Objective To provide a synopsis of past, current, and potential next-generation approaches to prevention for positives (PfP) interventions in the United States. Findings/Summary For a variety of reasons, PfP interventions, with the goals of limiting HIV transmission from people living with HIV/AIDS (PLWHA) to others, and protecting the health of PLWHA, did not appear with any frequency in the United States until about 2000. Even today, the number and breadth of evidence-based PfP interventions is very limited. Nevertheless, meta-analytic evidence demonstrates that such interventions can be effective, perhaps even more so than interventions targeting HIV-uninfected individuals. We review early and more recent PfP interventions and suggest that next-generation PfP interventions must involve behavioral and biologic components and target any element that affects HIV risk behavior and/or infectivity. Next generation PfP should include increased HIV testing to identify additional PLWHA, components to initiate and maintain HIV care, to initiate antiretroviral therapy (ART) and promote adherence, and to reduce sexual and injection drug use risk behavior, as well as ancillary treatments and referrals to services. Comprehensive next-generation PfP, including all of these elements and effective linkages among them, is depicted in Figure 1.

ObjectiveFor married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program.MethodsOne hundred thirty dyads were randomized to Weight Watchers (WW; n = 65) or to a self‐guided control group (SG; n = 65) and assessed at 0, 3, and 6 months. Inclusion criteria were age ≥ 25 years, BMI 27 to 40 kg/m2 (≥ 25 kg/m2 for untreated spouses), and no weight loss contraindications. WW participants received 6 months of free access to in‐person meetings and online tools. SG participants received a weight loss handout. Spouses did not receive treatment.ResultsUntreated spouses lost weight at 3 months (WW = −1.5 ± 2.9 kg; SG = −1.1 ± 3.3 kg) and 6 months (WW = −2.2 ± 4.2 kg; SG = −1.9 ± 3.6 kg), but weight losses did not differ by condition. Overall, 32.0% of untreated spouses lost ≥ 3% of initial body weight by 6 months. Baseline weight was significantly correlated within couples (r = 0.26; P < 0.01) as were weight loss trajectories (r = 0.52; P < 0.001).ConclusionsEvidence of a ripple effect was found in untreated spouses in both formal and self‐guided weight management approaches. These data suggest that weight loss can spread within couples, and that widely available lifestyle programs have weight loss effects beyond the treated individual.

Objective To examine the relationship between job type, weight status and lifestyle factors that are potential contributors to obesity including, diet, physical activity and perceived stress among employees enrolled in the Working on Wellness (WOW) project. Methods Randomly selected employees at 24 worksites completed a baseline survey (n=1700); some also an in-person survey and anthropometric measures (n=1568). Employees were classified by US Labor standards as: white collar (n=1297), blue collar (n=303), or service worker (n=92), 8 unknown. Associations were analyzed using Chi-Square, GLM procedures, and adjusted for demographics using Logistic Regression. Results In unadjusted models, BMI of service workers was higher than white collar workers; F&V intake was higher for service and blue collar than white collar; white collar workers reported highest stress levels in job and life. However, in models adjusted for demographics, the only significant difference was to physical activity (i.e., MET/min per week), with blue collar workers reporting higher levels of physical activity than service workers, who reported higher levels than the white collar workers. Conclusions Future research should further examine the relationship between health and job status to corroborate the results of the current study and to consider designing future worksite health promotion interventions that are tailored by job category.

Considering both the type and context of support for weight management is worthwhile. Intervention participants had access to treatment resources that may have engendered more effective responses to spouses' concerns or a sense of obligation to their spouse (indirect social control), whereas pressures to lose weight-while engaged in treatment-may have undermined behavior-change efforts. (PsycINFO Database Record