Designing and delivering a prevention project within an HIV treatment setting: lessons learned from a specialist model.
ABSTRACT This paper presents lessons learned from an intervention designed to provide HIV prevention counseling within a hospital-based, multidisciplinary HIV clinic. The model, Positive Prevention, used Master's-level social workers (MSWs) as intervention specialists to minimize burden on primary care providers and to offer a replicable way to provide prevention in a similar setting. The intervention goal was to reduce risk behaviors through Motivational Interviewing, a patient-centered counseling approach with proven success impacting behavioral change. Implementation experiences offer insight into the challenges of using MSWs as prevention specialists. Particular challenges were related to patient engagement and retention. Experiences early in the implementation process were informative and allowed for adaptations to facilitate a more viable program; however even after executing new strategies, many of the program issues remained. Thus, the Positive Prevention model is not recommended as a best HIV prevention model for replication in similar high-volume, hospital-based, multidisciplinary HIV clinic settings.
- SourceAvailable from: nnaapc.org[Show abstract] [Hide abstract]
ABSTRACT: HIV prevention education and counseling efforts have historically been directed toward those individuals considered at risk for exposure to HIV and assumed to be uninfected with HIV. In the late 1990s, prevention efforts began to include individuals who were HIV-infected. In 2003, the Centers for Disease Control and Prevention recommended that HIV prevention be incorporated into the medical care of persons living with HIV. This domain of HIV prevention work is known as prevention with positives or positive prevention, and research within this domain has been ongoing for a decade. This article provides a review of the scientific evidence within the prevention with positives domain from 1998 to 2008. A discussion is provided regarding early descriptive and formative studies as well as more recent and ongoing intervention trials specifically designed for persons living with HIV. A summary of current knowledge, a description of ongoing research, and gaps in knowledge are identified. Topics for future research are suggested.The Journal of the Association of Nurses in AIDS Care: JANAC 03/2009; 20(2):92-109. DOI:10.1016/j.jana.2008.11.001 · 1.23 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Regular interactions with people living with HIV/AIDS (PLWHA) who are receiving care provide caregivers opportunities to deliver interventions to reduce HIV-related risks. We conducted a systematic review of behavioral interventions for PLWHA (provided at individual level by caregivers at HIV care settings) to determine their efficacy in reducing sexual risk behavior. Conference websites and biomedical literature databases were searched for studies from 1981 to 2013. Randomized and quasi-randomized controlled trials (with standard-of-care control groups), considering at least one of a list of HIV-related behavioral or biological outcomes in PLWHA aged ≥18 receiving HIV care with at least 3-month follow-up were included. No language or publication status restrictions were set. Standardized search, data abstraction, and evaluation methods were used. Five randomized controlled trials were included in the review. We found limited evidence that sexual risk reduction interventions increase condom use consistency in HIV transmission risk acts, and reduce the number of (casual) sexual partners. We still believe that regular interactions between HIV care providers and PLWHA provide valuable opportunities for theory-based sexual risk reduction interventions to restrain the spread of HIV.AIDS patient care and STDs 04/2015; 29(5). DOI:10.1089/apc.2014.0240 · 3.58 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Nigerian women comprise the fastest growing group of persons with AIDS in Africa. Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable, chronic illness worldwide. The purpose of this pilot study was to assess the efficacy of a group intervention using motivational interviewing (MI) to promote adherence to antiretroviral therapy (ART) and use of risk reduction behaviors (RRB) among HIV-infected women in Nigeria. Recruited participants (n=60) were randomly assigned to the motivational group or the health promotion program (HPP) control group. The 6 month follow-up results indicate that, compared to the control group, MI participants reported significantly higher levels of adherence to ART, higher knowledge of HIV, higher use of condoms/protection during sexual encounters and decision-making not to have sex when no protection was available. The MI participants also had fewer mean number of sexual partners. MI in group format shows promise in promoting adherence to ART and use of RRB in HIV-infected Nigerian women.African Journal of Reproductive Health 09/2012; 16(3):14-27.