Trends in HIV infection and prevention are changing. Although a growing number of prevention efforts have demonstrated efficacy, positive intervention effects have not been as evident among the populations currently at greatest risk, particularly women and people of color. While prevention has until recently focused on HIV- negative persons, the need to also target HIV-positives is increasingly being recognized. HIV researchers and practitioners are also turning attention to the potential of """"""""structural interventions"""""""" (e.g., policies and laws, organizational procedures, media campaigns, environmental interventions) to have synergistic effects with the prevailing """"""""behavioral interventions"""""""" that target individuals and small groups. The proposed project will provide HIV prevention professionals with key resources that facilitate access to, replication of, and re-evaluation of efficacious behavioral and structural HIV prevention interventions. These resources will update, expand, augment, and complement Sociometrics'existing HIV/AIDS Prevention Program Archive (HAPPA), a widely- disseminated collection of replication kits for efficacious behavioral prevention programs targeting HIV-negative adults. Specifically, the project will (1) update HAPPA with (new) efficacious behavioral programs for HIV- negative adults;(2) expand the HAPPA collection to include efficacious prevention programs for HIV-positive adults;(3) develop a research-based Program Adaptation Toolkit, in a customized version for each HAPPA kit and a stand-alone version for use with efficacious programs acquired elsewhere;(4) develop a complementary Compendium of Effective Structural Interventions that includes the content and describes the impact of empirically-validated structural interventions;and (5) develop an Online Selection Resource to help users identify empirically-validated behavioral and structural interventions suited to their needs and local contexts. In Phase I, efficacious interventions were identified and selected by a Scientist Expert Panel and agreements negotiated with their developers to acquire, package, and disseminate them should the current Phase II proposal be funded. Prototypes of all products were developed and subjected to usability testing with HIV prevention professionals. In Phase II, program packages will be developed for the new interventions, product prototypes will be modified per the results of the Phase I usability tests and then developed in their entirety, a second round of usability tests will be conducted on all products, and a field test in real world settings will be conducted to asses the value added contributions of the augmented HAPPA replication kit (i.e., with customized Program Adaptation Toolkit) in helping to bridge the gap between Type 1 translation research (development of intervention programs shown to be efficacious in a research-controlled environments) and Type 2 translation research (appropriate use of effective interventions in the practitioner-controlled """"""""real world"""""""").
HIV/AIDS continues to be a deadly international disease. A vaccine has proved elusive thus far. Although a growing number of HIV behavioral prevention efforts have demonstrated evidence of efficacy, positive intervention effects have not been as evident among the populations currently at greatest risk, particularly women and people of color. Research suggests that prevention practitioners need additional resources to help them select, acquire, and appropriately tailor efficacious interventions for implementation with diverse target populations. In addition, although every new HIV infection begins with someone who is already infected, prevention efforts to date have largely focused on HIV-seronegative persons. The increasing recognition of the need to target prevention efforts to seropositive persons as well is notably reflected in the Centers for Disease Control and Prevention's (CDC) HIV Prevention Strategic Plan: Extended Through 2010 where decreasing HIV risk behaviors among seropositive persons is listed as the first objective in the effort to attain Goal #1 of decreasing by 5% per year, or at least by 10% by 2010, the number of persons in the U.S. at high risk for acquiring or transmitting HIV (CDC, 2007a). Finally, there is increasing attention to the role of structural factorssuch as laws and policies, organizational protocols, environmental conditions, and broader social normsin influencing HIV risk behaviors. Structural interventions often have the potential to reach more people than behavioral interventions that target individuals and small groups, and can potentially achieve large effects. Greater access to information about effective structural interventions among practitioners and policy/advocacy professionals would facilitate their more widespread replication and re-evaluation in new settings. The proposed SBIR project will provide prevention practitioners and policy/advocacy professionals with key science-based resources to respond to the above current challenges in HIV prevention.
| Cunningham, Shayna D; Card, Josefina J (2014) Realities of replication: implementation of evidence-based interventions for HIV prevention in real-world settings. Implement Sci 9:5 |
| Card, Josefina J; Cunningham, Shayna D; Newman, Emily N et al. (2013) Update and expansion of the HIV/AIDS prevention program archive (HAPPA). J Clin Res HIV AIDS Prev 1:19-28 |
