HIV/AIDS Prevention Practitioner Institute (HPPI)

Investigators: Josefina J. Card & Diana Dull Akers

The HIV/AIDS Prevention Practitioner Institute (HPPI) was created to empower HIV prevention professionals facing programmatic challenges and health disparities on the front line of the epidemic. HPPI consists of five interactive, multimedia, computer-delivered courses (and accompanying texts). The courses are designed to increase HIV health professionals' capacity to plan, evaluate, and sustain scientifically effective, culturally competent HIV prevention interventions. Each course in the multimedia HPPI series includes a video course guide, video segments with practitioners, quizzes, glossaries, workbook activities, and interactive learning exercises. Course 1: Developing a Program Model. defines and reviews the elements that make up a program model, explains how program models are used and what is involved in creating a program model, guides you through the specific steps for developing a program model and assessing its strength, and finally, explores strategies for assessing and improving the strength of your program model. Course 2: Program Replication and Adaptation. This course walks you through the steps required to select and adapt effective programs successfully. In particular, it addresses the following questions: 1. How do you identify effective programs? 2. How do you decide whether to replicate a program, and, if so, which one? 3. If necessary, how do you adapt a program to better meet the needs of your target population and setting? Course 3: Understanding Process Evaluation. This course focuses on strategies to assess an intervention program to see what is working and what is not, to determine what factors contribute to success or failure, and to refine the ways a program is im plemented. The course defines process evaluation, identifies key questions process evaluati on can answer, identifies uses of process evaluation findings, explains the steps necessary to conduct a process evaluation, and describes how a process evaluation can contribute to an outcome evaluation. Course 4: Understanding Outcome Evaluation. This course focuses on the most scientific way to determine if your program is having the desired positive impact on program participants' knowledge, attitudes, beliefs, skills, intentions, behaviors, or health status outcomes, such as prevention of HIV or sexually transmitted infection (STI). This course will help you: 1) Identify key research questions that can be answered by an outcome evaluation; 2) Understand the similarities and differences between outcome and process evaluations; 3) Understand the benefits of conducting outcome evaluations; 4) Implement the steps necessary to conduct a basic outcome evaluation; and 5) Understand why a comparison group is essential to outcome evaluation. Course 5: Creating Culturally Competent Programs. This course focuses on culture, cultural identity, and the importance of striving for cultural competence in your HIV prevention program. The course explores strategies for bringing cultural competence goals to bear on HIV/AIDS prevention program planning, implementation and evaluation processes.

HIV/AIDS Warriors Program

Investigators: Eric G. Bing, MD, Daniel J. Ortiz, PhD, Ricardo E. Ovalle-Bahamn, C. Phil., Karen G. Cheng, PhD, Francisco Ernesto, MD, & Cherrie B. Boyer, PhD

The HIV/AIDS Warriors Program aims to enhance HIV risk reduction knowledge, motivation, and behaviors among soldiers or other at-risk populations. The program is composed of five, 4-hour sessions delivered on consecutive days to groups of soldiers by civilian facilitators. Optional monthly booster sessions last 1-hour and reinforce the information provided by the initial program and give participants an opportunity to discuss their experiences related to the program. Program participants significantly increased their HIV/AIDS knowledge, perceived vulnerability to HIV, and condom use. Program participants also engaged in fewer unprotected sex acts with girlfriends, occasional partners, and sex workers; reduced the number of unprotected anal sex acts with live-in partners; and reduced the overall number of occasional partners and sex workers. The HIV/AIDS Warriors Program was originally designed for and implemented with soldiers in the Angolan Armed Forces. The HIV prevention messages presented in the curriculum are applicable to other non-military populations at risk of acquiring and transmitting STIs/HIV. Click here to view more detailed information on this program.

HORIZONS: STI/HIV Sexual Risk Reduction Intervention for African American Girls

Investigators: Ralph J. DiClemente, Gina M. Wingood, Eve S. Rose, Jessica M Sales, Delia L. Lang, Angela M. Calienda, James W. Hardin & Richard A. Crosby

HORIZONS, a two-session STI-prevention program developed for small groups of sexually-active African American adolescent girls, was developed to address a broad range of risk factors, including personal, relational, sociocultural, and structural factors. The overall goals of the program are to reduce recurrent STIs and enhance STI/HIV preventive behaviors. The workshops are interactive, involving the participants in games, role playing, poetry readings, condom skills practice, and self-reflection activities. HORIZONS was evaluated with a randomized control trial that included two conditions (control and intervention). Data was collected from the subjects at baseline, 6-months and 12-months post-completion of the program. When the program participants were compared to their control group peers, the program participants had, on average, a 35% lower risk of having Chlamydia than the control participants (RR, 0.65; 95% CI, 0.42 to 0.98; P=.04). Overall, participants in the program condition had higher self-reported condom use during sexual activity in the previous 14 days (P=.004) and 60 days (Phere to view more detailed information on this program.

Health Behavior Study of Detroit Minority Youth, 1991

Investigators: Kathleen Ford and Anne Norris

Low income minority urban youth have been identified as a group for whom there is current concern about HIV transmission. The aim of this study was to evaluate AIDS knowledge, perception of risk, and risk behaviors related to sex in a sample of urban, low income, African American and Hispanic adolescents and young adults. The study was conducted between February and July of 1991. Data were obtained from a household probability sample of 1,435 individuals. Completed interviews included 726 African American (324 males, 402 females) and 709 Hispanic (359 males, 350 females) adolescents and young adults from low income areas of Detroit, Michigan. Interviewers were hired and trained specifically for the study. Over 95% of the 60 interviewers employed were minority residents of Detroit. Interviewer training consisted of instruction of general interviewing techniques, as well as instruction relevant to obtaining drug and sexual histories. The study questionnaire was developed through pilot testing using open-ended questions, consultation with youth and youth service providers, and formal pretesting. The final questionnaire consisted of close-ended questions and required about one hour to administer. About 108 of the interviews were conducted using a Spanish language questionnaire. The questionnaire assessed general knowledge of AIDS transmission; knowledge of routes of sexual transmission (both heterosexual and homosexual); respondents' sexual behavior, number of sexual partners, and condom use; and perceived susceptibility to AIDS infection.

HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Wellbeing and Healthy Relationships)

Investigators: Scott D. Rhodes, PhD, MPH, CHES, Kenneth C. Hergenrather, PhD, MSEd, MRC, Fred R. Bloom, PhD, Jami S. Leichliter, PhD, Jaime Montano

HoMBReS is a lay health advisor (LHA), community-based, behavioral intervention that aims to increase condom use and HIV testing among Latino men by working with sports teams. Each team selects a leader to serve as an LHA, known as a Navegante (Navigator or Health Navigator), who receives a 4-session, 16-hour training from the HoMBReS facilitator in order to become a health advisor, opinion leader, and community advocate. He may then provide his teammates with information and referrals to increase their knowledge about HIV and STI transmission, prevention, and testing, and increase their condom use skills. In addition, the Navegantes advocate positive and reframe negative sociocultural expectations about what it means to be a man, and they work toward structural changes in their communities. Click here to view more detailed information on this program.

Holistic Health Recovery Program for Injection Drug Users (HHRP)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Mary Helen Usubiaga, MD, Cheryl Doebrick, PhD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS is a 12-session, manual-guided, group therapy intervention delivered over six weeks. This risk reduction and health promotion intervention is appropriate for use with drug users in a substance abuse treatment program, and it was designed to specifically address the special needs of HIV-negative and status unknown injection drug users (IDUs). HHRP is based on the Information-Motivation-Behavioral Skills (IMB) model of HIV prevention through behavioral change and uses cognitive remediation components to facilitate learning and retention of IMB treatment components. The primary goals of this intervention are harm reduction, health promotion, and improved quality of life. More specific objectives include abstinence from illicit drug use or from sexual risk behaviors, reduced drug use, reduced risk of HIV infection, and improved medical, psychological, and social functioning. The HHRP program includes session topics such as: reaching your goals; health care participation; reducing the harm of injection drug use; harm reduction with latex; negotiating harm reduction with partners; preventing relapse to risky behavior; healthy lifestyle choices; introduction to the 12-steps; overcoming stigma; motivation for change; emotional and spiritual healing; and healthy social relationships and activities. Click here to view more detailed information on this program.

Holistic Health Recovery Program for Injection Drug Users Living with HIV (HHRP+)

Investigators: S. Kelly Avants, PhD, Arthur Margolin, PhD, Lara A. Warburton, PhD, Keith A. Hawkins, PsyD, Julia Shi, MD

HOLISTIC HEALTH RECOVERY PROGRAM FOR INJECTION DRUG USERS LIVING WITH HIV is a 12-session, manual-guided, group therapy intervention delivered over six weeks. This risk reduction and health promotion intervention is appropriate for use with drug users in a substance abuse treatment program, and it was designed to specifically address the special needs of HIV-positive injection drug users (IDUs). HHRP+ is based on the Information-Motivation-Behavioral Skills (IMB) model of HIV prevention through behavioral change and uses cognitive remediation components to facilitate learning and retention of IMB treatment components. The primary goals of this intervention are harm reduction, health promotion, and improved quality of life. More specific objectives include abstinence from illicit drug use or from sexual risk behaviors, reduced risk for HIV transmission, reduced drug use, and improved medical, psychological, and social functioning. The HHRP+ program includes session topics such as: reaching your goals; health care participation; reducing the harm of injection drug use; harm reduction with latex; negotiating harm reduction with partners; preventing relapse to risky behavior; healthy lifestyle choices; introduction to the 12-steps; overcoming stigma; motivation for change; moving beyond grief; and healthy social relationships and activities. Click here to view more detailed information on this program.

Hot, Healthy, and Keeping it Up!

Investigators: Kyung-Hee Choi, Steve Lew Eric Vittinghoff, Joseph Catania, Donald Barrett & Thomas Coates

This program is a three-hour, single session, culturally appropriate intervention for use with homosexual Pacific Islander and/or Asian men. The intervention is designed to increase positive ethnic and sexual identity in order to help participants acknowledge HIV risk behaviors by discussing negative experiences of being both Asian or Pacific Islander and homosexual (e.g., lack of social support, racism, homophobia). Guided by the Health Belief Model, the theory of reasoned action, and social cognitive theory, facilitators use interactive and group process techniques to address the following four intervention components: 1) development of positive self-identity and social support; 2) safer sex education; 3) eroticizing safer sex; and 4) negotiating safer sex. Of the 258 participants in the original evaluation, most were about 29 years old, Chinese, college-educated, immigrants. Most had been tested for HIV and had reported multiple partners in the three months prior to the intervention. Results of the evaluation indicate that intervention participants were significantly more knowledgeable about HIV-risk reduction, were significantly more motivated about addressing risk, had significantly fewer partners, and were significantly less likely to report unprotected anal intercourse than counterparts in the control group at three-month follow-up. (Choi et al., 1996). Click here to view more detailed information on this program.

Information-Motivation-Behavioral Skills HIV Prevention Program (IMB)

Investigators: Jeffrey Fisher, William A. Fisher, Stephen J. Misovich, & Angela D. Bryan

The goal of the Information-Motivation-Behavioral Skills HIV Prevention Program (IMB Program) is to reduce high school students' risk of HIV infection. Program objectives include positively influencing students' HIV prevention knowledge, attitudes and norms, increasing students' levels of HIV prevention behavioral skills, and increasing students' levels of HIV preventive behavior. The intervention involves a four-session classroom component to be conducted by trained high school teachers. The IMB Program is based on the Information, Motivation and Behavioral Skills (IMB) model of health behavior change, which assumes that information, motivation and behavioral skills are the fundamental determinants of HIV preventive behavior. An evaluation of the curriculum offered in three intervention formats (classroom-based only, peer-based only, and combination classroom and peer-based delivery) was conducted by the Center for Health/HIV Intervention and Prevention in 1999. Participants were 1,577 students in four inner-city high schools in Connecticut (61% African-American, 28% Hispanic-American, 11% Caucasian, mixed or "other.") The classroom-based HIV prevention education component effectively promoted risk reduction behavior change in these urban high school settings at one year post-intervention. Click here to view more detailed information on this program.

Intervention with Microfinance for AIDS and Gender Equity (IMAGE)

Investigators: Tanya Abramsky, Joanna Busza, John Gear, James Hargreaves, Julia Kim, Mzamani Benjamin Makhubele, Kalipe Mashaba, Linda Morison, Matshilo Motsei, Luceth Ndhlovu, Chris Peters, Godfrey Phetla, John Porter, Paul Pronyk, & Charlotte Watts

IMAGE is comprised of a gender and HIV training curriculum called Sisters-for-Life. A microfinance program augments the curriculum. For the microfinance component, groups of five women receive loans to establish small businesses. Further credit is offered when all women in these solidarity groups repay their loans. Loan centers of approximately 40 women meet fortnightly. Sisters-for-Life consists of two phases. Phase I is a structured series of 10 one-hour participatory training sessions that are integrated into the Loan Center meetings. Phase II moves the participants toward collective action. Natural Leaders are elected by their peers to participate in a one-week training workshop on leadership and community mobilization. Taking these skills back to their respective loan centers, these Leaders are responsible for developing an Action Plan, with the aim of implementing what they regard as appropriate responses to priority issues. Click here to view more detailed information on this program.