Finding and Using HIV Prevention Research to Develop Programs Jeffrey Bernstein, MS Ellen Goldstein, MA Center for AIDS Prevention Studies University of California San Francisco

Take Home Message n HIV prevention research is more than just evidence-based interventions. n Using research for program design is an ongoing, full-agency activity. n Using research findings and methods can lead to more specific, successful programs.

What is HIV prevention research? n Epidemiological data n Basic behavioral science n Behavioral change theory n Evidence-based programs n Evaluation methods

Epidemiology Describes the number of people (i.e., prevalence of disease or behavior) n 35% of Latino MSM CSW in the neighborhood are HIV+ n 20% of IDUs in your community have used NEP So What? n If you knew that a segment of the community had not tested, you might want to increase outreach for your testing program.

Basic Behavioral Science Studies to understand mechanisms by which behaviors are acquired n Depression is a co-factor in transmission. n Traditional gender roles in young people are associated with higher sexual risk behavior. So What? n If you knew this, you might want to train your case managers to assess for depression and make appropriate referrals.

Behavioral Change Theory Describes how behaviors change n Health Belief Model: Perceived susceptibility; perceived severity; perceived benefits of behavior; perceived barriers of the behavior. So What? n A program would want to include elements that help clients address all four areas.

Evidence-based Programs Rigorously evaluated interventions n Example: Popular Opinion Leader or MPowerment So What? n New programs can replicate efficacy of model programs. n New grants can be written to fund model programs at the agency.

Evaluation Methods Techniques for understanding people and programs n Example: Formative, process, outcome, or impact evaluations conducted at the agency. So What? n An agency’s own data can be used by agency staff to develop new programs, modify existing programs, or discontinue outdated programs.

Activity: Use it or Lose it Using the Research in Program Design

Additional Information Epidemiology n 40% of all new HIV cases here are among MSM between the ages of n A recent behavioral surveillance study showed that 60% of MSM reported drug use (speed, crystal, crack,) during their last episode of UAI.

Additional Information Basic behavioral science Persons who experience incidents of sexual abuse during childhood and adolescence are at a significantly higher risk of mental health problems and HIV risk behavior. A study of adult gay and bisexual men found that those who had been abused were much more likely to engage in unprotected anal intercourse and injection drug use.

Additional Information Behavioral change theory n Stages of Change theory is based on the premise that behavior change occurs in stages. Movement through the stage varies from person to person and group to group. The process is not linear and often includes relapse. [Pre-contemplation, contemplation, preparation; action, maintenance]

Additional Information Evidence-based programs n The 1999 CDC Compendium includes interventions for MSM. (See handout) n Do any of these look useful? Or not?

Additional Information Evaluation methods n You have just received funding to do a formative evaluation – a series of 3 focus groups to ask members of the population about their program needs. What questions might you want to include in the focus group guide?

Where do you find the research?

Where can you find research?

Where can you find research? n CTAP brochure n Visit our website for a list of California and National resources in English and Spanish n

Criteria for evaluating what you find n Does the research resonate what you already know about your clients/ community (through your experience or because you did your own research)? n Does the research answer a question you have about your clients/ community that you can confirm with your community?

Criteria: Evaluated Programs n Is it feasible in your agency setting? n Is there buy-in from all parts of the agency? n Are there adequate resources committed? n Is there staff training? n What other resources in the community are available for this need?

Take Home Message n HIV prevention research is more than just evidence-based interventions. n Using research for program design is an ongoing, full-agency activity. n Using research findings and methods can lead to more specific, successful programs.