Behaviour Change: The Future

1. Behaviour Change: The Future Rob Wardle GMI Partnership Services Manager rob@metrocentreonline.org METRO Positive East West London Gay Men’s Project

2. Behaviour Change • What influences behaviour? • The past • The present • The future • Negative and positive experiences influence our: • Wellbeing • Decision making • Risk taking • Experiences, thoughts and coping strategies are often unique to individuals. • Should ‘symptoms’ or ‘causes’ be targeted in terms of behaviour change interventions?

3. Community MSM HIV prevention. Who is the audience & whatare the approaches? General population – includes all risk categories from low to high Approaches: campaigns / widespread messaging to increase knowledge, raise awareness and promote testing Targeted audience: all - but aimed at high risk Effective for high risk individuals? Low risk Medium – high risk groups Approaches: as above + regional & local work to reinforce messaging and provide short intervention. Target audience: medium - high risk Effective for high risk individuals? • Clinical Intervention • Reinforces HIV prevention strategy objectives • PEP / Prep • Consistent in-depth behaviour change support options / referral links? High risk individuals Is the above enough? What else is done? Additional support varies by location High risk

4. What do we know? • HIV rates among MSM are rising • Past and present campaigns have ensured men know that: • Condoms reduce risk • Risk reduction strategies will reduce risk • Being diagnosed early will increase life expectancy and protect others • It is their responsibility to look after their own health • Drugs and alcohol may affect your decision making ability Some men, both HIV+ and HIV-, are continuing to take risks despite the above • What has GMI learned from working with high risk men on the ground? • Reasons for risk taking are multi-layered and complex and influenced by any number and combination of factors (culture, religion, identity, mental health, age, ethnicity, drug and alcohol) • Medical model and behavioural model – can these fit together?

5. How do we move forward? • Accept that treating symptoms is important but will not change behaviour • Understand that risk taking is about behaviour which is connected to wellbeing and is complex, multi-layered and unique to individuals • Learn from the community • Why do some men take risks and others do not? • Which messages have worked for men and which have not? • What would make men who take risks stop and reflect on behaviours? • Use the above to inform campaigns, messaging and intervention and truly focus them on high risk men • Provide a holistic approach which combines clinical intervention with person-centred intervention – can this truly be embedded into society, the workforce and will political agendas support it?

6. What does the future look like at the moment? Uncertain… but…has to be: • Collaborative • Built from the ground up • Based on combination prevention strategies