What Works in HIV Prevention for Youth
Chapter 5: Summary and Resources
We do not yet have a cure or a vaccine to prevent HIV and AIDS. AIDS is still winning the war, but we do have an arsenal of weapons at our command. We have the resources and the know-how. Now we must have the will, the energy, and the passion to continue the fight. Community-based organizations on the front lines can make all the difference between a resigned acceptance of 20,000 new infections each year among American youth and an ardent recommitment to HIV prevention.
Key to making a difference for youth at the local level is the adoption or careful adaptation of successful HIV prevention interventions, paired with ongoing evaluation of their effectiveness in reducing risky behavior or increasing safer behavior. This concluding chapter refers CBOs to readily available resources that can help them achieve this goal.
Adapting Prevention ProgramsAdapting proven HIV prevention interventions to meet local needs and client circumstances is a cost-effective and often-successful strategy for CBOs. Before a CBO chooses to adapt, it is critically important to understand the characteristics of the original intervention and its audience, and how they are similar to or different from the CBO's intended use. The Center for AIDS Prevention Studies illustrates this crucial aspect of adapting programs:
"One successful prevention program for gay men in small cities recruited popular opinion leaders from bars, and trained them to deliver and model prevention messages to their peers. This program was then adapted to address minority women in inner city housing developments. However, the program didn't work there. The reason? Women didn't know their neighbors, and because of high crime rates in the housing developments, were reluctant to open their doors to someone they didn't know. This program was then reworked, starting by helping women in the housing developments establish a sense of community through potluck dinners and music festivals. As a result, not only did the women increase condom use and communication, but the community began to tackle other issues besides HIV such as drugs and violence in the housing development." (DeCarlo and Kelly, 1996, p.3)
Failing to account for such differences can torpedo an intervention that might otherwise be successful. Recognizing them and making adjustments allows CBOs to tailor interventions to local needs and populations while retaining the core of what makes an intervention work.
ResourcesCBOs interested in beginning or expanding their HIV prevention services for youth can choose from a wide range of easily obtainable resources, the majority of them free of charge. The CDC is a rich source of information, a great deal of it available on the Web. Many prevention science centers, such as the Center for AIDS Prevention Studies at the University of California San Francisco also have useful Web sites. CBOs, too, are increasingly making available information about their prevention programs through their own Web sites or through collaborative efforts. Finally, a number of local and national organizations offer CBOs direct technical assistance.
Centers for Disease Control and PreventionThe CDC is responsible for administering federal HIV prevention programs and is an excellent resource for a wide range of information from epidemiological data to fact sheets and updates to consensus documents on HIV prevention. Almost all of this information is available for downloading from the Web. The CDC's home page is www.cdc.gov.
Look for Compendium of HIV Prevention Interventions with Evidence of Effectiveness at www.cdc.gov/hiv/pubs/hivcompendium/HIVcompendium.htm. The CDC developed the compendium to respond to requests from CBOs and others for science-based interventions that work. It is a collection of summaries of rigorously studied behavioral and social interventions that are state-of-the-science, have no negative findings, and have demonstrated evidence of effectiveness in reducing sex- and drug-related risk behaviors or improving health outcomes, with a statistically significant difference between the intervention and control groups. The summaries include content, method, intervention goal, setting, population, findings, and a contact person. Nine interventions included in the Compendium target youth.
Interventions included in the document were identified by CDC's HIV/AIDS Prevention Research Synthesis Project, an ongoing database of studies. For more information on the Compendium, contact Linda Kay at the CDC, 1600 Clifton Road, Mailstop E-37, Atlanta, GA 30333, (404) 639-1900.
Look also for Replicating Effective Programs Plus at www.cdc.gov/hiv/projects/rep/default.htm. Like the Compendium, the REP+ site offers descriptions of science-based programs with demonstrated effectiveness in reducing risky behaviors or encouraging safer ones. The CDC has translated program information into everyday language and packaged it to be user-friendly. REP interventions are available for a variety of populations; information is provided on the research behind the interventions and on how to get program materials.
Center for AIDS Prevention Studies (CAPS)CAPS is a program of the AIDS Research Institute at the University of California San Francisco. CAPS conducts theory-based HIV prevention research and focuses heavily on disseminating research results in a variety of user-friendly formats. For this reason, CAPS is an excellent resource for CBOs. CAPS' Web site, HIV InSite (hivinsite.ucsf.edu), offers a comprehensive array of prevention tools, fact sheets, monographs, reports, articles from the media, and links, including links to download documents from other sources. A stated goal of the site's prevention section is to help service providers build strong programs based on prevention science.
A CAPS publication of special interest to CBOs wanting to know more about targeting HIV prevention for youth is Dangerous Inhibitions: How America is Letting AIDS Become an Epidemic of the Young. The sections on "Understanding Risk" and "Rethinking the Message" offer a succinct analysis of why prevention paradigms for youth need changing and why some research methods are missing the mark.
CBOs can contact CAPS at: AIDS Research Institute, University of California San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105, (415) 597-9100.
The Kaiser Family FoundationThe Henry J. Kaiser Family Foundation is an independent philanthropy dedicated to health care issues. The foundation runs its own research and communications programs, often partnering with universities, policy think tanks, and other organizations. The Kaiser Family Foundation is a leading source for policy and program information related to HIV/AIDS, and disseminates the "Daily HIV/AIDS Report." Most foundation products are available free from the publications request line (1-800-656-4533) or through download from www.kff.org. The Web site includes a section devoted to HIV/AIDS prevention, including links to facts sheets, briefs, and reports.
Of special interest to CBOs concerned about youth-friendly HIV testing services is Hearing Their Voices: A Qualitative Research Study on HIV Testing and Higher-Risk Teens, a report on research conducted for the Kaiser Family Foundation about the attitudes and concerns of at-risk youth toward HIV testing. The report, which is based on a series of in-depth interviews and focus groups with 73 high-risk teenagers in Miami, Houston, New York City, and Newark, examines the complex issues surrounding adolescents' views of and experiences with HIV testing, including why they do or do not get tested.
This article was provided by AIDS Action Council.