Advancing HIV Prevention Demonstration Projects: New Strategies for a Changing Epidemic

Heffelfinger, James D.; Sullivan, Patrick S.; Branson, Bernard M.; Mastro, Timothy D.; Purcell, David W.; Griffiths, Sean D.; Romaguera, Raul; Janssen, Robert S.

doi:10.1177/00333549081230s302

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…Program developers have taken advantage of these spontaneous connections to increase HIV testing uptake. For example, the CDC has funded CBOs to provide incentives for at-risk individuals to persuade members of their immediate networks to request an HIV test 90,91. Other examples of interventions making use of spontaneous social connections are social network and community-based programs 92…”

Section: Application Of the Modelmentioning

confidence: 99%

A Dynamic Social Systems Model for Considering Structural Factors in HIV Prevention and Detection

et al. 2010

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We present a model for HIV-related behaviors that emphasizes the dynamic and social nature of the structural factors that influence HIV prevention and detection. Key structural dimensions of the model include resources, science and technology, formal social control, informal social influences and control, social interconnectedness, and settings. These six dimensions can be conceptualized on macro, meso, and micro levels. Given the inherent complexity of structural factors and their interrelatedness, HIV prevention interventions may focus on different levels and dimensions. We employ a systems perspective to describe the interconnected and dynamic processes of change among social systems and their components. The topics of HIV testing and safer injection facilities are analyzed using this structural framework. Finally, we discuss methodological issues in the development and evaluation of structural interventions for HIV prevention and detection. KeywordsHIV; AIDS; structural factors; diagnosis; prevention Structural interventions have had a profound impact on public health. Even a casual observer of history can see the connection between structural changes such as water purification or highway safety and reductions in morbidity and mortality. Structural interventions can have a tremendous effect on individual-level health behaviors as well. Legislative changes such as regulating tobacco sales and usage have led individuals to modify their health behaviors and dramatically reduced smoking rates. 1Although structural approaches to health promotion are clearly effective, they are often viewed as outside the purview of behavioral interventionists. Prevailing conceptions of "cause" as immediate and necessary antecedents of health outcomes consider factors that affect outcomes in more indirect and indefinite ways as less important or less relevant. 2,3 Structural factors have also been neglected because researchers in the field of HIV prevention are often unprepared to develop and evaluate strategies to change laws, social organizations, or physical structures. Moreover, because of the scope and focus of structural interventions, randomized controlled trials, the gold standard to evaluate interventions'

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Section: Application Of the Modelmentioning

confidence: 99%

A Dynamic Social Systems Model for Considering Structural Factors in HIV Prevention and Detection

et al. 2010

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“…2 In 2003, the Centers for Disease Control and Prevention (CDC) launched a national initiative, Advancing HIV Prevention (AHP), to identify persons with undiagnosed HIV infection and provide them with medical care and prevention services. 4,5 The AHP demonstration projects included the implementation of social network strategy to identify at-risk partners and peers (network associates) of HIV-positive or high-risk HIV-negative persons (recruiters) for HIV counseling and testing. The social network demonstration project aimed at early diagnosis of HIV infections among minority populations among whom HIV incidence remains high.…”

mentioning

confidence: 99%

Cost-effectiveness of Using Social Networks to Identify Undiagnosed HIV Infection Among Minority Populations

Shrestha¹,

Sansom²,

Kimbrough³

et al. 2010

Journal of Public Health Management and Practice

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“…43,44 In an effort to expand access to HIV testing in the United States, CDC funded demonstration projects to determine the feasibility and effectiveness of using conventional and rapid HIV tests in various clinical and nonclinical settings. 45 Challenges to expanding the scope of HIV testing included competing priorities for limited resources within clinical settings; logistical difficulties testing large numbers of people in clinical and correctional settings; delivering preliminary positive test results in community-based venues and confirmatory results to transient, homeless and other hard-to-reach populations; and linking persons with HIV infection to care in nonclinical settings. 45 Many of the implementation challenges highlighted by these demonstration projects and other published studies examining various HIV testing strategies readily lend themselves to OR.…”

Section: Hiv Testing In Clinical and Nonclinical Settingsmentioning

confidence: 99%

“…45 Challenges to expanding the scope of HIV testing included competing priorities for limited resources within clinical settings; logistical difficulties testing large numbers of people in clinical and correctional settings; delivering preliminary positive test results in community-based venues and confirmatory results to transient, homeless and other hard-to-reach populations; and linking persons with HIV infection to care in nonclinical settings. 45 Many of the implementation challenges highlighted by these demonstration projects and other published studies examining various HIV testing strategies readily lend themselves to OR. 46,47 At a minimum, OR must identify optimal strategies for reaching high-risk persons to increase early detection, receipt of test results, and linkage to medical care.…”

Section: Hiv Testing In Clinical and Nonclinical Settingsmentioning

confidence: 99%

Operational Research to Improve HIV Prevention in the United States

Herbst

Glassman²,

Carey³

et al. 2012

JAIDS Journal of Acquired Immune Deficiency Syndromes

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The HIV/AIDS epidemic in the United States continues despite several recent noteworthy advances in HIV prevention. Contemporary approaches to HIV prevention involve implementing combinations of biomedical, behavioral, and structural interventions in novel ways to achieve high levels of impact on the epidemic. Methods are needed to develop optimal combinations of approaches for improving efficiency, effectiveness, and scalability. This article argues that operational research offers promise as a valuable tool for addressing these issues. We define operational research relative to domestic HIV prevention, identify and illustrate how operational research can improve HIV prevention, and pose a series of questions to guide future operational research. Operational research can help achieve national HIV prevention goals of reducing new infections, improving access to care and optimization of health outcomes of people living with HIV, and reducing HIV-related health disparities.

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Advancing HIV Prevention Demonstration Projects: New Strategies for a Changing Epidemic

Cited by 17 publications

References 14 publications

A Dynamic Social Systems Model for Considering Structural Factors in HIV Prevention and Detection

A Dynamic Social Systems Model for Considering Structural Factors in HIV Prevention and Detection

Cost-effectiveness of Using Social Networks to Identify Undiagnosed HIV Infection Among Minority Populations

Operational Research to Improve HIV Prevention in the United States

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