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Behavioral Interventions

Behavioral Interventions. Thomas J. Coates PhD Director, UCLA Center for World Health Associate Director, UCLA AIDS Institute. It’s All About Behavior. Thomas J. Coates PhD Distinguished Professor of Medicine Director, UCLA Center for World Health. HIV prevention and treatment need to.

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Behavioral Interventions

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  1. Behavioral Interventions Thomas J. Coates PhD Director, UCLA Center for World Health Associate Director, UCLA AIDS Institute

  2. It’s All About Behavior Thomas J. Coates PhD Distinguished Professor of Medicine Director, UCLA Center for World Health

  3. HIV prevention and treatment need to Mobilize Communities Mobilize Communities Encourage widespread HIV testing HIV Uninfected HIV Infected Behavioral risk reduction Behavioral risk reduction Provide support Access prevention strategies and devices Access care and treatment & prevention strategies and devices

  4. Silver et al, NYC Health Dept. IOM Presentation, Nov. 2008

  5. Changing the Context People like the status quo People place higher value on present costs and benefits vs. those in the future Tangible benefits count more, especially if they occur immediately People like freedom of choice Silver et al, IOM Presentation, Nov. 2008 Silver et al, NYC Health Dept. IOM Presentation, Nov. 2008

  6. Two PremisesBehavioral and social strategies are necessary but not sufficient for HIV prevention and treatmentThe same is true of biomedical strategies 7

  7. Coates et al, Lancet, 2008 8

  8. But the question is:Whose behavior?andWhat behavior is the most important? 9

  9. HIV prevention and treatment need to Mobilize Communities Mobilize Communities Encourage widespread HIV testing HIV Uninfected HIV Infected Behavioral risk reduction Behavioral risk reduction Provide support Access prevention strategies and devices Access care and treatment & prevention strategies and devices

  10. What Does It Mean To: Mobilize Communities? 11

  11. What Does It Mean To: Encourage widespread HIV testing? 12

  12. What Does It Mean To: Encourage widespread HIV testing? Routine HCT Community HCT Home-based HCT Workplace-HCT 13

  13. For HIV-uninfectedBehavioral risk reductionMale-- MMCSTI symptomsTB symptomsFamily planningSexual and reproductive healthSubstance useGender based violence 14

  14. For HIV-infectedPoint-of-care CD4 testingTreatment and support systemsSTI symptomsTB symptomsPMTCTFamily planningSexual and reproductive healthSubstance useGender based violence 15

  15. Essential Elements (1)Easily accessible services 16

  16. Essential Elements (1)Easily accessible servicesPatient-centered 17

  17. Essential Elements (1)Easily accessible servicesPatient-centeredEffectively managed 18

  18. Essential Elements (2)Community-wide support services 19

  19. Essential Elements (2)Community-wide support servicesMotivate testing and linkage 20

  20. Essential Elements (2)Community-wide support servicesMotivate testing and linkageSupport adherence to prevention and treatment technologies 21

  21. Essential Elements (3)Effective initial and continued counseling and support 22

  22. Essential Elements (3)Initial and continued counseling and supportRisk reduction, adherence, substance use PMTCT, gender-based violenceSexual and reproductive health services 23

  23. Essential ElementsMultiple strategies for identifying and linking patients to careAccessible and effective patient-centered servicesCommunity support systemsEffective counselingStrategies for monitoring output and using it to maintain quality 24

  24. HIV prevention and treatment need to Mobilize Communities Mobilize Communities Encourage widespread HIV testing HIV Uninfected HIV Infected Behavioral risk reduction Behavioral risk reduction Provide support Access prevention strategies and devices Access care and treatment & prevention strategies and devices

  25. Exposure Condoms Behavior Change Rapid spread  ART Ongoing transmission  PrEP, PEP, MC Infectivity Susceptibility

  26. UCLA Center for World Health Saving Human Lives Worldwide by Investing in People

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