Strengthening HIV prevention: application of a research-to-practice framework.

As the HIV epidemic continues to affect at-risk and vulnerable populations, providers strive to improve prevention programs, in part by seeking new interventions with greater effects. Although interventions with scientific evidence of effectiveness are vital to this effort, many challenges limit access to research products. We examine key challenges and offer a framework for moving research to practice, one in which research steps are linked to practice steps and all these activities take place in a complex and dynamic environment. The Replicating Effective Programs (REP) project of the Centers for Disease Control and Prevention and other technology transfer activities illustrate the operation of this framework for HIV prevention. Further actions to improve technology transfer are called for. These include reducing time from study design to practice; learning from field-based implementations; providing guidance about fidelity to, and tailoring of, science-based interventions; improving linkages among consumers, providers, and researchers; and seeking additional resources.

Development and use of role model stories in a community level HIV risk reduction intervention.

A theory-based HIV prevention intervention was implemented as part of a five-city AIDS Community Demonstration Project for the development and testing of a community-level intervention to reduce AIDS risk among historically underserved groups. This intervention employed written material containing stories of risk-reducing experiences of members of the priority populations, in this case, injecting drug users, their female sex partners, and female sex workers. These materials were distributed to members of these populations by their peers, volunteers from the population who were trained to deliver social reinforcement for interest in personal risk reduction and the materials. The participation of the priority populations in the development and implementation of the intervention was designed to increase the credibility of the intervention and the acceptance of the message. The techniques involved in developing role-model stories are described in this paper.

Prevention campaigns for hard-to-reach populations at risk for HIV infection: theory and implementation.

Using applied behavioral science techniques that have been successful in other areas of health promotion, community-level campaigns were implemented in 5 cities to prevent HIV infection among hard-to-reach, at-risk populations: men who have sex with men but do not self-identify as gay; women who engage in sex for money or drugs; injecting drug users (IDUs), female sex partners of IDUs; and youth in high-risk situations. Communication materials presented positive role models for risk-reducing behaviors, and peer networks prompted and reinforced the behavior change process. This article describes the first year of intervention experience and documents the practical application of theoretical concepts of persuasion and learning. The use of theory and data to develop 188 educational messages is illustrated and training methods and experiences are reported for 150 peer leaders, 104 other community networkers, and 22 outreach workers. These activities are feasible and appear to offer an effective, general approach for diverse, special populations.