A “Common Factors” Approach to Developing Culturally Tailored HIV Prevention Interventions

Abstract

The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of “common factors,” or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency’s program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources.

‘Pure’ drug users, commercial sex workers and ‘ordinary girls’: gendered narratives of HIV risk and prevention in post-Soviet Ukraine

“…Our paper draws on data collected during a five-year HIV prevention project that included site visits, in-depth interviews, structured interviews, focus groups and conversations with staff from eight HIV-focused NGOs in the central, southern and eastern regions of Ukraine, areas with the highest HIV rates and epidemics concentrated among people who inject drugs (PWID). Agencies were recruited as part of a larger study investigating the ability of NGOs to develop and implement behaviour change HIV prevention interventions (Owczarzak, Filippova, and Phillips 2014; Owczarzak et al 2016). We announced the study to HIV prevention organisations throughout Ukraine and invited interested agencies to complete an application.…”

“…In September 2014, members of a US and Ukraine-based research team and eight representatives from Ukrainian HIV prevention agencies met in Vilnius, Lithuania to finalise a survey to assess the effectiveness of HIV prevention programmes developed by the agencies (Owczarzak, Filippova, and Phillips 2014; Owczarzak et al 2016). Because one of the agencies planned to work with female clients exclusively and the others planned to include women in their work, we needed survey questions that captured the unique risks women face related to drug and condom use with sex partners.…”

Outcome evaluation of a “common factors” approach to develop culturally tailored HIV prevention interventions for people who inject drugs

“…As described in detail elsewhere (Owczarzak et al, 2016(Owczarzak et al, , 2014, in Phase I of the project we trained service providers from eight nongovernmental organizations (NGOs) that work in HIV prevention from regions with the highest rates of HIV and epidemics concentrated among PWID, to develop interventions based on a "common factors" approach that also reflected their local HIV and drug use contexts, organizational resources, and clients. All study agencies worked in urban areas from a harm reduction perspective and provided a range of services that included HIV and hepatitis C testing, psychosocial support, case management, and community centers.…”

“…All agencies served diverse populations that included PWID, people living with HIV, youth, and commercial sex workers. At the conclusion of Phase I, all participating agencies successfully developed a manualized intervention based on a common factors approach (Owczarzak et al, 2016). Phase II involved an outcome evaluation of four of the eight NGOs' intervention.…”

Strategies Chosen by YMSM During Goal Setting to Reduce Risk for HIV and Other Sexually Transmitted Infections: Results From the Keep It Up! 2.0 Prevention Trial

“…More generally, setting clear goals has been found to be a core component of effective HIV prevention (Owczarzak et al, 2016), but little is known about the specific goals that YMSM adopt and what challenges they face in implementing these skills. Better understanding of this is critical for developing and improving interventions, particularly for automated interventions such as eHealth approaches where decisions may need to be made in advance about what goals to offer participants and how to help guide them through addressing pitfalls in achieving their goals.…”