Finding and Using HIV Prevention Research to Develop Programs

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Finding and Using HIV Prevention Research to
Develop Programs

• Jeffrey Bernstein, MS
• Ellen Goldstein, MA
• Center for AIDS Prevention Studies
• University of California San Francisco

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Take Home Message

• HIV prevention research is more than just
  evidence-based interventions.
• Using research for program design is an ongoing,
  full-agency activity.
• Using research findings and methods can lead to
  more specific, successful programs.

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What is HIV prevention research?

• Epidemiological data
• Basic behavioral science
• Behavioral change theory
• Evidence-based programs
• Evaluation methods

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Epidemiology

• Describes the number of people (i.e., prevalence
  of disease or behavior)
• 35 of Latino MSM CSW in the neighborhood are
  HIV
• 20 of IDUs in your community have used NEP
• So What?
• If you knew that a segment of the community had
  not tested, you might want to increase outreach
  for your testing program.

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Basic Behavioral Science

• Studies to understand mechanisms by which
  behaviors are acquired
• Depression is a co-factor in transmission.
• Traditional gender roles in young people are
  associated with higher sexual risk behavior.
• So What?
• If you knew this, you might want to train your
  case managers to assess for depression and make
  appropriate referrals.

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Behavioral Change Theory

• Describes how behaviors change
• Health Belief Model Perceived susceptibility
  perceived severity perceived benefits of
  behavior perceived barriers of the behavior.
• So What?
• A program would want to include elements that
  help clients address all four areas.

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Evidence-based Programs

• Rigorously evaluated interventions
• Example Popular Opinion Leader or MPowerment
• So What?
• New programs can replicate efficacy of model
  programs.
• New grants can be written to fund model programs
  at the agency.

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Evaluation Methods

• Techniques for understanding people and programs
• Example Formative, process, outcome, or impact
  evaluations conducted at the agency.
• So What?
• An agencys own data can be used by agency staff
  to develop new programs, modify existing
  programs, or discontinue outdated programs.

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Activity Use it or Lose it

• Using the Research
• in Program Design

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Additional Information

• Epidemiology
• 40 of all new HIV cases here are among MSM
  between the ages of 30-35.
• A recent behavioral surveillance study showed
  that 60 of MSM reported drug use (speed,
  crystal, crack,) during their last episode of
  UAI.

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Additional Information

• Basic behavioral science
• Persons who experience incidents of sexual abuse
  during childhood and adolescence are at a
  significantly higher risk of mental health
  problems and HIV risk behavior. A study of adult
  gay and bisexual men found that those who had
  been abused were much more likely to engage in
  unprotected anal intercourse and injection drug
  use.

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Additional Information

• Behavioral change theory
• Stages of Change theory is based on the premise
  that behavior change occurs in stages. Movement
  through the stage varies from person to person
  and group to group. The process is not linear and
  often includes relapse.
• Pre-contemplation, contemplation, preparation
  action, maintenance

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Additional Information

• Evidence-based programs
• The 1999 CDC Compendium includes interventions
  for MSM. (See handout)
• Do any of these look useful? Or not?

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Additional Information

• Evaluation methods
• You have just received funding to do a formative
  evaluation a series of 3 focus groups to ask
  members of the population about their program
  needs. What questions might you want to include
  in the focus group guide?

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Where do you find the research?
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Where can you find research?

• www.caps.ucsf.edu

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Where can you find research?

• CTAP brochure
• Visit our website for a list of California and
  National resources in English and Spanish
• www.caps.ucsf.edu/CTAP

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Criteria for evaluating what you find

• Does the research resonate what you already know
  about your clients/ community (through your
  experience or because you did your own research)?
  
• Does the research answer a question you have
  about your clients/ community that you can
  confirm with your community?

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Criteria Evaluated Programs

• Is it feasible in your agency setting?
• Is there buy-in from all parts of the agency?
• Are there adequate resources committed?
• Is there staff training?
• What other resources in the community are
  available for this need?

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Take Home Message

• HIV prevention research is more than just
  evidence-based interventions.
• Using research for program design is an ongoing,
  full-agency activity.
• Using research findings and methods can lead to
  more specific, successful programs.