The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

Rotheram‐Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

doi:10.1146/annurev.clinpsy.032408.153530

Cited by 197 publications

(189 citation statements)

References 153 publications

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“…We note that as HIV prevention efforts shift towards combination prevention where behavioral efforts are combined with biomedical approaches to HIV prevention, understanding resiliencies will also be an essential tool to translating efficacious biomedical strategies into real world effectiveness [23][24][25]. The impressive strides that have been made recently in the effort to prevent HIV through pre-exposure prophylaxis (PrEP) [26,27], post-exposure prophylaxis (PEP) [28,29], and treatment as prevention [30,31] will be useless if there is not uptake by those most at risk.…”

Section: Incorporating a Resilience Framework Into Research Among Gaymentioning

confidence: 99%

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

et al. 2013

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This commentary presents the content and results of a recent symposium held to discuss how resiliencies among gay and bisexual men, and other men who have sex with men, could inform HIV prevention interventions. We outline the argument for including resiliencies in prevention work and present a critique of the deficitbased approached to public health research as it applies to this line of inquiry. The commentary makes the case that HIV prevention work would be more efficacious if it were designed to incorporate naturally occurring resiliencies that manifest among gay male communities rather than primarily using interventions that address vulnerabilities among men who continue to reside in high risk contexts. The commentary concludes by listing a set of resiliency variables and constructs proposed at the meeting that could be tested in theoretically-based investigations to raise resiliencies among gay and bisexual men thereby lowering HIV risks in this population.Keywords Resilience Á MSM health Á Gay and bisexual men Á TheoryIn the summer of 2011, The Fenway Institute of Boston and the University of Pittsburgh Center for Lesbian, Gay, Bisexual and Transgender (LGBT) Health Research convened a meeting of many of the thought leaders in the field of Gay and Bisexual men's health to discuss how resilience among gay and bisexual men, and other men who have sex with men (henceforth referred to simply as gay and bisexual men), could inform HIV prevention interventions. The idea behind the meeting was to outline ways in which resiliencies could be used to move the field forward towards the abatement or elimination of health disparities within this population. The primary goals of this meeting were to raise interest in the study of resilience as a way to improve health outcomes among gay and bisexual men, to learn from community-based programs that were already using resilience-based approaches in their work, and to begin conceptualizing how researchers could adapt and use a resilience-based framework in their study of HIV and other health disparities in gay and bisexual men. We also critically reviewed deficit-based approach to health, focusing on assumptions underlying these methods.Relative to the field of prevention research, communitybased organizations for gay and bisexual men have better recognized that focusing on strengths, resilience, and other protective factors can bring about positive individual and community-level results. However, few community programs have had the resources to test or evaluate their work. To begin to bridge this divide, the meeting organizers brought together leaders in research as well as key informants from resilience-based community programs including Manifest Love, the Harlem United Community AIDS Center (www.harlemunited.org), Easton Mountain (www. eastonmountain.com), Life Lube (www.lifelube.org), and others who have already been using strength-based approaches to promote health among gay and bisexual men. After a day of sharing methods, challenges, questions and results f...

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Section: Incorporating a Resilience Framework Into Research Among Gaymentioning

confidence: 99%

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

et al. 2013

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“…A subsequent review had similar conclusions. 27 Furthermore, unless these types of strategies are designed to be pro-poor, they run the risk of widening disparities within countries. Studies in Guatemala and Thailand suggest that village-level fortifi cation is feasible and can have a positive eff ect on the poorest, rural, indigenous populations with the highest burden of nutritional defi ciencies.…”

Section: Structural Interventions To Change Behavioursmentioning

confidence: 99%

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

et al. 2012

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Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the eff ective coverage of essential interventions. First, we identify four diff erent intervention delivery channels-ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions' deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to examine the evidence for a range of strategies designed to overcome supply and demand bottlenecks to eff ective coverage of interventions that improve child survival, health, and nutrition. Although knowledge gaps exist, several strategies show promise for improving coverage of eff ective interventionsand, in some cases, health outcomes in children-including expanded roles for lay health workers, task shifting, reduction of fi nancial barriers, increases in human-resource availability and geographical access, and use of the private sector. Policy makers and planners should be informed of this evidence as they choose strategies in which to invest their scarce resources.

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“…cART, an antiretroviral treatment, is to be offered according to the updated guidelines (de Cock et al, 2009) as part of additional behavioral prevention programs (Rotheram-Borus et al, 2009, Padian et al, 2008. However, this can work only for those who are aware of their HIV infection; will current prevention campaigns reach the estimated tens of millions of people (globally) still unaware of their infection?…”

Section: Cart Treatment Project For Reducing Hiv Transmission (Tasp)mentioning

confidence: 99%

Dilemma of concepts and strategies for the prevention of spread of HIV in relation to human behavior, law and human rights

Dennin

Lafrenz

Sinn

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:The new prevalence data regarding the estimated global number of human immunodeficiency virus positive (HIV + ) cases, i.e., including people who are either aware or unaware of their HIV infection in 2010, lead many to wonder why the increase in incidence has reached today's unprecedented level and escalated within such a short time. This, in spite of prevention campaigns in countries affected by HIV/acquired immune deficiency syndrome (AIDS) with their urgent messages aimed at preventing HIV transmission by promoting changes in individual's behavior. This article analyzes the background of the prevention strategies, in particular their political, social and legal concepts in terms of human rights, and reveals traits of human behavior not considered thus far. A radical reappraisal is necessary, at social and legislative levels, as well as options additional to current concepts. When ethical issues come up, they become blamed for outmoded moralistic positions. However, ignoring the reality has led to dire consequences from prioritizing individual human rights over society's collective need to prevent the spread of HIV.

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The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

Cited by 197 publications

References 153 publications

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

Dilemma of concepts and strategies for the prevention of spread of HIV in relation to human behavior, law and human rights

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