1 / 28

HIV Prevention at 25 Years: What Have We and What Have I Learned? Where Should We Go From Here?

HIV Prevention at 25 Years: What Have We and What Have I Learned? Where Should We Go From Here?. Rick S. Zimmerman, Ph.D. Professor Dept. of Social and Behavioral Health Virginia Commonwealth University September 17, 2009. Largely Individual Models Work Pretty Well at Predicting Behavior.

awen
Download Presentation

HIV Prevention at 25 Years: What Have We and What Have I Learned? Where Should We Go From Here?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. HIV Prevention at 25 Years:What Have We and What Have I Learned?Where Should We Go From Here? Rick S. Zimmerman, Ph.D. Professor Dept. of Social and Behavioral Health Virginia Commonwealth University September 17, 2009

  2. Largely Individual Models Work Pretty Well at Predicting Behavior IMB TPB Integrated Model EPPM Others

  3. Multiple Domain Modelof Health Related behavior Attitudes Situation Individual Differences Intention Behavior Norms Social Structure Social environment Prep. Behavior Self- Efficacy

  4. They may even work with, with some modification in more collectivist, developing world contexts

  5. School Programs • A number of comprehensive sex education programs have been found to be effective • No abstinence-only programs have been found to be effective • More effective programs are: • At least 10-12 hours long • Theory-based • Include components on skills, norms, and attitude

  6. Mass Media Campaigns Can Change BehaviorPast 3 Months Condom Use

  7. Time Series Results:Past 3 Months Condom Use Slope change pre- to post-campaign for Lexington, p<.05

  8. National Leadership can be more important than work in the trenches • Thailand • Uganda • US • South Africa

  9. We can achieve 90% retention even in “difficult” populations Kalichman et al., 2009

  10. Short interventions can be just as effective as long ones, but what cost-effectiveness? Motivational Interviewing

  11. Parent Interventions • Relatively new area of research • Small number of interventions have been found to be effective: • Focus on Kids ImPACT: parental monitoring and communication • Real Men: African-American fathers initiating education on delay and condom use with 11-14 year old boys • Family Matters adaptation focusing on rule-setting, monitoring, communication

  12. Peer Interventions • Many programs, especially in the developing world, have utilized peers to implement all or parts of the programs • Research is relatively scant, however, on the comparative effectiveness of peer vs. other sorts of programs • Indeed initial work on social networks and interventions suggests the risk level of the network may affect the results

  13. Community Interventions • Quite a few successful psychosocial community-based interventions • Focus on Youth + ImPACT • Voices/VOCES • Popular Opinion Leader • Examples of elements of successful programs: • Cultural relevance • Using social networks • Practicing refusal/negotiation skills

  14. Be Careful What You Say or Ask to Powerful People • CDC Evaluation of “America Responds to AIDS” Campaign

  15. Being on a hit list can be a badge of courage • 100+ projects and 75+ researchers (including some dead ones) on list of conservative “watchdog” group • A little scary • Not sure what advice to give here!

  16. Don’t assume you can’t do something • Condom PSAs in Kentucky and Tennessee • HIV/pregnancy prevention curricula in Appalachian Kentucky

  17. Trust has to be earned in the community and we must give back Working with gay teen youth groups Working with adolescent females in inner city housing developments

  18. NIH and other health funders may fund economic oriented interventions Pronyk et al., 2008 Combined microfinance and training intervention: 8 villages pair-matched and randomly allocated VCT: AOR 1.64; Unprotected sex 0.76

  19. Snowball samples mature into “Respondent-Driven Samples” • More scientific and systematic • Estimates of standard errors and attempts at statistical inference

  20. Now have to worry about clustering effects • School interventions • Community interventions? • Small group interventions?

  21. Now have to worry about “attention-matched” comparison groups • Schools? • Community groups?

  22. Be careful what you do around your kids! • Penile models

  23. Do your homework in a new population or location • Alcohol and sex in South Africa • Adolescent boys in detention hated reading and writing

  24. Take advantages of opportunities • Friend of wife’s colleague • Substituted in trip to Ethiopia

  25. Wait to do some things until after you have tenure! • Sex survey of undergraduates • Research on sexual arousal, effects of marijuana use, and decision-making

  26. Decide how much is personal, how much is professional • Test results • Health of co-worker • Sexual orientation

  27. Decide what is most important to you • Helping people in Africa • Spending time with your family

  28. Where to go from Here? • Think outside of the box • education, video games, news reporting • New technology • Theories about Methods/techniques of Presenting/Delivering Interventions • Multiple levels of intervention • Various combinations of interventions • Maintenance/sustaining behavior change still a problem • Dissemination/translation/implementation research important • Cost-effectiveness research

More Related