AIDS 11 3 week 7

Health Behavior Change

- Behavior change models are COMPLEMENTARY and WORK IN CONCE - 7 Principles Cognitive, emotional, behavior, interpersonal, social ecological, structural, and scientific priniciple

HIV Prevalence

- Number of people living with HIV - Time - 1 year - Demographics; Gender, Sexuality, Race, Age -Geography ; community, nation,, globally

WHY we are losing the fight against AIDS in Africa

- Uganda's success was due to partner reduction B encouraged by the concept of " collective efficacy" -Ability of people to JOIN TOGETHER AND RELY ON ONE ANOTHER - small initiated discussions led by " government worker, home- base volunteer, churchgoers, women's-right activists"

CASE STUDY: Positive Prevention

- interventions with and for HIV-positive individuals -SUSTAIN HEALTHY NORMAL LIVES -CDC OFFICIALLY ENDORSED postive presentation in 2003 -Consistent with principles disease epidemiology Aims to reduce risk of transmission -KNOWLEDGE of status - BIOMEDICAL TREATMEANT -how to USE PREVENTION EFFECTIVELY -Focus on both SELF AND PARTNERS

Emotional Principle

-Change may be motivated by emotion -Positive emotion works better than negative emotion, but fear is an effective email of used in proper amounts

Not simple to prevent HIV /AIDS

-Even when people clear understand a health risk and the means of prevention, they still are sisitanct to change- dissmenatin HIV/AIDs knowledge is different from chang HIV/AIDS attitude and infection - Changing attitudes and intentions is different again from changing behaviors that put someone at risk for HIV/ AIDS.

Cognitive Principle

-Relevant and correct knowledge about the risks, spread and prevention of HIV or any agent causing disease -Putting relevant knowledge into action requires motivation

Behavioral Principle

-Specific behaviors are encouraged, EX the 100% condom use campaigns that encourage individual; that use condoms ever time they have intercourse -Instuction on how to use condoma correctly may be useful

Interpersonal Principle

-Target the social network of the person, pole are relational and social groups influence the members' behavior -to be effective information about the social norms of the group will help tailor the message

Implementing Psotice prevention

-having knowledge of one's HIV status -DISCLOSURE of HIV status to partner -PREVENTION of mother to child transmission -Testing OF PARTNERS of this with HIV -Provide ARV THERAPY to HIV positive -Treating OTHER SEXUALLY TRANSMITTED INFECTIONS -REDUCE BEHAVIORS s that increase transmission risk -encouraging HIV positive leadership -In concert with preventative intervention

Prevent HIV/AIDS

1. give the information about stopping HIV transmission to people who are at potential risk- avoid very risky sexual behaviors , use condoms , stop sharing needles- avoid fluid contact 2. They act on the information - once informed, everyone would follow HIV/ AIDS prevention measure and the spread of the virus would be halted, preventing AIDs

Health Belief Model

A person's perception of risk is mistaken - recognize that they are SUSCEPTIBLE to a particular condition - Perceive that the SEVERITY of the condition is such that is worth avoiding - Perceive that the BENEFITS OF AVOIDING THE CONDITION are worth the effort of changing the behavior and the possible adverse effects of he change - they have a SELF-EFFICACY (skill) to change their behavior- CUES TO ACTION are considered important in assisting all stages of change in this model

ABC Campaign

Abstain from sex (delay first sex) Be faithful ( to 1 partner or have fewer partners Condoms ( use male or female versions consistently and correctly)

Intrapersonal Level

Behavior

Serodiscordant

Couple with one HIV- positive and one HIV negative partner

Scientific Principles

EVALUATED INFORMATION within a target group and create presentation programs for that particular groups SCIENTIFIC METHODS objectively evaluated cause and effect of the prevention program

Public Policy

Government regulations

Precaution-Adoption Precoess Model

Model focuses on *Process rather than particular variables* Process model suggest five stages in decision making with not particular order 1. awareness or knowledge of risk or threat 2.Acknowledgement of a significant risk to a group 3. Acknowledgement of a significant risk to oneself 4. Decision to take action to reduce the risk 5. Initiation of the behavior to reduce risk -emotions, values, knowledge, intentions, actions, and social context CHANGE OVER TIME

Sociol Ecological Principle

More effective throughout social environment - Recognizes the importance of people surrounding a target individual - Socio-Ecological Model Identifies target areas for health promotion or intervention SphERES of Influence -INTRAPERSONAL level - INTERPERSOASONAL Level: -INSTITUTIONAL -PUBLIC POLICY

PrEP

Pre-Exposure Prophylaxis

Structural Principle

Prevention programs considering laws, technology and physical circumstances of the target population -encourage testing for HIV requires having clinics or site for testing in accessible locations with clear disclosure or reporting laws

Institutional Level

School, workplace

ABC Debate

Ugandan AIDS control calls faithfulness and pattern reduction "zero grazing" -some groups (mostly religious- base) attribute success to ABSTINENCE PROGRAMS -other suggest that success is due to PARTER REDUCTION -"the abstinence-vs condoms rhetoric.. appears more related to the CULTURE WARS IN THE UCA THAN TO AFRICAN SOCIAL REALTY"

ABC successful in Uganda

WITHOUT A RANDOMIZED CONTROLLED TRAIL, there is no way to answer this definitively - in its absence, we rely on OBSERVATIONAL DATA -survey conducted in 1989 and 1995 indicated that > 50% DECLINE OCCURRED IN SEXUAL RELATIONS WITH MULTIPLE/CASUAL PARTNERS -CONDOMS BECOME MORE READLY AVAILABLE in the mice- to late 1990s -Observational data suggests the PARTNER REDUCTION (B) PRECEDED USE OF CONDOMS (C) WITH MULTIPLE/ CASUAL PARTNERS

Community Level

churches, community organization

Interpersonal Level

family, friends, coworkers

HIV incidence

number of NEW CASES OF HIV, time 1 year, demographics (gender sexuality, race, ages), Geography ( community, nation, globally)

Health Decision Model

take social variables of experience, knowledge and interaction into account -Decisions about health action are made in the context of other people -required knowledge and appreciation of the impratanct of **social contest, peer attitudes , and influential groups**