PREVENTION STRATEGIES FOR HIV AND AIDS 10
Treatment alone is not going to solve the HIV epidemic. Getting aHIV test is the first
step to identify a person who is infected with HIV infection and thepivotal entry point into the
medical care system for both treatment and prevention. More than 1.1million people in the
United States are living with HIV and almost 1 in 5 or 18% do notknow that they are infected.
(CDC,2012). Early identification of the HIV infection empowersindividuals to take protective
actions to stop the spread of this disease. For persons living withor at risk for HIV
infection, the following safeguards are crucial. These clients shouldknow their HIV status
through routine testing. They should get into medical care after aHIV diagnosis and start
antiretroviral treatment immediately. It is imperative that theseclients once diagnosed stay in
treatment and continue their HIV care.
These clients must modify their behaviors to decrease the spread ofHIV by using condoms properly, reducing number of sexual partners andavoiding sharing needles and syringes. Poor engagement in the careprotocol for clients being treated for HIV results in added risks tofurther transmit the virus (Dieffenbach et al 2011). This paperdocuments some prevention strategies for HIV/AIDS prevention anddiscusses some strategies that if implemented, may help health careworkers to do a better job in planning the prevention strategies.
Prevention Among Ethnic Majority Youths
In 2009, African Americans accounted for 65% of HIV infectionsamong individuals aged 13 to 24 and African American women andHispanic Latino females aged 13 to 24 accounted for 82% of allreported HIV infections in this age group (CDC 2011). This papersites evidence that behavior intervention which targets risky sexualbehavior and needle sharing at the individual level are insufficientstrategies to decrease the incidence and prevalence of HIV/AIDS inethnic minority youths. Socioeconomic status, limited lack of accessto quality health care, limited quality education and institutionaldiscrimination are macro social structural factors that
potentially contribute to the HIV epidemic at the population level.This paper states that those
macro level factors such as stigma of HIV, discrimination of HIVpatients, poor social economic
factors, poverty and lack of adequate health care for HIV patientsmust be addressed in all the prevention programs. Much of theliterature on "Reducing Aggressive Behavior in Youth SchoolsClimate Change", coupled with individual HIV preventionstrategies use a multilevel approach and could be used as a model forfuture broad based intervention programs. Similarly, literature onother public health challenges and epidemics has proven that macrolevel interventions are effective at decreasing mortality andmorbidity at population level. For instance, increasing the tax onalcohol to reduce alcohol related deaths was a very successful macrointervention. The increasing number of HIV infected minority youngpeople in crisis demands strategies at population level.
To target individual level factors is insufficient to have acommunal impact on the HIV epidemic. Macro level interventions orcombinations of macro level and individual level
interventions hold the most promise for reducing HIV disparities thatexist between ethnic minority youth and other segments of thispopulation (Prado et al, 2013).
Identification of EBI for HIV/AIDs Prevention
The concept of core element was developed to denote characteristicsof an intervention such as activities or delivery methods, presumedto be responsible for the efficiency of evidence based behaviorinterventions for HIV/AIDS. This paper describes the development oftaxonomy of core elements based on a literature review of theoreticalapproaches and characteristics of evidence-based interventions.Sixty-one categories of core elements were identified from theliterature and grouped into three distinct domains: implementation,content and pedagogy. The taxonomy was tested by categorizing coreelements from 20 HIV prevention evidence-based interventionsdisseminated by the Centers for Disease Control and Prevention.Results indicated that core elements represented all three domainsbut several were difficult to operationalize due to vague language orthe inclusion of numerous activities or constructs. A process isproposed to describe core elements in a method that overcomes some ofthese challenges. The most common characteristics in the domaininclude: select providers, volunteers and key staff with desiredcharacteristics that have clearly defined target population from whomintervention is appropriate. The content categories include ensureproviders, volunteers and key staff who have appropriate supervisionand behavior reinforcement.
The most common content characters include enhanced interpersonalcommunication skills, assertiveness, negotiation, disclosure andinfluencing cognitions for positive behavior such as attitudes. Themost common pedagogy addressed personalized information such as rollmodel stories, personal risks, teachable moments, disclosure andassessment forms. This taxonomy of core elements can be used toidentify core elements of evidence-based interventions and canstrengthen the translation of evidence-based interventions fromresearch to practice and guide future research seeking to identifyessential core elements in prevention intervention (Galbraith et al.,2011).
Substance Use Disorders and HIV/AIDS Prevention
This article presents canoed data on HIV transmission and researchevidence on
prevention and intervention with substance abusers. It highlights howindividual social workers can take advantage of this knowledge inpractice and through adoption and implementation withinorganizations. Individuals with substance abuse disorders continue tobe a high risk group for becoming infected with HIV/AIDS. Men havingsex with men continue to be the most affected subgroup of peopleaccounting for 61% of new infections. Women in thug dense communitieswho have a male partner who is a substance abuser are also vulnerable(CDC, 2012b). Given the multiple risks for men and women involved insubstance use and the
gaps in HIV sexual prevention, effectiveness research that tests,evidence-based safer sexual
interventions in the real world treatment programs is a criticalpublic health priority.
Individuals with substance use disorder are at a high risk forHIV/AIDS through drug risk and risky sexual behaviors. HIV/AIDStreatment can be hampered by the problem of substance use includingseeking testing, receiving test results, linking to treatment,remaining in treatment and adhering to HIV/AIDS care regimens. Socialworkers interact with individuals, families
and communities challenged by substance use disorder and HIV/AIDS andthey must create multiple entry points for these interventions.Several key areas should he addressed to maximize the impact socialwork has in improving services and care for these populations.
This study shows that they should include a sexual assessment aspart of every ongoing care program. They should try to identifypotential intervention options for adoption and implementation thatmight be an appropriate with the setting in regards to the populationand resources. They should also consider behavior, biological andstructural options that at available to use. They should accessorganizational characteristics that facilitate or challengeimplementation of evidence-based HIV prevention and treatmentinterventions. They also need to identify potential organizationalinterventions to address all barriers to care provision. The socialworkers need to conduct ongoing evaluation of intervention outcomesto access areas for adoption or provider drift from effectivecomponents.
They need to promote linkages between substance abuse treatmentprograms, HIV primary care and other public health providers. Toreach their goals, the research shows that social workers needs toparticipate in and promote collaborative partnership with researchersand other providers to enhance the effectiveness, feasibility andrelevance of HIV/AIDS prevention and treatment (Campbell, A.N.C.,Tross, S. & Calsyn, D.A.,2013).
HIV/Aids Prevention Behaviors Among baby boomers
The center for disease control and prevention estimates thatthere are more than 1.1 million people living in the United Stateswith the human immunodeficiency virus. There has been limited focuson baby boomers and HIV is steadily increasing in this population.The incidence rates among older adults have remained relativelystable, and it is predicted in the year 2015, 50% of HIV infectedindividuals will be 50 years and older (Adekeye et al., 2012). Due tolate diagnosis, older adults develop Aids at a much faster rate thanyounger adults. One study found that due to late diagnosis, peopleaged 50 years and older were twice as likely to contract aids withintwelve months as people aged 13 to 49. This is due to their weakenedimmune system and age related complications (Linley et al., 2012).
This study was conducted mostly on Caucasian women living inthe Florida area. The study examined the correlation of HIVperception, HIV prevention Information, HIV prevention,motivation and Aids prevention motivation skills with the intent topractice safe sex. The study results showed that Aids preventionbehavior skills and HIV prevention information have a significantcorrelation on intent to practice safe sex. This study showed thatolder adults who have more HIV prevention skills and preventionbehavior skills are more inclined to practice safe sex. Although thisstudy cannot be applied to be applied to all baby boomers due to sizeof study, results relied on honesty of participants and the use ofthe information. Motivation behavior skills model which only focus onindividual level variables and sexual behaviors may be influenced byrelationship factors. The study offered insight into the olderadults’ perception of HIV/Aids and the socio-cognitive determinantsof Prevention. Preventative programs will benefit from reaching outto physicians to address and provide HIV prevention information andto teach behavior skills that will reach populations who are at risk(Haynes, 2016).
HIV/Aids Prevention and Identification of Structured Interventions
Structured interventions have been defined as those preventioninterventions that include
physical, social, cultural, organizational, community, economic,legal and policy factors. In an effort to examine the feasibility,availability and sustainability, the Center for Disease Control andPrevention implemental a program that involved asking experts in HIVprevention and other areas of public health to provide input on theidentification of structural interventions listed above. This processresulted in a list of 123 interventions that met the definition. Theexperts were then asked to group these interventions in terms ofimpact they would have, if implemented on reducing HIV transmission.This project stimulated ideas from subject matter experts aroundstructural interventions that might be studied and eventuallyimplemented to reduce HIV incidence.
The findings presented in this article provide a suggested list ofstructural interventions for HIV intervention that may be bothfeasible and efficacious at reducing HIV incidence. The projectfailed in its attempt to determine those structural interventionswith the greatest perceived impact, as most expert opinions weresubjective mod biased based. Further research will be needed tofeasibly and effectively identify further some of theseinterventions. Findings from this study may help identify appropriatestructural interventions that will be feasible to implement,sustainable and lead to further prevention of HIV transmission (Abuet a1., 2011).
Summary
The aggregate effect of radical and sustained behaviorchanges in a sufficient number of
individuals potentially at risk is needed for reductions in HIVtransmissions. Reductions in HIV transmission need widespread andsustained efforts to motivate people to engage in a number of optionsto reduce risk. Preventions programs can do better. The effect ofbehavior strategies could be increased by aiming at many goals suchas a delay in onset of first intercourse, reduction in sexualpartners and an increase in condom use. These goals could be achievedby use of multilevel approaches such as families, social network,sexual networks, entire communities and with populations infected andnot infected with HIV. Interventions derived from behavior sciencehave a role in overall HIV prevention efforts, but when used bythemselves to produce substantial and lasting reductions in HIVtransmission between individuals or entire communities they areSufficient. A fundamental approach to HIV prevention finally needs tobe agreed upon by everyone, funded, implemented, measured and haveachievable goals. This is presently not the case (Gardner et al.,2011)
References
Abul, S., Abdul-Quader, & Collins, C. (2011). Identification ofstructured Interventions for HIV/AIDS Prevention: The ConceptMapping Exercise, Public Health Reports (1974), VoL126, No 6,pp.777- 778
Adekeye, O.A., Heiman, H. J., Onyeabor, O. S., Hyacinth, H. I. &Kissinger, P. (2012). The new invincibles: HIV among older adults inthe U.S., Plos ONE, 7(8),1-9.
Campbell, N.C., Tross, S. & Calsyn, D. A. (2013). Substance UseDisorders and HIV/AIDS Prevention and Treatment Intervention:Research and Practice Considerations, Social Work in PublicHealth, 28:3-4, 333-348.
CDC. (2011). Estimate of New HIV Infections in the United States2006-2009. Retrieved from: http//www.cdc.gov/nchhstp/newsroorn/doc/hiv.infections2006-2009/pdf
CDC. (2012). HIV Surveillance Supplement Report,17 (No3, partA).
Centers for Disease Control and Prevention. (2012). HIVSurveillance Report, 2010 vo122. Retrieved from:http://www.cdc.gov/hiv/topics/surveillance/resources/reports/
Dieffenbach, C. W. & Fauci, A. S. (2011). Thirty years of HIV andAIDS: future challenges and opportunities. Ann Intern Med.`54:766-771.
Haynes, C. R. (2016). The socio-cognitive determinates of HIV/AIDSprevention behaviors among baby boomers, Education Gerontology. Tylor Francis Online.
Galgraith, J. S. Herbst, J. H., Whittier, D. K., Jones, P. L., Smith,B. D., Uhi, G. & Fisher, H. H. (2011). Taxonomy forstrengthening the identification core elements for evidence-based behavior interventions for HIV/AIDS prevention. Health EducationResearch, Vol. 26 no.5 2011, pages 872-885.
Gardner, E., McLees, M., Steiner, J., Del Rio, C. & Burman, W.(2011). The Spectrum of Engagement in HIV Care and its Relevance to,Test and Treat Strategies for Prevention of HIV Infection. ClinicalInfectious Diseases, Vol 52 (6) p-793.
Linley, L., Pregean, J., An. Q., Chen, M. & Hall, I. (2012).Racial /ethical disparities in HIV
diagnoses among persons aged 50 years and older in 37 US states,2005-2008. American Journal of Public Health, 102(8),1527-1532.
Prado, G., Lightfoot, M. & Brown, H. (2013). Macro-LevelApproaches to HIV Prevention Among Ethnic Majority Youth: State ofScience, Opportunities and Challenges. American PsychologistVol.68(4) p286-299.
Ambasa-Shisanya, C. R. (2009). Cultural determinants ofadoption of HIV/AIDS prevention measures, andstrategies among girls, and women in western Kenya. Addis Ababa: Organisation for Social Science Research in Eastern and SouthernAfrica.