHANGES

    PubMed Central

    Chutuape, Kate S.; Willard, Nancy; Sanchez, Kenia; Straub, Diane M.; Ochoa, Tara N.; Howell, Kourtney; Rivera, Carmen; Ramos, Ibrahim; Ellen, Jonathan M.

    2010-01-01

    Increasingly, HIV prevention efforts must focus on altering features of the social and physical environment to reduce risks associated with HIV acquisition and transmission. Community coalitions provide a vehicle for bringing about sustainable structural changes. This article shares lessons and key strategies regarding how three community coalitions located in Miami and Tampa, Florida, and San Juan, Puerto Rico engaged their respective communities in bringing about structural changes affecting policies, practices and programs related to HIV prevention for 12–24-year-olds. Outcomes of this work include increased access to HIV testing and counseling in the juvenile correctional system (Miami), increased monitoring of sexual abuse between young women and older men within public housing, and support services to deter age discordant relationships (Tampa) and increased access to community-based HIV testing (San Juan). PMID:20166784

  20. Implementation of HIV Prevention Interventions in Resource Limited Settings: the Partner Project

    PubMed Central

    Jones, Deborah; Weiss, Stephen M.; Arheart, Kris; Cook, Ryan; Chitalu, Ndashi

    2013-01-01

    Introduction Evidence-based HIV prevention interventions have been translated to a variety of contexts across sub-Saharan Africa. Non-specialized community health center (CHC) staff members have been successfully engaged to deliver the interventions, which can be integrated into pre-existing HIV service programs in community-based health care delivery sites. This manuscript describes the process of implementing the Partner Project, a couples HIV risk reduction intervention, and examines the ability of CHC staff to achieve risk reduction outcomes comparable to those of the highly-trained research staff. Methods The Partner Project was implemented within the HIV Counseling and Testing program in 6 urban community health clinics in Lusaka, Zambia. One hundred ninety seven HIV-seroconcordant and –discordant couples were sequentially enrolled to the control group or to receive the intervention from Partner research or CHC staff members. Couple members completed assessments on condom use, alcohol use, and intimate partner violence (IPV) at baseline, 6, and 12 months follow-up. Results Sexual barrier use outcomes achieved by the CHC staff were comparable to or better than those achieved by the Partner Project research staff, and both were superior to the control group. A reduction in IPV was observed for the entire sample, although no change in alcohol use was observed. Conclusions Implementation of HIV prevention interventions at the community level should take advantage of existing resources available within the CHC staff. This is especially relevant in resource limited settings as consideration of the financial and clinical requirements of intervention programs is essential to the achievement of successful program implementation. PMID:23963855

  1. Pollution Prevention Program: Technology summary

    SciTech Connect

    Not Available

    1994-02-01

    The Department of Energy (DOE) has established a national Research, Development, Demonstration, Testing, and Evaluation (RDDT&E) Program for pollution prevention and waste minimization at its production plants During FY89/90 the Office of Environmental Restoration and Waste Management (EM), through the Office of Technology Development (OTD), established comprehensive, pollution prevention technical support programs to demonstrate new, environmentally-conscious technology for production processes. The RDDT&E program now entails collaborative efforts across DOE. The Pollution Prevention Program is currently supporting three major activities: The DOE/US Air Force Memorandum of Understanding Program is a collaborative effort to utilize the combined resources of DOE and the Department of Defense, eliminate duplication of effort in developing technologies, and to facilitate technology solutions aimed at reducing waste through process modification, material substitution or recycling. The Waste Component Recycle, Treatment and Disposal Integrated Demonstration (WeDID) will develop recycle, treatment, and disposal processes and associated technologies for use in the dismantlement of non-nuclear weapons components, to support US arms treaties and policies. This program will focus on meeting all security and regulatory requirements (with additional benefit to the commercial electronics industry). The Environmentally Conscious Manufacturing Integrated Demonstration (ECMID) will effectively implement ECM technologies that address both the needs of the DOE Complex and US electronics industry, and encourage strong interaction between DOE and US industry. The ECMID will also develop life cycle analysis tools that will aid decisionmakers in selecting the optimum process based on the tradeoffs between cost an environmental impact.

  2. Technologies for HIV prevention and care: challenges for health services.

    PubMed

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  3. Informing HIV prevention efforts targeting Liberian youth: a study using the PLACE method in Liberia

    PubMed Central

    2013-01-01

    Background Preventing HIV infection among young people is a priority for the Liberian government. Data on the young people in Liberia are scarce but needed to guide HIV programming efforts. Methods We used the Priorities for Local AIDS Control Efforts (PLACE) method to gather information on risk behaviors that young people (ages 14 to 24) engage in or are exposed to that increase their vulnerability for HIV infection. Community informants identified 240 unique venues of which 150 were visited and verified by research staff. 89 of the 150 venues comprised our sampling frame and 571 females and 548 males were interviewed in 50 venues using a behavioral survey. Results Ninety-one percent of females and 86% of males reported being sexually active. 56% of females and 47% of males reported they initiated sexual activity before the age of 15. Among the sexually active females, 71% reported they had received money or a gift for sex and 56% of males reported they had given money or goods for sex. 20% of females and 6% males reported that their first sexual encounter was forced and 15% of females and 6% of males reported they had been forced to have sex in the past year. Multiple partnerships were common among both sexes with 81% females and 76% males reporting one or more sex partners in the past four weeks. Less than 1% reported having experiences with injecting drugs and only 1% of males reporting have sex with men. While knowledge of HIV/AIDS was high, prevention behaviors including HIV testing and condom use were low. Conclusion Youth-focused HIV efforts in Liberia need to address transactional sex and multiple and concurrent partnerships. HIV prevention interventions should include efforts to meet the economic needs of youth. PMID:24107301

  4. Antiretroviral Therapy for the Prevention of HIV-1 Transmission.

    PubMed

    Cohen, Myron S; Chen, Ying Q; McCauley, Marybeth; Gamble, Theresa; Hosseinipour, Mina C; Kumarasamy, Nagalingeswaran; Hakim, James G; Kumwenda, Johnstone; Grinsztejn, Beatriz; Pilotto, Jose H S; Godbole, Sheela V; Chariyalertsak, Suwat; Santos, Breno R; Mayer, Kenneth H; Hoffman, Irving F; Eshleman, Susan H; Piwowar-Manning, Estelle; Cottle, Leslie; Zhang, Xinyi C; Makhema, Joseph; Mills, Lisa A; Panchia, Ravindre; Faesen, Sharlaa; Eron, Joseph; Gallant, Joel; Havlir, Diane; Swindells, Susan; Elharrar, Vanessa; Burns, David; Taha, Taha E; Nielsen-Saines, Karin; Celentano, David D; Essex, Max; Hudelson, Sarah E; Redd, Andrew D; Fleming, Thomas R

    2016-09-01

    Background An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission. Methods We randomly assigned 1763 index participants to receive either early or delayed ART. In the early-ART group, 886 participants started therapy at enrollment (CD4+ count, 350 to 550 cells per cubic millimeter). In the delayed-ART group, 877 participants started therapy after two consecutive CD4+ counts fell below 250 cells per cubic millimeter or if an illness indicative of the acquired immunodeficiency syndrome (i.e., an AIDS-defining illness) developed. The primary study end point was the diagnosis of genetically linked HIV-1 infection in the previously HIV-1-negative partner in an intention-to-treat analysis. Results Index participants were followed for 10,031 person-years; partners were followed for 8509 person-years. Among partners, 78 HIV-1 infections were observed during the trial (annual incidence, 0.9%; 95% confidence interval [CI], 0.7 to 1.1). Viral-linkage status was determined for 72 (92%) of the partner infections. Of these infections, 46 were linked (3 in the early-ART group and 43 in the delayed-ART group; incidence, 0.5%; 95% CI, 0.4 to 0.7) and 26 were unlinked (14 in the early-ART group and 12 in the delayed-ART group; incidence, 0.3%; 95% CI, 0.2 to 0.4). Early ART was associated with a 93% lower risk of linked partner infection than was delayed ART (hazard ratio, 0.07; 95% CI, 0.02 to 0.22). No linked infections were observed when HIV-1 infection was stably suppressed by ART in the index participant. Conclusions The early initiation of ART led to a sustained

  5. Internalized heterosexism among HIV-positive, gay-identified men: implications for HIV prevention and care.

    PubMed

    Johnson, Mallory O; Carrico, Adam W; Chesney, Margaret A; Morin, Stephen F

    2008-10-01

    Internalized heterosexism (IH), or the internalization of societal antihomosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and it has been inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, the authors tested a model framed in social action theory (C. K. Ewart, 1991, 2004) in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results support the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART nonadherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse and 17% of the variance in ART nonadherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men.

  6. Incorporating couples-based approaches into HIV prevention for gay and bisexual men: opportunities and challenges.

    PubMed

    Purcell, David W; Mizuno, Yoko; Smith, Dawn K; Grabbe, Kristina; Courtenay-Quick, Cari; Tomlinson, Hank; Mermin, Jonathan

    2014-01-01

    Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67% of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services,and support mutual disclosure of HIV status.

  7. A Complex Systems Approach to Evaluate HIV Prevention in Metropolitan Areas: Preliminary Implications for Combination Intervention Strategies

    PubMed Central

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

    2012-01-01

    Background 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. Methodology/Principal Findings 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. Conclusions/Significance Complex systems models of adaptive HIV transmission

  8. Structural drivers and social protection: mechanisms of HIV risk and HIV prevention for South African adolescents

    PubMed Central

    Cluver, Lucie Dale; Orkin, Frederick Mark; Meinck, Franziska; Boyes, Mark Edward; Sherr, Lorraine

    2016-01-01

    Introduction Social protection is high on the HIV-prevention agenda for youth in sub-Saharan Africa. However, questions remain: How do unconditional cash transfers work? What is the effect of augmenting cash provision with social care? And can “cash plus care” social protection reduce risks for adolescents most vulnerable to infection? This study tackles these questions by first identifying mediated pathways to adolescent HIV risks and then examining potential main and moderating effects of social protection in South Africa. Methods This study was a prospective observational study of 3515 10-to-17-year-olds (56.7% female; 96.8% one-year retention). Within randomly selected census areas in four rural and urban districts in two South African provinces, all homes with a resident adolescent were sampled between 2009/2010 and 2011/2012. Measures included 1) potential structural drivers of HIV infection such as poverty and community violence; 2) HIV risk behaviours; 3) hypothesized psychosocial mediating factors; and 4) types of social protection involving cash and care. Using gender-disaggregated analyses, longitudinal mediation models were tested for potential main and moderating effects of social protection. Results Structural drivers were associated with increased onset of adolescent HIV risk behaviour (p<0.001, B=0.06, SE=0.01), fully mediated by increased psychosocial problems. Both cash and care aspects of social protection were associated with reductions in HIV risk behaviour and psychosocial deprivations. In addition, cash social protection moderated risk pathways: for adolescent girls and boys experiencing more acute structural deprivation, social protection had the greatest associations with HIV risk prevention (e.g. moderation effects for girls: B=−0.08, p<0.002 between structural deprivation and psychosocial problems, and B=−0.07, p<0.001 between psychosocial problems and HIV risk behaviour). Conclusions Adolescents with the greatest structural

  9. HIV prevention research ethics: an introduction to the special issue.

    PubMed

    Fisher, Celia B

    2014-02-01

    This special issue of the Journal of Empirical Research on Human Research Ethics represents a sampling of projects fostered through the NIDA-funded Fordham University HIV Prevention Research Ethics Institute. The first three articles employ processes of co-learning to give voice to the experiences of individuals recovering from substance abuse and engaged in sex work who have participated in HIV prevention studies in the United States, India, and the Philippines. The fourth article describes a unique community-based approach to the development of research ethics training modules designed to increase participation of American Indian and Alaskan Native (AI/AN) tribal members as partners in research on health disparities. The last two articles focus a critical scholarly lens on two underexamined areas confronting IRB review of HIV research: The emerging and continuously changing ethical challenges of using social media sites for recruitment into HIV prevention research, and the handling of research-related complaints from participants involving perceived research harms or research experiences that do not accord with their initial expectations. Together, the articles in this special issue identify key ethical crossroads and provide suggestions for best practices that respect the values and merit the trust of research participants.

  10. After the Fact: A Brief Educational Program on HIV Postexposure Prophylaxis for Female Detainees in a Local Jail.

    PubMed

    Gupta, Neha; Schmidt, Heidi; Buisker, Timothy; Dufour, Mi-Suk Kang; Goldenson, Joe; Myers, Janet; Tulsky, Jacqueline

    2015-04-01

    Women who have been in jail are at increased risk of acquiring HIV when they are in the community. Nonoccupational postexposure prophylaxis (nPEP) reduces HIV transmission following high-risk behaviors and is an effective HIV prevention strategy. The authors designed a 15-minute interactive educational program to increase inmates' knowledge of nPEP. Before the program, participants self-reported high HIV risk yet low risk perception and lack of nPEP awareness. After the program, nPEP knowledge scores increased by 40% regardless of demographic or HIV-risk characteristics. This study demonstrates that a brief, easy-to-deliver educational intervention can be carried out in a jail, is effective at raising awareness of both HIV risk and nPEP, and may be useful for others seeking to increase use of this prevention strategy for high-risk women during incarceration.

  11. Paying for prevention: challenges to health insurance coverage for biomedical HIV prevention in the United States.

    PubMed

    Underhill, Kristen

    2012-01-01

    Reducing the incidence of HIV infection continues to be a crucial public health priority in the United States, especially among populations at elevated risk such as men who have sex with men, transgender women, people who inject drugs, and racial and ethnic minority communities. Although most HIV prevention efforts to date have focused on changing risky behaviors, the past decade yielded efficacious new biomedical technologies designed to prevent infection, such as the prophylactic use of antiretroviral drugs and the first indications of an efficacious vaccine. Access to prevention technologies will be a significant part of the next decade's response to HIV and advocates are mobilizing to achieve more widespread use of these interventions. These breakthroughs, however, arrive at a time of escalating healthcare costs; health insurance coverage therefore raises pressing new questions about priority-setting and the allocation of responsibility for public health. The goals of this Article are to identify legal challenges and potential solutions for expanding access to biomedical HIV prevention through health insurance coverage. This Article discusses the public policy implications of HIVprevention coverage decisions, assesses possible legal grounds on which insurers may initially deny coverage for these technologies, and evaluates the extent to which these denials may survive external and judicial review. Because several of these legal grounds may be persuasive, particularly denials on the basis of medical necessity, this Article also explores alternative strategies for financing biomedical HIV prevention efforts.

  12. HIV testing for HIV prevention: a comparative analysis of policies in Britain, Hungary and Sweden.

    PubMed

    Danziger, R

    1998-10-01

    This paper compares policies on named HIV testing in the context of HIV prevention in Britain, Hungary and Sweden, and considers the extent to which these policies are based on evidence of effectiveness or on other, more contextual, factors. In Britain, testing has not featured significantly as a prevention strategy, and named testing has generally been carried out only with the voluntary, informed consent of individuals. In Hungary, testing is central to HIV prevention, and is required by law of certain groups. HIV testing is carried out mainly on a voluntary basis in Sweden, but, unlike in Britain, it has been actively promoted by public health authorities. The paper contrasts the 'right not to know' one's HIV status which is widely respected in Britain, with the 'responsibility to find out' which is more pervasive in Hungary and Sweden. Although policy makers in all three countries appear convinced that their's is the right approach, there appears to be as yet a dearth of convincing evidence to support their arguments. PMID:9828953

  13. Shifting Resources and Focus to Meet the Goals of the National HIV/AIDS Strategy: The Enhanced Comprehensive HIV Prevention Planning Project, 2010-2013.

    PubMed

    Flores, Stephen A; Purcell, David W; Fisher, Holly H; Belcher, Lisa; Carey, James W; Courtenay-Quirk, Cari; Dunbar, Erica; Eke, Agatha N; Galindo, Carla A; Glassman, Marlene; Margolis, Andrew D; Neumann, Mary Spink; Prather, Cynthia; Stratford, Dale; Taylor, Raekiela D; Mermin, Jonathan

    2016-01-01

    In September 2010, CDC launched the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project to shift HIV-related activities to meet goals of the 2010 National HIV/AIDS Strategy (NHAS). Twelve health departments in cities with high AIDS burden participated. These 12 grantees submitted plans detailing jurisdiction-level goals, strategies, and objectives for HIV prevention and care activities. We reviewed plans to identify themes in the planning process and initial implementation. Planning themes included data integration, broad engagement of partners, and resource allocation modeling. Implementation themes included organizational change, building partnerships, enhancing data use, developing protocols and policies, and providing training and technical assistance for new and expanded activities. Pilot programs also allowed grantees to assess the feasibility of large-scale implementation. These findings indicate that health departments in areas hardest hit by HIV are shifting their HIV prevention and care programs to increase local impact. Examples from ECHPP will be of interest to other health departments as they work toward meeting the NHAS goals.

  14. Investigating combination HIV prevention: isolated interventions or complex system

    PubMed Central

    Brown, Graham; Reeders, Daniel; Dowsett, Gary W.; Ellard, Jeanne; Carman, Marina; Hendry, Natalie; Wallace, Jack

    2015-01-01

    Introduction Treatment as prevention has mobilized new opportunities in preventing HIV transmission and has led to bold new UNAIDS targets in testing, treatment coverage and transmission reduction. These will require not only an increase in investment but also a deeper understanding of the dynamics of combining behavioural, biomedical and structural HIV prevention interventions. High-income countries are making substantial investments in combination HIV prevention, but is this investment leading to a deeper understanding of how to combine interventions? The combining of interventions involves complexity, with many strategies interacting with non-linear and multiplying rather than additive effects. Discussion Drawing on a recent scoping study of the published research evidence in HIV prevention in high-income countries, this paper argues that there is a gap between the evidence currently available and the evidence needed to guide the achieving of these bold targets. The emphasis of HIV prevention intervention research continues to look at one intervention at a time in isolation from its interactions with other interventions, the community and the socio-political context of their implementation. To understand and evaluate the role of a combination of interventions, we need to understand not only what works, but in what circumstances, what role the parts need to play in their relationship with each other, when the combination needs to adapt and identify emergent effects of any resulting synergies. There is little development of evidence-based indicators on how interventions in combination should achieve that strategic advantage and synergy. This commentary discusses the implications of this ongoing situation for future research and the required investment in partnership. We suggest that systems science approaches, which are being increasingly applied in other areas of public health, could provide an expanded vocabulary and analytic tools for understanding these

  15. Quality of Care for HIV/AIDS and for Primary Prevention by HIV Specialists and Nonspecialists.

    PubMed

    Landovitz, Raphael J; Desmond, Katherine A; Gildner, Jennifer L; Leibowitz, Arleen A

    2016-09-01

    The role of HIV specialists in providing primary care to persons living with HIV/AIDS is evolving, given their increased incidence of comorbidities. Multivariate logit analysis compared compliance with sentinel preventive screening tests and interventions among publicly insured Californians with and without access to HIV specialists in 2010. Quality-of-care indicators [visit frequency, CD4 and viral load (VL) assessments, influenza vaccine, tuberculosis (TB) testing, lipid profile, glucose blood test, and Pap smears for women] were related to patient characteristics and provider HIV caseload. There were 9377 adult Medicare enrollees (71% also had Medicaid coverage) and 2076 enrollees with only Medicaid coverage. Adjusted for patient characteristics, patients seeing providers with greater HIV caseloads (>50 HIV patients) were more likely to meet visit frequency guidelines in both Medicare [98%; confidence interval (CI 97.5-98.2) and Medicaid (97%; CI 96.2-98.0), compared to 60% (CI 57.1-62.3) and 45% (CI 38.3-50.4), respectively, seeing providers without large HIV caseloads (p < 0.001). Patients seeing providers with larger caseloads were significantly more likely to have CD4 (p < 0.001), VL (p < 0.001), and TB testing (p < 0.05). A larger percentage of patients seeing large-volume Medicare providers received influenza vaccinations. Provider caseload was unrelated to lipid or glucose assessments or Pap Smears for women. Patients with access to large-volume providers were more likely to meet clinical guidelines for visits, CD4, VL, tuberculosis testing, and influenza vaccinations, and were not less likely to receive primary preventive care. Substantial insufficiencies remain in both monitoring to assess viral suppression and in preventive care. PMID:27610461

  16. 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

  17. Information Vaccine: Using Graphic Novels as an HIV/AIDS Prevention Resource for Young Adults

    ERIC Educational Resources Information Center

    Albright, Kendra S.; Gavigan, Karen

    2014-01-01

    HIV/AIDS infections are growing at an alarming rate for young adults. In 2009, youth, ages 13-29, accounted for 39% of all new HIV infections in the U.S. (Division of HIV/ AIDS Prevention, Centers for Disease Control (CDC), 2011). South Carolina ranks eighth in the nation for new HIV cases, while the capital city of Columbia ranks seventh…

  18. Opportunities for HIV Combination Prevention to Reduce Racial and Ethnic Health Disparities

    ERIC Educational Resources Information Center

    Grossman, Cynthia I.; Purcell, David W.; Rotheram-Borus, Mary Jane; Veniegas, Rosemary

    2013-01-01

    Despite advances in HIV prevention and care, African Americans and Latino Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, and are less likely to have suppressed viral load than are Whites. The first National HIV/AIDS Strategy…

  19. 76 FR 66721 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention CDC/HRSA Advisory Committee on HIV and STD... and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS and other STDs. Matters To...

  20. [Individuals, structures, and risks: an overview of primary HIV prevention in Portugal].

    PubMed

    Sacramento, Octávio

    2016-06-20

    This article debates the principal guidelines and procedures that shape HIV/AIDS prevention in Portugal, focusing on risk reduction in the two major scenarios for spread of the epidemic: sexuality and injection drug use. The analysis views the risks of infection as expressions of practices that are densely interwoven into social structures and cultural frameworks. Based on this conception, the article seeks to evaluate and understand the extent to which preventive strategies take a broad and integrative underlying approach by including individuals and their circumstances. Meanwhile, the study identifies some of the main structural constraints impeding the achievement of more favorable conditions for minimizing risks and adopting safe behaviors. These analytical exercises include not only policy and program guidelines, but also processes in daily reality, showing how the non-implementation of measures already guaranteed by law poses powerful structural barriers to HIV prevention.

  1. [The 50-year-old women or older: preventive actions to the HIV infection].

    PubMed

    Rodrigues, Daniela Angelo de Lima; Praça, Neide de Souza

    2010-06-01

    The present study is a qualitative research which aimed to verify the adoption of preventive measures on the transmission of HIV in 50-year-old women or older, who lived in poor communities and were assisted by the Family Health Program in São Paulo, Brazil. Medical Anthropology has been adopted as a theoretical reference, as well as the Discourse of the Collective Individual for data analysis. Thirteen women were interviewed and three discourses were presented: prevention appreciation, invisibility of HIV/AIDS and the rejection of the use of condom. The analysis showed that the group did not realize the risk of contamination through sexual intercourse due to their trust in the partner's loyalty. The casual use of condoms was taken into consideration just out of curiosity. The preventive actions adopted need more scientific support. The results point out the necessity of planning and implementing interventions which are culturally based and directed to the studied segment. PMID:21500513

  2. Community mobilization, empowerment and HIV prevention among female sex workers in south India

    PubMed Central

    2013-01-01

    Background While community mobilization has been widely endorsed as an important component of HIV prevention among vulnerable populations such as female sex workers (FSWs), there is uncertainty as to the mechanism through which it impacts upon HIV risk. We explored the hypothesis that individual and collective empowerment of FSW is an outcome of community mobilization, and we examined the means through which HIV risk and vulnerability reduction as well as personal and social transformation are achieved. Methods This study was conducted in five districts in south India, where community mobilization programs are implemented as part of the Avahan program (India AIDS Initiative) of the Bill & Melinda Gates Foundation. We used a theoretically derived “integrated empowerment framework” to conduct a secondary analysis of a representative behavioural tracking survey conducted among 1,750 FSWs. We explored the associations between involvement with community mobilization programs, self-reported empowerment (defined as three domains including power within to represent self-esteem and confidence, power with as a measure of collective identity and solidarity, and power over as access to social entitlements, which were created using Principal Components analysis), and outcomes of HIV risk reduction and social transformation. Results In multivariate analysis, we found that engagement with HIV programs and community mobilization activities was associated with the domains of empowerment. Power within and power with were positively associated with more program contact (p < .01 and p < .001 respectively). These measures of empowerment were also associated with outcomes of “personal transformation” in terms of self-efficacy for condom and health service use (p < .001). Collective empowerment (power with others) was most strongly associated with “social transformation” variables including higher autonomy and reduced violence and coercion, particularly in

  3. Focusing HIV prevention on those most likely to transmit the virus.

    PubMed

    West, Gary R; Corneli, Amy L; Best, Kim; Kurkjian, Katie M; Cates, William

    2007-08-01

    Despite some success in reducing HIV incidence, the global epidemic continues to grow. For every person with AIDS in developing countries placed on treatment in 2005, many others were newly infected. We need more effective prevention programs that focus interventions on those most at risk for HIV transmission (MART), particularly those with 1) high behavioral risk and 2) high viral loads due to acute or recent infection, co-infections with other diseases, high viral set points, or untreated AIDS. This article provides examples of how prevention programs can incorporate emerging testing technologies and social/behavioral approaches to reach these individuals, their partners, and the social networks where active transmission is occurring. PMID:17685841

  4. HIV prevention: Making male circumcision the 'right' tool for the job.

    PubMed

    Bell, Kirsten

    2015-01-01

    In recent years, HIV/AIDS programming has been transformed by an ostensibly 'new' procedure: male circumcision. This article examines the rise of male circumcision as the 'right' HIV prevention tool. Treating this controversial topic as a 'matter of concern' rather than a 'matter of fact', I examine the reasons why male circumcision came to be seen as a partial solution to the problem of HIV transmission in the twenty-first century and to what effect. Grounded in a close reading of the primary literature, I suggest that the embrace of male circumcision in HIV prevention must be understood in relation to three factors: (1) the rise of evidence-based medicine as the dominant paradigm for conceptualising medical knowledge, (2) the fraught politics of HIV/AIDS research and funding, which made the possibility of a biomedical intervention attractive and (3) underlying assumptions about the nature of African 'culture' and 'sexuality'. I conclude by stressing the need to expand the parameters of the debate beyond the current polarised landscape, which presents us with a problematic either/or scenario regarding the efficacy of male circumcision.

  5. Sex workers in HIV prevention: From Social Change Agents to Peer Educators.

    PubMed

    George, Annie; Blankenship, Kim M; Biradavolu, Monica R; Dhungana, Nimesh; Tankasala, Nehanda

    2015-01-01

    We utilised a comparative ethnographic approach to study the implementation of a community mobilisation intervention addressing HIV risk among female sex workers (FSWs) in India, as implemented first by an non-governmental organisation and after oversight of the intervention was transitioned to the government. We demonstrate that the work of peer outreach workers changed from Social Change Agents within a community-led structural intervention (CLSI) to Peer Educators within a targeted intervention (TI). In the CLSI approach, built on the assumption that FSW risk for HIV is rooted in power inequality and structural vulnerability, peer outreach workers mobilised their peers through community-based organisations to address underlying conditions of inequality and vulnerability. In contrast, the TI approach, which views FSW risk as a function of limited knowledge and barriers to services, addressed peers' access to information and health services. Analysis of changes in the function of peer outreach workers reveals critical differences of which we discuss four: assumptions about conditions that produce HIV risk; degree of emphasis placed on collective mobilising and building collective power; extent to which community mobilisation and HIV prevention goals are linked; and the intervention's use of peer input. We discuss the implications of these findings for HIV prevention programming.

  6. Enhancing HIV Communication between Parents and Children: Efficacy of the Parents Matter! Program

    ERIC Educational Resources Information Center

    Miller, Kim S.; Lin, Carol Y.; Poulsen, Melissa N.; Fasula, Amy; Wyckoff, Sarah C.; Forehand, Rex; Long, Nicholas; Armistead, Lisa

    2011-01-01

    We examine efficacy of the Parents Matter! Program (PMP), a program to teach African-American parents of preadolescents sexual communication and HIV-prevention skills, through a multicenter, randomized control trial. A total of 1115 parent-child participants were randomized to one of three intervention arms (enhanced, brief, control). Percentages…

  7. Towards Combination HIV Prevention for Injection Drug Users: Addressing Addictophobia, Apathy and Inattention

    PubMed Central

    Strathdee, Steffanie A.; Shoptaw, Steven; Dyer, Typhanye Penniman; Quan, Vu Minh; Aramrattana, Apinun

    2013-01-01

    Purpose of the review Recent breakthroughs in HIV-prevention science led us to evaluate the current state of combination HIV-prevention for injection drug users (IDUs). We review the recent literature focusing on possible reasons why coverage of prevention interventions for HIV, HCV and tuberculosis among IDUs remains dismal. We make recommendations for future HIV research and policy. Recent findings IDUs disproportionately under-utilize VCT, primary care and ART, especially in countries that have the largest burden of HIV among IDUs. IDUs present later in the course of HIV infection and experience greater morbidity and mortality. Why are IDUs under-represented in HIV-prevention research, access to treatment for both HIV and addiction, and access to HIV combination prevention? Possible explanations include addictophobia, apathy, and inattention, which we describe in the context of recent literature and events. Summary This commentary discusses the current state of HIV-prevention interventions for IDUs including, VCT, NSP, OST, ART and PrEP, and discusses ways to work towards true combination HIV-prevention for IDU populations. Communities need to overcome tacit assumptions that IDUs can navigate through systems that are maintained as separate silos, and take a rights-based approach to HIV-prevention to ensure that IDUs have equitable access to life-saving prevention and treatments. PMID:22498479

  8. HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention

    PubMed Central

    Baggaley, Rebecca F; White, Richard G; Boily, Marie-Claude

    2010-01-01

    Background The human immunodeficiency virus (HIV) infectiousness of anal intercourse (AI) has not been systematically reviewed, despite its role driving HIV epidemics among men who have sex with men (MSM) and its potential contribution to heterosexual spread. We assessed the per-act and per-partner HIV transmission risk from AI exposure for heterosexuals and MSM and its implications for HIV prevention. Methods Systematic review and meta-analysis of the literature on HIV-1 infectiousness through AI was conducted. PubMed was searched to September 2008. A binomial model explored the individual risk of HIV infection with and without highly active antiretroviral therapy (HAART). Results A total of 62 643 titles were searched; four publications reporting per-act and 12 reporting per-partner transmission estimates were included. Overall, random effects model summary estimates were 1.4% [95% confidence interval (CI) 0.2–2.5)] and 40.4% (95% CI 6.0–74.9) for per-act and per-partner unprotected receptive AI (URAI), respectively. There was no significant difference between per-act risks of URAI for heterosexuals and MSM. Per-partner unprotected insertive AI (UIAI) and combined URAI–UIAI risk were 21.7% (95% CI 0.2–43.3) and 39.9% (95% CI 22.5–57.4), respectively, with no available per-act estimates. Per-partner combined URAI–UIAI summary estimates, which adjusted for additional exposures other than AI with a ‘main’ partner [7.9% (95% CI 1.2–14.5)], were lower than crude (unadjusted) estimates [48.1% (95% CI 35.3–60.8)]. Our modelling demonstrated that it would require unreasonably low numbers of AI HIV exposures per partnership to reconcile the summary per-act and per-partner estimates, suggesting considerable variability in AI infectiousness between and within partnerships over time. AI may substantially increase HIV transmission risk even if the infected partner is receiving HAART; however, predictions are highly sensitive to infectiousness assumptions

  9. MTV's "Staying Alive" Global Campaign Promoted Interpersonal Communication about HIV and Positive Beliefs about HIV Prevention

    ERIC Educational Resources Information Center

    Geary, Cynthia Waszak; Burke; Holly McClain; Castelnau, Laure; Neupane; Shailes; Sall, Yacine Ba; Wong, Emily; Tucker, Heidi Toms

    2007-01-01

    In 2002 MTV launched a global multicomponent HIV prevention campaign, "Staying Alive," reaching over 166 countries worldwide. An evaluation of this campaign focused on three diverse sites: Kathmandu, Nepal; Sao Paulo, Brazil; and Dakar, Senegal. Data were collected before and after campaign implementation through population-based household…

  10. 'Getting to zero' in Asia and the Pacific through more strategic use of antiretrovirals for HIV prevention.

    PubMed

    Cassell, Michael M; Holtz, Timothy H; Wolfe, Mitchell I; Hahn, Michael; Prybylski, Dimitri

    2014-07-01

    Encouraged by experimental trials demonstrating the efficacy of antiretrovirals (ARVs) in preventing HIV infection, countries across the Asia-Pacific region have committed to the achievement of ambitious targets tantamount to ending AIDS. The available data suggest that some countries still can make progress through targeted condom promotion and the expansion of harm-reduction interventions, but that none may realise its vision of 'zero new HIV infections' without more strategic use of ARVs as part of a combination of HIV prevention efforts targeting key populations. Low rates of HIV testing among men who have sex with men, people who inject drugs, sex workers and other key populations evidence low treatment coverage where treatment could have the greatest impact on curbing local epidemics. Studies have demonstrated the promise of adding ARV treatment and pre-exposure prophylaxis to the existing HIV prevention toolkit, but achieving population-level impact will require service-delivery approaches that overcome traditional prevention, care and treatment program distinctions. Priorities include: (1) innovative strategies to reach, test, treat and retain in services the individuals most likely to acquire or transmit HIV; (2) task shifting and enhanced partnerships between the public sector and civil society; (3) improved 'cascade' data systems to assess and promote service uptake and retention; and (4) policy and financing reform to enhance HIV testing and treatment access among key populations.

  11. The costs of HIV prevention strategies in developing countries.

    PubMed Central

    Söderlund, N.; Lavis, J.; Broomberg, J.; Mills, A.

    1993-01-01

    Since many evaluations of HIV (human immunodeficiency virus) prevention programmes do not include data on costs, a preliminary analysis of the costs and outputs of a sample of HIV prevention projects was attempted. Case studies, representing six broad HIV prevention strategies in developing countries with differing levels of per capita gross domestic product, were sought on the basis of availability of data and potential generalizability. The six prevention strategies studied were mass media campaigns, peer education programmes, sexually transmitted disease treatment, condom social marketing, safe blood provision, and needle exchange/bleach provision programmes. Financial cost data were abstracted from published studies or were obtained directly from project coordinators. Although estimates of cost-effectiveness were not made, calculations of the relative cost per common process measure of output were compared. Condom distribution costs ranged from US$ 0.02 to 0.70 per condom distributed, and costs of strategies involving personal educational input ranged from US$ 0.15 to 12.59 per contact. PMID:8261563

  12. Clinical Trial Design for HIV Prevention Research: Determining Standards of Prevention.

    PubMed

    Dawson, Liza; Zwerski, Sheryl

    2015-06-01

    This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions. PMID:25230397

  13. Clinical Trial Design for HIV Prevention Research: Determining Standards of Prevention.

    PubMed

    Dawson, Liza; Zwerski, Sheryl

    2015-06-01

    This article seeks to advance ethical dialogue on choosing standards of prevention in clinical trials testing improved biomedical prevention methods for HIV. The stakes in this area of research are high, given the continued high rates of infection in many countries and the budget limitations that have constrained efforts to expand treatment for all who are currently HIV-infected. New prevention methods are still needed; at the same time, some existing prevention and treatment interventions have been proven effective but are not yet widely available in the countries where they most urgently needed. The ethical tensions in this field of clinical research are well known and have been the subject of extensive debate. There is no single clinical trial design that can optimize all the ethically important goals and commitments involved in research. Several recent articles have described the current ethical difficulties in designing HIV prevention trials, especially in resource limited settings; however, there is no consensus on how to handle clinical trial design decisions, and existing international ethical guidelines offer conflicting advice. This article acknowledges these deep ethical dilemmas and moves beyond a simple descriptive approach to advance an organized method for considering what clinical trial designs will be ethically acceptable for HIV prevention trials, balancing the relevant criteria and providing justification for specific design decisions.

  14. Pollution prevention program plan 1996

    SciTech Connect

    1996-06-01

    This plan serves as the principal crosscutting guidance to Department of Energy (DOE) Headquarters, Operations Office, laboratory, and contractor management to fully implement pollution prevention programs within the DOE complex between now and 2000. To firmly demonstrate DOE`s commitment to pollution prevention, the Secretary of Energy has established goals, to be achieved by December 31, 1999, that will aggressively reduce DOE`s routine generation of radioactive, mixed, and hazardous wastes, and total releases and offsite transfers of toxic chemicals. The Secretary also has established sanitary waste reduction, recycling, and affirmative procurement goals. Site progress in meeting these goals will be reported annually to the Secretary in the Annual Report on Waste Generation and Waste Minimization Progress, using 1993 as the baseline year. Implementation of this plan will represent a major step toward reducing the environmental risks and costs associated with DOE operations.

  15. Traditional women's associations as channels for HIV / AIDS / STD prevention.

    PubMed

    Niang, C I

    1995-01-01

    Women of the Laobe ethnic group and the Dimba, a traditional women's association, provide advice about sexuality and reproductive health in southern Senegal. Research was initiated in October 1992 by the Cheikh Anta Diop University to determine whether these women could also help in HIV/AIDS and STD prevention activities. The study investigated men's and women's knowledge, attitudes, beliefs, and practices (KABP) related to sexuality and HIV/AIDS/STDs in the community of Kolda; practices potentially increasing women's risk of HIV/STD infection; and possibilities for integrating HIV/STD prevention messages into the interactions which take place between the Laobe and Dimba groups and the Kolda community. The KABP study was a questionnaire administered to 250 men and 250 women of reproductive age representing five ethnic groups residing in Kolda. 11 men and 14 women older than age 40 participated in in-depth sexual life history interviews. The survey and interviews indicate that people in Kolda do not generally see a link between sexual relations and STD transmission. Instead, STDs are attributed to behaviors such as urinating, walking barefoot on the urine of an already-infected person, encountering a "bad wind", and being cursed. Women may be at increased risk of HIV infection through practices designed to enhance sexual pleasure, including the insertion of organic and mineral product into the vagina, and the cutting of bumps and warts in and around the vagina. Sexual practices, knowledge, prevention through the Laobe and Dimba, and outcome and follow-up are discussed. PMID:12346870

  16. A perspective on progress and gaps in HIV prevention science.

    PubMed

    Kiser, Patrick F; Mesquita, Pedro M M; Herold, Betsy C

    2012-11-01

    In the past few years, the transdisciplinary field of HIV prevention has reached several milestones. Topically applied tenofovir gel provided significant protection from sexual transmission of HIV in a large-scale clinical trial and oral Truvada (emtricitabine/tenofovir disoproxil fumarate) was recently approved for preexposure prophylaxis (PrEP) following two successful clinical trials in men and women. These achievements are tempered by the disappointing results of other clinical trials, which highlight the complexities of prevention research. In this perspective, we discuss scientific and developmental gaps for topical chemoprophylaxis of the sexual transmission of HIV, which depends on the complex interactions between the pharmacokinetics and pharmacodynamics of drugs, formulation and delivery systems, anatomic site of transmission, and host mucosal immune defenses. Despite the considerable time and resources devoted to unraveling the initial steps in sexual transmission of HIV, current knowledge is based on animal models and human explanted tissue, which may not fully recapitulate what happens clinically. Understanding these events, including the role that sex hormones, semen, and mucosal secretions play in transmission, and the interplay between innate immunity, the mucosal environment, and drug efficacy is paramount. This drives some of the most pressing questions in the field. PMID:22966871

  17. HIV and family living. Preventing the spread of HIV and other diseases.

    PubMed

    Sax, P; Weinberger, H

    1995-10-01

    HIV is spread through direct contact with body fluids, such as blood, semen, vaginal fluids, and breast milk. HIV is not spread through everyday contact. People with HIV are not dangerous to the people they live with at home or in the community and with whom they have ordinary, non-sexual contact. Certain precautions should be taken, however, to minimize risk. First, personal items such as razors, toothbrushes or earrings, should not be shared. Latex gloves should be worn by uninfected family members when they may come into contact with bodily fluids, and the family members should always wash their hands with soap and water after touching blood and other fluids, even if gloves have been worn. The person with HIV can be protected by minimizing exposure to food-borne illnesses carried by raw or undercooked meat, eggs or unpasteurized milk; limiting contact with people who have colds, the flu or diarrhea; and avoiding contact with cages or litter boxes of pets. To help clarify sanitary measures, some frequently asked questions are answered. These questions address the safety of sharing food with HIV-infected people; chickenpox infection and emergence of shingles; prevention of CMV infection; toxoplasmosis and cats; spread of M. avium complex (MAC); and the safety of contact between HIV-infected people and infants.

  18. 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…

  19. Sources of HIV-Prevention Information for Individuals at High Risk.

    ERIC Educational Resources Information Center

    Sagrestano, Lynda M.; Heiss-Wendt, Renate M.; Mizan, Ainon N.; Kittleson, Mark J.; Sarvela, Paul D.

    2001-01-01

    Identified the best methods of reaching people at high risk with HIV-prevention messages. Data from men who had sex with men, injection drug users, sex workers, HIV-positive people, heterosexuals, migrant workers, and perinatal women indicated that over 70 percent were exposed to HIV-prevention messages, though sources of exposure varied by risk…

  20. Associations between Social Capital and HIV Stigma in Chennai, India: Considerations for Prevention Intervention Design

    ERIC Educational Resources Information Center

    Sivaram, Sudha; Zelaya, Carla; Srikrishnan, A. K.; Latkin, Carl; Go, V. F.; Solomon, Suniti; Celentano, David

    2009-01-01

    Stigma against persons living with HIV/AIDS (PLHA) is a barrier to seeking prevention education, HIV testing, and care. Social capital has been reported as an important factor influencing HIV prevention and social support upon infection. In the study, we explored the associations between social capital and stigma among men and women who are…

  1. "It's Crazy Being a Black, Gay Youth." Getting Information about HIV Prevention: A Pilot Study

    ERIC Educational Resources Information Center

    Voisin, Dexter R.; Bird, Jason D. P.; Shiu, Chen-Shi; Krieger, Cathy

    2013-01-01

    Background: Access and adoption of HIV prevention information are important criteria for reducing HIV infection rates among men who have sex with men. Methods: Using focus group data, researchers sought to identify sources of HIV prevention information and barriers to adopting protective behaviors among young African American men who have sex with…

  2. 75 FR 39264 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In accordance with section 10(a)(2..., CDC and the Administrator, HRSA, regarding activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education...

  3. Combination HIV Prevention Interventions: The Potential of Integrated Behavioral and Biomedical Approaches

    PubMed Central

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

    2014-01-01

    Background Combination HIV prevention interventions that integrate efficacious behavioral and biomedical strategies offer the potential to reduce new HIV infections. Purpose We overview the efficacy data for three biomedical HIV prevention approaches: microbicides, pre-exposure prophylaxis (PrEP), and an HIV vaccination, review factors associated with differential acceptability and uptake of these methods, and suggest strategies to optimize the effectiveness and dissemination of combination HIV prevention approaches. Methods A narrative review was conducted highlighting key efficacy data for microbicides, PrEP, and an HIV vaccination and summarizing acceptability data for each of the three biomedical HIV prevention approaches. Recommendations for the integration and dissemination of combined behavioral and biomedical HIV prevention approaches are provided. Results To date, microbicides and an HIV vaccination have demonstrated limited efficacy for the prevention of HIV. However, PrEP has demonstrated efficacy in reducing HIV incident infections. A diverse array of factors influences both hypothetical willingness and actual usage of each biomedical prevention method. Conclusions Strategies to effectively integrate and evaluate combination HIV prevention interventions are urgently needed. PMID:25216985

  4. HIV, sex, and social change: applying ESID principles to HIV prevention research.

    PubMed

    Fernández, M Isabel; Bowen, G Stephen; Gay, Caryl L; Mattson, Tiffany R; Bital, Evelyne; Kelly, Jeffrey A

    2003-12-01

    The HIV epidemic has been the most significant public health crisis of the last 2 decades. Although Experimental Social Innovation and Dissemination (ESID) principles have been used by many HIV prevention researchers, the clearest application is the series of model-building and replication experiments conducted by Kelly and colleagues. The model mobilized, trained, and engaged key opinion leaders to serve as behavior change and safe-sex endorsers in their social networks. This paper illustrates how ESID principles were used to develop, test, and disseminate an innovative social model and discusses the challenges of applying ESID methodology in the midst of a public health emergency. PMID:14703268

  5. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium.

    PubMed

    Ousman, Kevin; Polomano, Rosemary C; Seloilwe, Esther; Odero, Theresa; Tarimo, Edith; Mashalla, Yohana J; Voss, Joachim G; O'Malley, Gabrielle; Chapman, Susan A; Gachuno, Onesmus; Manabe, Yukari; Nakanjako, Damalie; Sewankambo, Nelson; Urassa, David; Wasserheit, Judith N; Wiebe, Douglas J; Green, Wendy; Farquhar, Carey

    2016-01-01

    HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses.

  6. Why Parents Matter!: The Conceptual Basis for a Community-Based HIV Prevention Program for the Parents of African American Youth

    ERIC Educational Resources Information Center

    Dittus, Patricia; Miller, Kim S.; Kotchick, Beth A.; Forehand, Rex

    2004-01-01

    The Parents Matter! Program (PMP) is a community-based family intervention designed to promote positive parenting and effective parent-child communication about sexuality and sexual risk reduction. Its ultimate goal is to reduce sexual risk behavior among adolescents. PMP offers parents instruction and guidance in general parenting skills related…

  7. Communication as a Protective Factor: Evaluation of a Life Skills HIV/AIDS Prevention Program for Mexican Elementary-School Students

    ERIC Educational Resources Information Center

    Pick, Susan; Givaudan, Martha; Sirkin, Jenna; Ortega, Isaac

    2007-01-01

    Literature suggests that communication is a protective factor against high-risk sexual behavior. This study assessed the impact of a fourth-grade communication-centered life skills program on attitudes, norms, self-efficacy, behaviors, and intentions toward communication about difficult subjects. Participants included 1,581 low-income Mexican…

  8. 3 CFR 13649 - Executive Order 13649 of July 15, 2013. Accelerating Improvements in HIV Prevention and Care in...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum Initiative 13649... Accelerating Improvements in HIV Prevention and Care in the United States Through the HIV Care Continuum... respond to the ongoing domestic HIV epidemic, it is hereby ordered as follows: Section 1....

  9. Social network characteristics and HIV vulnerability among transgender persons in San Salvador: identifying opportunities for HIV prevention strategies.

    PubMed

    Barrington, Clare; Wejnert, Cyprian; Guardado, Maria Elena; Nieto, Ana Isabel; Bailey, Gabriela Paz

    2012-01-01

    The purpose of this study is to improve understanding of HIV vulnerability and opportunities for HIV prevention within the social networks of male-to-female transgender persons in San Salvador, El Salvador. We compare HIV prevalence and behavioral data from a sample of gay-identified men who have sex with men (MSM) (n = 279), heterosexual or bisexual identified MSM (n = 229) and transgender persons (n = 67) recruited using Respondent Driven Sampling. Transgender persons consistently reported higher rates of HIV risk behavior than the rest of the study population and were significantly more likely to be involved in sex work. While transgender persons reported the highest rates of exposure to HIV educational activities they had the lowest levels of HIV-related knowledge. Transgender respondents' social networks were homophilous and efficient at recruiting other transgender persons. Findings suggest that transgender social networks could provide an effective and culturally relevant opportunity for HIV prevention efforts in this vulnerable population.

  10. Thirty years of condom-based HIV prevention by gay men in New Zealand.

    PubMed

    Hughes, Anthony J; Saxton, Peter J

    2015-12-01

    Three decades after the first government-funded HIV prevention campaign in 1985, gay and bisexual men (GBM) remain the population most at risk of infection in New Zealand. We review the major determinants of the elevated HIV risk for GBM, describe New Zealand's prevention response over the first 30 years, and summarise the public health record. HIV incidence among GBM is driven by the heightened biological efficiency of HIV transmission during unprotected anal intercourse, dense sexual partnering networks, and endemic HIV prevalence. Responses in New Zealand have emphasised evidence-based primary prevention by condom use, which were implemented in communities and supported by comprehensive public health action. New Zealand has a good international HIV prevention record among GBM, however HIV diagnosis rates are now higher than they were during the epidemic nadir of the late 1990s. Lessons from the first three decades must underpin future HIV control efforts. PMID:26913905

  11. Strategies to prevent HIV transmission among heterosexual African-American women

    PubMed Central

    Essien, E James; Meshack, Angela F; Peters, Ronald J; Ogungbade, GO; Osemene, Nora I

    2005-01-01

    someone who had contracted HIV. Conclusion This study offers a foundation for further research that may be used to create culturally relevant HIV prevention programs for African-American women. PMID:15774003

  12. STD / AIDS prevention: new challenges for family planning programs.

    PubMed

    Williamson, N; Townsend, S

    1991-12-01

    Family planning (FP) professionals and programs are increasingly called upon to respond to increasing rates of sexually transmitted diseases (STD) and AIDS. While structural and ideological readjustment to meet these demands may seem problematic for some programs, the AIDS epidemic allows the opportunity for programs to expand into preventive health activities. Dr. Nancy Williamson, Director of Family Health International's Division of Program Evaluation and 1 of the authors of the World Health Organization's guidelines on family planning and AIDS, responds to questions most frequently posed by FP providers considering the need for and process of FP program restructuring. She holds that programmatic expansion for the prevention of HIV infection enhances the capability to provide good contraceptive services. FP programs are not expected to abandon their central missions of preventing unwanted pregnancies, but to engage in both the prevention of STD infection and unwanted pregnancies where possible. Sharing responsible sex behavior and the condom as common means of prevention, these 2 missions are far from mutually exclusive. The AIDS epidemic has impacted upon FP programs in a number of ways. Increased demand for condoms has been observed in countries with high levels of HIV seropositivity, greater concern has been placed upon counseling and sterile procedures, view have been altered to accept this dual role of contraception, and universal precautions for the protection of both client and workers from infection are of greater importance. Promoting the consistent use of condoms for the prevention of STDs has proved more challenging than promoting for contraceptive uses. Gaining the legitimacy of condoms among married couples while they are also promoted among high-risk groups also remains difficult. On other issues, promoting the routine use of 2 temporary methods is not recommended, questions must be posed to determine clients' risk status for infection, counseling

  13. Prevention of atherosclerosis in patients living with HIV

    PubMed Central

    De Lorenzo, Ferruccio; Boffito, Marta; Collot-Teixeira, Sophie; Gazzard, Brian; McGregor, John L; Shotliff, Kevin; Xiao, Han

    2009-01-01

    Investigational product: Rosuvastatin (Crestor®; Astra Zeneca). Active ingredients: Rosuvastatin (5 mg). Study title: Prevention of Atherosclerosis in Patients Living with HIV. Phase of study: Phase III. Aims: Primary aim: To assess whether rosuvastatin therapy could slow the progression of the carotid intima-media thickness (C-IMT; as measured by the change in the mean IMT of the near and far walls of the distal common carotid arteries) over 2 years in HIV-infected patients (HIV-IP). Secondary aims: To assess whether rosuvastatin therapy could reduce highly sensitive C reactive protein (hs-CRP) inflammatory marker that is increased in HIV-IP.To assess the effect of rosuvastatin therapy on serum lipid levels (total cholesterol [TC], low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol and triglycerides [TG]) and apolipoproteins (APO A1, APO B and APO B/A1).To assess the safety of rosuvastatin in HIV-IP through the evaluation of clinical laboratory analyses (liver function tests and creatine kinase) and adverse events (AEs). Study design: Two-year randomized, double-blind, placebo-controlled, parallel group study. Planned sample size: 320 HIV-IP. Summary of eligibility criteria: HIV-IP who are aged between 30 and 60 years, with a CD4 count. greater than 200 cells/mm3. Patients must be stable on combination antiretroviral therapy (cART) for at least 12 months and have a 10-year CVD risk of less than 20% (using the Framingham risk score). Number of study centers: One. Duration of treatment: Two years (5 mg rosuvastatin or placebo once daily). Dose and route of administration: Oral rosuvastatin (5 mg) once daily. The incidence of cardiovascular disease (CVD) in HIV-IP is at least three times higher than in the general population and further increases each year with combination anti-retroviral therapy (cART). The carotid atherosclerosis progression rate is 10 times higher in HIV-IP than in uninfected individuals. The aim of this study

  14. Efficient Identification of HIV Serodiscordant Couples by Existing HIV Testing Programs in South Brazil

    PubMed Central

    Pilcher, Christopher D.; Bisol, Claudia Alquati; Paganella, Machline Paim; Vallabhaneni, Snigdha; da Motta, Leonardo Rapone; Kato, Sergio Kakuta; Sperhacke, Rosa Dea; Kallas, Esper G.; Hecht, Frederick M.; Diaz, Ricardo Sobhie

    2015-01-01

    Objective To examine the feasibility of identifying HIV negative at risk individuals in HIV serodiscordant couples, during voluntary HIV testing in South Brazil. Methods We surveyed HIV testers at 4 public testing sites in Rio Grande do Sul. We obtained information on risk behaviors and sexual partnerships. HIV testing and testing for recent infection were performed; HIV prevalence and risk behaviors were assessed among subjects who reported having a steady partner who was HIV positive (serodiscordant group) and compared with the general testing population. Results Among 3100 patients, 490 (15.8%) reported being in a steady relationship with an HIV positive partner. New HIV infections were diagnosed in 23% of the serodiscordant group (vs. 13% in the general population, p = 0.01); among newly positive subjects, recent HIV infections were more frequent (23/86, 26.7%) among testers with positive partners than among the general testing group (52/334; 15.6%; p = 0.016). Less than half of the serodiscordant testers reported having used a condom during the last sexual intercourse with their HIV-positive partner. Participants with inconsistent condom use with steady partner were four times more likely to test positive for HIV compared to those who reported always using condoms with the steady partner (OR: 4.2; 95% CI: 2.3 to 7.5). Conclusion It is highly feasible to identify large numbers of HIV susceptible individuals who are in HIV serodiscordant relationships in South Brazil testing sites. Condom use within HIV serodiscordant couples is low in this setting, suggesting urgent need for biomedical prevention strategies to reduce HIV transmission. PMID:26562436

  15. 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

  16. Emerging technologies for HIV prevention for MSM: what we have learned, and ways forward.

    PubMed

    Sullivan, Patrick S; Grey, Jeremy A; Simon Rosser, Brian R

    2013-06-01

    Technology-enabled HIV research and prevention has emerged in the past 10 years as an exciting dynamic field that offers great potential to help bring HIV prevention efforts to scale in key risk communities. Evolutions in technologies and in HIV epidemics suggest mutual opportunities to reach most at risk populations in novel ways. New technologies cannot completely replace interventions and services currently delivered by the people. However, we suggest that emerging technologies hold promise to bring services to scale and produce efficiencies in reaching rural populations of men who have sex with men (MSM), connecting with populations who are not reached in current urban outreach efforts, and providing services or research surveys that can be described algorithmically. Furthermore, the types of technologies (eg, internet-based, smartphone-based, text messaging) should be matched with both the content to be delivered and the technology usage patterns of target populations. We suggest several key principles and lessons learned that comprise a framework in which to consider the opportunities of technologies and HIV prevention and research. Future directions include improvement of data quality in online surveying, better characterization of biases, developing improved sampling approaches, working with funders to ensure compatibility of funding mechanisms and online research proposals, and promoting consensus approaches to the duplication and presentation of research and program evaluation results from online research. Given the current calls for comprehensive packages of prevention services for MSM, effective prevention might require an intentional combination of technology-enabled prevention services to achieve scale and strategic use of personally delivered package components in cases where non-algorithmic services, such as individualized counseling, are needed. PMID:23673879

  17. Emerging technologies for HIV prevention for MSM: What we’ve learned, and ways forward

    PubMed Central

    Sullivan, Patrick S; Grey, Jeremy A; Rosser, B R Simon

    2013-01-01

    The field of technology-enabled HIV research and prevention has emerged in the past 10 years as an exciting, dynamic field that offers great potential to help bring HIV prevention efforts to scale in key risk communities. Evolutions in technologies and in HIV epidemics suggest mutual opportunities to reach most at risk populations in novel ways. New technologies cannot completely replace interventions and services currently delivered by people. However, we suggest that emerging technologies hold promise to bring services to scale and produce efficiencies in reaching rural populations of MSM, connecting with populations who aren’t reached in current urban outreach efforts, and providing services or research surveys that can be described algorithmically. Further, the types of technologies (e.g., internet-based, smartphone-based, text messaging) should be matched with both the content to be delivered, and the technology usage patterns of target populations. We suggest several key principles and lessons learned that comprise a framework in which to consider the opportunities of technologies and HIV prevention and research. Future directions include improvement of data quality in online surveying, better characterization of biases, developing improved sampling approaches, working with funders to ensure compatibility of funding mechanisms and online research proposals, and promoting consensus approaches to the duplication and presentation of research and program evaluation results from online research. Given current calls for comprehensive packages of prevention services for MSM, effective prevention might require an intentional combination of technology-enabled prevention services to achieve scale, and strategic use of personally-delivered package components in cases where non-algorithmic services, such as individualized counseling, are needed. PMID:23673879

  18. Exploring Barriers and Facilitators to Participation of Male-To-Female Transgender Persons in Preventive HIV Vaccine Clinical Trials

    PubMed Central

    Yoon, Ro; Mooney, Jessica; Broder, Gail; Bolton, Marcus; Votto, Teress; Davis-Vogel, Annet

    2013-01-01

    Observed seroincidence and prevalence rates in male to female (MTF) transgender individuals highlight the need for effective targeted HIV prevention strategies for this community. In order to develop an effective vaccine that can be used by transgender women, researchers must understand and address existing structural issues that present barriers to this group’s participation in HIV vaccine clinical trials. Overcoming barriers to participation is important for ensuring HIV vaccine acceptability and efficacy for the MTF transgender community. To explore barriers and facilitators to MTF transgender participation in preventive HIV vaccine clinical trials, the HIV Vaccine Trials Network (HVTN) conducted focus groups among transgender women in four urban areas (Atlanta, Boston, Philadelphia and San Francisco). Barriers and facilitators to engagement of transgender women in preventive HIV vaccine clinical trials led to the following recommendations: (1) transgender cultural competency training; (2) creating trans-friendly environments; (3) true partnerships with local trans-friendly organizations and health care providers; (4) protocols that focus on transgender specific issues; and (5) data collection and tracking of transgender individuals. These results have implications for the conduct of HIV vaccine trials, as well as engagement of transgender women in research programs in general. PMID:23446435

  19. Women who use or inject drugs: an action agenda for women-specific, multilevel and combination HIV prevention and research

    PubMed Central

    El-Bassel, Nabila; Strathdee, Steffanie A.

    2016-01-01

    Women account for more than half of all individuals living with HIV globally. Despite increasing drug and HIV epidemics among women, females who use drugs are rarely found in research, harm reduction programs, or drug and HIV treatment and care. Women who use drugs continue to face challenges that increase their vulnerability to HIV and other co-morbidities due to high rates of gender-based violence, human rights violations, incarceration, and institutional and societal stigmatization. This special issue emphasizes how the burdens of HIV, drug use and their co-occurring epidemics affect women in a global context. Papers included focus on the epidemiology of HIV, HCV and other co-morbidities; HIV treatment, prevention, and care; and policies affecting the lives of female who use drugs. This issue also highlights the state of the science of biomedical and behavioral research related to women who use drugs. The final paper highlights the major findings of papers covered and presents a call to action regarding needed research, treatment, and preventive services for women who use drugs. To address these needs, we advocate for women-specific thinking and approaches that considers the social, micro, and macro contexts of women’s lives. We present a woman-specific risk environment framework that reflects the unique lives and contexts of women who use drugs and provide a call to action for intervention, prevention, and policies. PMID:25978486

  20. Exploring barriers and facilitators to participation of male-to-female transgender persons in preventive HIV vaccine clinical trials.

    PubMed

    Andrasik, Michele Peake; Yoon, Ro; Mooney, Jessica; Broder, Gail; Bolton, Marcus; Votto, Teress; Davis-Vogel, Annet

    2014-06-01

    Observed seroincidence and prevalence rates in male-to-female (MTF) transgender individuals highlight the need for effective targeted HIV prevention strategies for this community. In order to develop an effective vaccine that can be used by transgender women, researchers must understand and address existing structural issues that present barriers to this group's participation in HIV vaccine clinical trials. Overcoming barriers to participation is important for ensuring HIV vaccine acceptability and efficacy for the MTF transgender community. To explore barriers and facilitators to MTF transgender participation in preventive HIV vaccine clinical trials, the HIV Vaccine Trials Network conducted focus groups among transgender women in four urban areas (Atlanta, Boston, Philadelphia, and San Francisco). Barriers and facilitators to engagement of transgender women in preventive HIV vaccine clinical trials led to the following recommendations: (a) transgender cultural competency training, (b) creating trans-friendly environments, (c) true partnerships with local trans-friendly organizations and health care providers, (d) protocols that focus on transgender specific issues, and (e) data collection and tracking of transgender individuals. These results have implications for the conduct of HIV vaccine trials, as well as engagement of transgender women in research programs in general.

  1. Implications of Mobility Patterns and HIV Risks for HIV Prevention Among Migrant Market Vendors in Kazakhstan

    PubMed Central

    Gilbert, Louisa; Terlikbayeva, Assel; West, Brooke; Bearman, Peter; Wu, Elwin; Zhussupov, Baurzhan; Platais, Ingrida; Brisson, Anne

    2011-01-01

    Objectives. We examined the relationships between mobility characteristics and sexual risk behaviors among male and female migrant market vendors in Almaty, Kazakhstan. Methods. Participants completed a structured interview covering sociodemographics, mobility characteristics, sexual behaviors, and biomarkers for HIV, HCV, and syphilis. We used multivariate analyses to examine associations between mobility patterns and HIV risks after adjusting for sociodemographics. Results. Longer duration of a participant's last trip outside Almaty increased the odds of reporting multiple sexual partners. More frequent travel to visit family or friends was associated with multiple sexual partners and unprotected sex with steady partners. More frequent travel to buy goods in the past year was associated with multiple sexual partners. Men who traveled more often to buy goods were more likely to have purchased sex within the previous 90 days. Conclusions. Relationships between mobility patterns and sexual risk behaviors underscore the need for HIV-prevention strategies targeting the specific transmission dynamics that migrant vendors are likely to present. PMID:21493929

  2. Will "Combined Prevention" Eliminate Racial/Ethnic Disparities in HIV Infection among Persons Who Inject Drugs in New York City?

    PubMed

    Des Jarlais, Don; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Hagan, Holly; Cooper, Hannah; Campbell, Aimee; Tross, Susan; Perlman, David

    2015-01-01

    It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative interviews and HIV testing were conducted among persons who inject drugs entering Mount Sinai Beth Israel drug treatment (2007-2014). 703 persons who inject drugs who began injecting after implementation of large-scale syringe exchange were included in the analyses. Factors independently associated with being HIV seropositive were identified and a published model was used to estimate HIV infections due to sexual transmission. Overall HIV prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI 1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6-0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Racial/ethnic disparities among persons who inject drugs were not significantly different from previous disparities. Reducing these persistent disparities may require new interventions (treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.

  3. Failure to Return for Posttest Counseling and HIV Test Results at the Prevention and Voluntary Testing and Counseling Centers of Douala, Cameroon: An Evaluation of a Routine Five-Year Program.

    PubMed

    Ngangue, Patrice; Bedard, Emmanuelle; Ngueta, Gerard; Adiogo, Dieudonné; Gagnon, Marie-Pierre

    2016-01-01

    This study examined the magnitude and time trends in failure to return (FTR) rates and the relation between FTR and individual characteristics, tests procedures, waiting period for the results, and HIV test results among people who were screened for HIV in the prevention and voluntary testing and counseling centers (PVTCCs) of six district hospitals of the city of Douala in Cameroon, between January 2009 and December 2013. It was a retrospective analysis of medical records. Among the 32,020 analyzed records, the failure to return (FTR) rate was 14.3%. Overall, people aged 50 years and over, those tested between 2011 and 2012, and those tested in the PVTCC of Bonassama were less likely to return for their results. Significant factors associated with FTR included being a housewife, having a positive/undetermined/requiring confirmation result, and provider-initiated testing and counseling (PITC). There was an increasing trend for FTR in the PVTCCs of Bonassama, New-Bell, Nylon, and Cité des Palmiers. HIV testing and counseling services in Douala district hospitals must be reorganized such that individuals tested for HIV receive their results on the same day of the test. Also counselors need to better alert clients concerning the importance of returning for their test results. PMID:26925261

  4. Failure to Return for Posttest Counseling and HIV Test Results at the Prevention and Voluntary Testing and Counseling Centers of Douala, Cameroon: An Evaluation of a Routine Five-Year Program

    PubMed Central

    Ngangue, Patrice; Bedard, Emmanuelle; Ngueta, Gerard; Adiogo, Dieudonné; Gagnon, Marie-Pierre

    2016-01-01

    This study examined the magnitude and time trends in failure to return (FTR) rates and the relation between FTR and individual characteristics, tests procedures, waiting period for the results, and HIV test results among people who were screened for HIV in the prevention and voluntary testing and counseling centers (PVTCCs) of six district hospitals of the city of Douala in Cameroon, between January 2009 and December 2013. It was a retrospective analysis of medical records. Among the 32,020 analyzed records, the failure to return (FTR) rate was 14.3%. Overall, people aged 50 years and over, those tested between 2011 and 2012, and those tested in the PVTCC of Bonassama were less likely to return for their results. Significant factors associated with FTR included being a housewife, having a positive/undetermined/requiring confirmation result, and provider-initiated testing and counseling (PITC). There was an increasing trend for FTR in the PVTCCs of Bonassama, New-Bell, Nylon, and Cité des Palmiers. HIV testing and counseling services in Douala district hospitals must be reorganized such that individuals tested for HIV receive their results on the same day of the test. Also counselors need to better alert clients concerning the importance of returning for their test results. PMID:26925261

  5. Consistent condom use with regular, paying, and casual male partners and associated factors among men who have sex with men in Tamil Nadu, India: findings from an assessment of a large-scale HIV prevention program

    PubMed Central

    2013-01-01

    Background Men who have sex with men (MSM) are a marginalized population at high risk for HIV infection. Promoting consistent condom use (CCU) during anal sex is a key risk reduction strategy for HIV prevention among MSM. To inform effective HIV prevention interventions, we examined the factors associated with CCU among MSM with their regular, paying, and casual partners, as well as with all three types of partners combined. Methods Data for this analysis were from a large-scale bio-behavioural survey conducted during 2009–2010 in Tamil Nadu, India. MSM aged 18 years or older were recruited for the survey using time-location cluster sampling at cruising sites in four districts of Tamil Nadu. Binary logistic regression analyses were conducted to assess the association of CCU with selected socio-demographic characteristics and other contextual factors. Results Among 1618 MSM interviewed, CCU during anal sex with regular, paying, and a casual male partner was 45.3%, 50.8% and 57.9%, respectively. CCU with all three types of partners combined was 52.6%. Characteristics associated with increased odds for CCU with MSM having all three types of partners combined were frequent receptive anal sex acts with regular partners (adjusted odds ratio [AOR] 2.17, 95% confidence interval [CI] 1.01-4.65), fewer number of casual partners (AOR 3.41, 95% CI 1.50-7.73) and membership in a community-based organization (CBO) for MSM (AOR 3.54, 95% CI 1.62-7.74). CCU with regular partners was associated with membership in a CBO (AOR 1.96, 95% CI 1.23-3.11), whereas CCU with paying, and casual male partners was associated with perceived higher risk of acquiring HIV (AOR 1.92, 95% CI 1.22-3.01) and exposure to any HIV prevention intervention (AOR 3.62, 95% CI 1.31-10.0), respectively. Being aged 26 years or older, being in debt, and alcohol use were factors associated with inconsistent condom use across partner types. Conclusion HIV interventions among MSM need to promote CCU with all

  6. Adolescent Self-Consent for Biomedical HIV Prevention Research

    PubMed Central

    Gilbert, Amy Lewis; Knopf, Amelia S.; Fortenberry, J. Dennis; Hosek, Sybil G.; Kapogiannis, Bill G.; Zimet, Gregory D.

    2015-01-01

    Purpose The Adolescent Medicine Trials Network Protocol 113 (ATN113) is an open-label, multi-site demonstration project and phase II safety study of HIV pre-exposure prophylaxis with 15-17 year old young men who have sex with men that requires adolescent consent for participation. The purpose of this study was to examine factors related to the process by which Institutional Review Boards (IRBs) and researchers made decisions regarding whether to approve and implement ATN113, so as to inform future biomedical HIV prevention research with high-risk adolescent populations. Methods Participants included seventeen researchers at thirteen sites in twelve states considering ATN113 implementation. Qualitative descriptive methods were used. Data sources included interviews and documents generated during the initiation process. Results A common process for initiating ATN113 emerged, and informants described how they identified and addressed practical, ethical and legal challenges that arose. Informants described the process as responding to the protocol, preparing for IRB submission, abstaining from or proceeding with submission, responding to IRB concerns and reacting to the outcomes. A complex array of factors impacting approval and implementation were identified; and ATN113 was ultimately implemented in 7 of 13 sites. Informants also reflected on lessons learned that may help inform future biomedical HIV prevention research with high-risk adolescent populations. Conclusions The results illustrate factors for consideration in determining whether to implement such trials, demonstrate that such protocols have the potential to be approved, and highlight a need for clearer standards regarding biomedical HIV prevention research with high-risk adolescent populations. PMID:26095412

  7. The complex realities of primary prevention for HIV infection in a "just do it" world.

    PubMed

    Bradley-Springer, L A

    1999-03-01

    Primary prevention of HIV requires behavior changes to decrease the risk of sexual, drug using, and occupational exposure to infection. The difficulties associated with behavior change are related to social, cultural, and political constraints that reinforce heterosexism, sexism, and racism. These problems are compounded by concurrent epidemics of violence, poverty, and drug use, and are made more difficult by the absolutist mentality. Use of theory-based interventions, awareness of community attributes, and a change to pragmatic political agendas can help in the development of effective prevention programs.

  8. An alternate HIV preventive strategy: sex scripts in media for women of color.

    PubMed

    Medina, Catherine; Rios, Diana I

    2011-01-01

    New cases of HIV/AIDS among women of color in the United States highlight the continuing need for the public and private sectors to develop alternate preventive strategies. The author discusses the conceptual basis for using television sex scripts to incorporate women of color relational needs (trust, romance, sexual pressure) to promote HIV risk-reduction messages through a process of association with the television storyline. Sex scripts are a source of implicit knowledge about how to behave in situations that involve sexual intimacy. The article suggests that sexual scripts prevention messages build on the agency of women through the use of power theory-that is supporting woman's self-power by participating in sexual behavioral change. Implications for sexual equality in media programming are discussed.

  9. An alternate HIV preventive strategy: sex scripts in media for women of color.

    PubMed

    Medina, Catherine; Rios, Diana I

    2011-01-01

    New cases of HIV/AIDS among women of color in the United States highlight the continuing need for the public and private sectors to develop alternate preventive strategies. The author discusses the conceptual basis for using television sex scripts to incorporate women of color relational needs (trust, romance, sexual pressure) to promote HIV risk-reduction messages through a process of association with the television storyline. Sex scripts are a source of implicit knowledge about how to behave in situations that involve sexual intimacy. The article suggests that sexual scripts prevention messages build on the agency of women through the use of power theory-that is supporting woman's self-power by participating in sexual behavioral change. Implications for sexual equality in media programming are discussed. PMID:21534124

  10. Treating High-grade Lesions to Prevent Anal Cancer in HIV-infected People

    Cancer.gov

    This study, called the ANCHOR trial, will investigate whether screening and prevention methods similar to those used to prevent cervical cancer can help prevent anal cancer in HIV-infected men and women.

  11. Woman to Woman: Coming Together for Positive Change--using empowerment and popular education to prevent HIV in women.

    PubMed

    Romero, Lisa; Wallerstein, Nina; Lucero, Julie; Fredine, Heidi Grace; Keefe, Joanna; O'Connell, JoAnne

    2006-10-01

    HIV risk is the product of social, cultural, economic, and interpersonal forces that create sex-role definitions and expectations that can lead to gender inequalities in health. Woman to Woman: Coming Together for Positive Change is an HIV/AIDS prevention intervention that takes into account that choices and actions may be constrained by poverty, gender roles, and cultural norms. This project educates and empowers, promotes women's perspectives, reaches women "where they are," and encourages women to speak of their experience. The following study presents the evaluation of the effectiveness of an empowerment based participatory HIV prevention program over a 3-year period, implemented in both rural and urban settings in New Mexico, targeting over 300 women at-risk of HIV/AIDS. In addition, the practicalities of conducting participatory process and outcome evaluation with a small nonprofit with minimal budget will be discussed. PMID:17067251

  12. Sex isn't that simple: culture and context in HIV prevention interventions for gay and bisexual male adolescents.

    PubMed

    Harper, Gary W

    2007-11-01

    Gay and bisexual male adolescents and young adults in the United States have been disproportionately impacted by the HIV pandemic. Despite the steadily increasing rise in their HIV infection rates, there has not been a commensurate increase in HIV prevention programs targeted to the unique social and sexual lives of these youths. Programs that address cultural and contextual factors that influence sexual risk and protective behaviors need to be developed, implemented, and rigorously evaluated. These interventions should address the potential influences of sexual and gay culture on the HIV risk/protective behaviors of gay and bisexual adolescents, as well as the influence of more traditional cultural factors related to ethnicity. The influence of contextual developmental factors should also be addressed. This may include an incorporation into prevention programs of the societal-level influences of heterosexism and masculinity ideology and the individual-level influences of sexual identity and ethnic identity development. Researchers and interventionists need to be creative and innovative in their HIV prevention approaches and ensure that programs are grounded in the lives and realities of gay and bisexual adolescents and young adults.

  13. Prevention literacy: community-based advocacy for access and ownership of the HIV prevention toolkit

    PubMed Central

    Parker, Richard G; Perez-Brumer, Amaya; Garcia, Jonathan; Gavigan, Kelly; Ramirez, Ana; Milnor, Jack; Terto, Veriano

    2016-01-01

    Introduction Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings. Methods Between January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention. The review included searches in electronic databases including MEDLINE, PsycINFO, PubMed, and Google Scholar. Permutations of the following search terms were used: “treatment literacy,” “treatment education,” “health literacy,” and “prevention literacy.” Through an iterative process of analyses and searches, titles and/or abstracts and reference lists of retrieved articles were reviewed for additional articles, and historical content analyses of grey literature and websites were additionally conducted. Results and discussion Treatment literacy was a well-established concept developed in the global South, which was later partially adopted by international agencies such as the World Health Organization. Treatment literacy emerged as more effective antiretroviral therapies became available. Developed from popular pedagogy and grassroots efforts during an intense struggle for treatment access, treatment literacy addressed the need to extend access to underserved communities and low-income settings that might otherwise be excluded from access. In contrast, prevention literacy is absent in the recent surge of new biomedical prevention strategies; prevention literacy was scarcely referenced and undertheorized in the available literature. Prevention efforts today include multimodal techniques, which jointly comprise a toolkit of biomedical, behavioural, and structural/environmental approaches

  14. Prevention literacy: community-based advocacy for access and ownership of the HIV prevention toolkit

    PubMed Central

    Parker, Richard G; Perez-Brumer, Amaya; Garcia, Jonathan; Gavigan, Kelly; Ramirez, Ana; Milnor, Jack; Terto, Veriano

    2016-01-01

    Introduction Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings. Methods Between January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention. The review included searches in electronic databases including MEDLINE, PsycINFO, PubMed, and Google Scholar. Permutations of the following search terms were used: “treatment literacy,” “treatment education,” “health literacy,” and “prevention literacy.” Through an iterative process of analyses and searches, titles and/or abstracts and reference lists of retrieved articles were reviewed for additional articles, and historical content analyses of grey literature and websites were additionally conducted. Results and discussion Treatment literacy was a well-established concept developed in the global South, which was later partially adopted by international agencies such as the World Health Organization. Treatment literacy emerged as more effective antiretroviral therapies became available. Developed from popular pedagogy and grassroots efforts during an intense struggle for treatment access, treatment literacy addressed the need to extend access to underserved communities and low-income settings that might otherwise be excluded from access. In contrast, prevention literacy is absent in the recent surge of new biomedical prevention strategies; prevention literacy was scarcely referenced and undertheorized in the available literature. Prevention efforts today include multimodal techniques, which jointly comprise a toolkit of biomedical, behavioural, and structural/environmental approaches

  15. Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California

    PubMed Central

    DiStefano, Anthony S.; Hui, Brian; Barrera-Ng, Angelica; Quitugua, Lourdes F.; Peters, Ruth; Dimaculangan, Jeany; Vunileva, Isileli; Tui’one, Vanessa; Takahashi, Lois M.; Tanjasiri, Sora Park

    2012-01-01

    HIV and sexually transmitted human papillomavirus (HPV) are associated with each other and with the development of comorbid cancer. Current epidemiology indicates that among Pacific Islanders in the United States, young adults are at highest risk of HIV and HPV. In our inductive community based participatory research study, we used focus groups and key informant interviews (March – August 2010) with young adults, parents, community leaders, and providers (n = 95) to identify and contextualize factors that shape HIV and HPV risk and prevention among young adults in Chamorro and Tongan communities in Southern California. We identified nine themes that incorporated the following principal factors: misinformation and otherization; dominant concerns regarding premarital pregnancy; restricted intergenerational communication; family shame and privacy; gendered manifestations of religio-cultural norms; barriers impeding access to sexual health resources; parents’ role in prevention; community vs. individual responsibility; and family and ethnic pride. Our thematic findings fit well with Rhodes’ “risk and enabling environment” heuristic (2009), which we used to contextualize risk and prevention at micro and macro levels of physical, social, economic, and policy environments. We propose the addition of a separate cultural environment to the heuristic and conclude that a focus on applying individual and community agency at the micro-level would be an approachable starting point for intervention for our local Pacific Islander communities and groups in similar ecological contexts globally. Enhanced community-led education programs and engagement of religious and other community leaders to facilitate intergenerational communication could counteract taboos that obstruct prevention. PMID:22647562

  16. Contextualization of HIV and HPV risk and prevention among Pacific Islander young adults in Southern California.

    PubMed

    DiStefano, Anthony S; Hui, Brian; Barrera-Ng, Angelica; Quitugua, Lourdes F; Peters, Ruth; Dimaculangan, Jeany; Vunileva, Isileli; Tui'one, Vanessa; Takahashi, Lois M; Tanjasiri, Sora Park

    2012-08-01

    HIV and sexually transmitted human papillomavirus (HPV) are associated with each other and with the development of comorbid cancer. Current epidemiology indicates that among Pacific Islanders in the United States, young adults are at highest risk of HIV and HPV. In our inductive community based participatory research study, we used focus groups and key informant interviews (March-August 2010) with young adults, parents, community leaders, and providers (n = 95) to identify and contextualize factors that shape HIV and HPV risk and prevention among young adults in Chamorro and Tongan communities in Southern California. We identified nine themes that incorporated the following principal factors: misinformation and otherization; dominant concerns regarding premarital pregnancy; restricted intergenerational communication; family shame and privacy; gendered manifestations of religio-cultural norms; barriers impeding access to sexual health resources; parents' role in prevention; community vs. individual responsibility; and family and ethnic pride. Our thematic findings fit well with Rhodes' "risk and enabling environment" heuristic (2009), which we used to contextualize risk and prevention at micro and macro levels of physical, social, economic, and policy environments. We propose the addition of a separate cultural environment to the heuristic and conclude that a focus on applying individual and community agency at the micro-level would be an approachable starting point for intervention for our local Pacific Islander communities and groups in similar ecological contexts globally. Enhanced community-led education programs and engagement of religious and other community leaders to facilitate intergenerational communication could counteract taboos that obstruct prevention.

  17. 78 FR 63990 - HIV/AIDS Bureau; Ryan White HIV/AIDS Program Core Medical Services Waiver; Application Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... disease. This includes those who know their HIV status and are not in care as well as those individuals... HUMAN SERVICES Health Resources and Services Administration HIV/AIDS Bureau; Ryan White HIV/AIDS Program... the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan White Program or RWHAP), requires...

  18. Cancer Prevention Fellowship Program (CPFP) | Division of Cancer Prevention

    Cancer.gov

    The Cancer Prevention Fellowship provides a strong foundation for scientists and clinicians to train in the field of cancer prevention and control. This structured, multidisciplinary program offers early career scientists from different health disciplines a variety of postdoctoral training opportunities . | Training to form a strong foundation in cancer prevention and control for scientists and clinicians.

  19. International Collaboration in HIV Prevention Research: Evidence from a Research Seminar in Russia

    PubMed Central

    Batluk, Julia V.; Bryant, Kendall J.; Shaboltas, Alla V.

    2015-01-01

    Abstract HIV transmission is a major health concern. Global efforts are necessary to control the spread of infection. International collaborative studies in countries with high rates of new infections are essential for increasing knowledge on the behavioral, social, and biomedical aspects of HIV/AIDS and HIV transmission. Statistics indicate a growing HIV epidemic in Russia. There are alarming proportions of new cases attributed to heterosexual contact, and HIV is increasingly affecting people in the general population who are not part of any traditional high-risk group. Despite recent advances in HIV prevention, data on effective behavioral prevention approaches are limited. There is minimal evidence to suggest which types of prevention will be effective in reducing the risk for HIV transmission among people at risk in the general population. This article presents a review and discussion of an international research seminar, HIV Prevention Research: Evidence-Based Behavioral Approaches. Local and international interdisciplinary researchers gathered for the purposes of exchanging research results and information about ongoing studies, identifying gaps in knowledge, and discussing promising prevention strategies. The overarching goal was to advance HIV prevention research through scientific integration. The seminar provided an excellent platform for building research capacity in interdisciplinary HIV research in Russia and integrating research efforts with the international research community to contribute to HIV prevention research throughout the world. PMID:25430518

  20. Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.

    PubMed

    Samuelson, Julia; Hargreave, Timothy; Ridzon, Renee; Farley, Tim

    2016-06-01

    World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations.

  1. Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.

    PubMed

    Samuelson, Julia; Hargreave, Timothy; Ridzon, Renee; Farley, Tim

    2016-06-01

    World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations. PMID:27331591

  2. "Typhoid Mary" and "HIV Jane": responsibility, agency and disease prevention.

    PubMed

    Chan, Kit Yee; Reidpath, Daniel D

    2003-11-01

    The construction of disease risks as knowable, calculable and preventable in dominant social science and public health discourses has fostered a certain kind of logic about individual risk and the responsibility for infection. Disease control measures that have developed out of this logic typically fail to recognise the socio-structural roots of many high-risk behaviours that are linked to the spread of infection. Instead, they hold the disease carrier responsible for managing his/her own risk of infection of others, and rely on constraining the agency of the carrier (e.g. by constraining movement, contact or occupation). In occupations associated with a high risk of infection, the idea of responsibility of the actor implicitly raises issues of "professional responsibility". Using the case of "Typhoid Mary" and a hypothetical case of "HIV Jane", this paper explores some of the problems with making sex workers responsible for the prevention of HIV transmission. It argues that for the notion of "responsibility" to make any sense, the HIV-positive person must be in a position to exercise responsibility, and for this they must have agency.

  3. Pharmacological considerations for tenofovir and emtricitabine to prevent HIV infection

    PubMed Central

    Anderson, Peter L.; Kiser, Jennifer J.; Gardner, Edward M.; Rower, Joseph E.; Meditz, Amie; Grant, Robert M.

    2011-01-01

    The use of antiretroviral medications in HIV-negative individuals as pre-exposure prophylaxis (PrEP) is a promising approach to prevent HIV infection. Tenofovir disoproxil fumarate (TDF) and emtricitabine exhibit desirable properties for PrEP including: favourable pharmacokinetics that support infrequent dosing; few major drug-drug or drug-food interactions; an excellent clinical safety record; and pre-clinical evidence for efficacy. Several large, randomized, controlled clinical trials are evaluating the safety and efficacy of TDF and emtricitabine for this new indication. A thorough understanding of variability in drug response will help determine future investigations in the field and/or implementation into clinical care. Because tenofovir and emtricitabine are nucleos(t)ide analogues, the HIV prevention and toxicity effects depend on the triphosphate analogue formed intracellularly. This review identifies important cellular pharmacology considerations for tenofovir and emtricitabine, which include drug penetration into relevant tissues and cell types, race/ethnicity/pharmacogenetics, gender, cellular activation state and appropriate episodic or alternative dosing strategies based on pharmacokinetic principles. The current state of knowledge in these areas is summarized and the future utility of intracellular pharmacokinetics/pharmacodynamics for the PrEP field is discussed. PMID:21118913

  4. Exploring Social Networking Technologies as Tools for HIV Prevention for Men Who Have Sex With Men.

    PubMed

    Ramallo, Jorge; Kidder, Thomas; Albritton, Tashuna; Blick, Gary; Pachankis, John; Grandelski, Valen; Grandeleski, Valen; Kershaw, Trace

    2015-08-01

    Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social etiquettes and rules that may increase HIV risk by discouraging HIV status disclosure. Overall, successful interventions for MSM using social networking technologies must consider aspects of privacy, stigma, and social norms in order to enact HIV reduction among MSM.

  5. World Bank oil-pipeline project designed to prevent HIV transmission.

    PubMed

    Kigotho, A W

    1997-11-29

    A World Bank-funded oil pipeline project, in Chad and Cameroon, is the first large-scale construction project in sub-Saharan Africa to incorporate an HIV/AIDS prevention component. The project entails the development of oil fields in southern Chad and construction of 1100 km of pipeline to port facilities on Cameroon's Atlantic coast. 3000 construction workers from the two countries will be employed between 1998 and 2001, including about 600 truck drivers. In some areas along the pipeline route, 50% of the prostitutes (who are frequented by truck drivers) are HIV-infected. The HIV/AIDS intervention aims to prevent HIV and sexually transmitted diseases (STDs) among project workers through social marketing of condoms, treatment of STDs in prostitutes along the route, and health education to modify high-risk behaviors. The program is considered a test case for African governments and donors interested in whether the integration of a health component in major construction projects can avoid AIDS epidemics in affected countries.

  6. Implementation Science for the Prevention and Treatment of HIV/AIDS

    PubMed Central

    Schackman, Bruce R.

    2010-01-01

    Implementation science is the scientific study of methods to promote the integration of research findings and evidence-based interventions into healthcare policy and practice and, hence, to improve the quality and effectiveness of health services and care. Implementation science is distinguished from monitoring and evaluation by its emphasis on the use of the scientific method. The origins of implementation science include operations research, industrial engineering, and management science. Today, implementation science encompasses a broader range of methods and skills including decision science and operations research, health systems research, health outcomes research, health and behavioral economics, epidemiology, statistics, organization and management science, finance, policy analysis, anthropology, sociology, and ethics. Examples of implementation science research are presented for HIV prevention (prevention of mother-to-child transmission of HIV, male circumcision) and HIV and drug use (syringe distribution, treating drug users with antiretroviral therapy (ART) and opioid substitution therapy). For implementation science to become an established field in HIV/AIDS research, there needs to be better coordination between funders of research and funders of program delivery and greater consensus on scientific research approaches and standards of evidence. PMID:21045596

  7. Preventing HIV Infection Among Juvenile Delinquents: Educational Diagnosis Using the Health Belief Model.

    PubMed

    Lux, K M; Petosa, R

    1994-01-01

    The purpose of this study was to use an enhanced version of the Health Belief Model as a conceptual framework to describe health beliefs and safer sex intentions for HIV prevention educational needs of juvenile delinquents between the ages of thirteen to eighteen years incarcerated in state supported training schools in Ohio. An accessible sample (n = 452) of juvenile delinquents from four of nine institutions was the study population. Juvenile delinquents in this study were at high risk for HIV infection. They reported low rates of safer sex intentions. Rates of perceived barriers to condom use and perceived social barriers to safer sex were high and consistent with low rates of safer sex intention. Rates of self-efficacy for condom use were high but inconsistent with intentions. While a majority of subjects reported self-efficacy for discussion of sexual histories, a larger majority reported low efficacy for disclosing previous high-risk behavior. This suggests that discussion of sexual history with a partner may not be effective in reducing risk among this population. The primary source of information about HIV was the mass media. HIV prevention programs for juvenile delinquents should consider the current health beliefs of this high-risk, hard-to-reach population.

  8. 40 CFR 68.170 - Prevention program/Program 2.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Prevention program/Program 2. 68.170 Section 68.170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention...

  9. 40 CFR 68.170 - Prevention program/Program 2.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Prevention program/Program 2. 68.170 Section 68.170 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.170 Prevention...

  10. 40 CFR 68.170 - Prevention program/Program 2.