Assessing the Social and Behavioral Science Base for HIV/AIDS Prevention and Intervention Workshop Summary (1995) / Chapter Skim
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PART IV MAKING A DIFFERENCE: CONTROLLING THE EPIDEMIC THROUGH SOCIAL INTERVENTION
PART IV MAKING A DIFFERENCE: CONTROLLING THE EPIDEMIC THROUGH SOCIAL INTERVENTION
Pages 29-40
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From page 29... ...
However, additional basic research questions should be central in the development of new interventions to reduce those high-risk behaviors that remain and are spreading HIV-even after all that has been done. SOCIAL NETWORKS Social networks are sets of social linkages or interactions among individuals.
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From page 31... ...
There is evidence that HIV may spread rapidly in a particular city when the virus penetrates the core of a large sociometric network of drug injectors. Other research has shown that many male injection drug users are involved in primary relationships with women who do not use drugs, thus, involving these women in the drug injectors' network.
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From page 32... ...
These include geographical location, local social structure, cultural beliefs and activities, racial and gender stratification, laws, policies, and programs, as well as the process of community disruption described earlier in the case examples from New York City, Haiti, and Thailand. All of these factors are important for understanding and influencing HIV-risk behavior.
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From page 33... ...
A number of social models discussed at the workshop can be used as a basis for changing subculture: diffusion theory, leadership-focused models, social network theory, social movement/community mobilization theory, models of changing the social environment, and public communication models. HIV prevention strategies based on these social models' which are described below, can effect change at a number of levels, including individual behavior, network structures and norms, and broader social structures.
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From page 34... ...
Successful HIV interventions based on this model have included recruiting former injection drug users to communicate with social networks of injection drug users about the risks of sharing needles; recruiting popular opinion leaders in gay bars to exhibit and communicate AIDS risk reduction messages to their peers; and recruiting sex workers, clients, brothel owners, and brothel managers as peer educators to target behavior changes, including consistent condom use. However, to the extent that influence patterns change rapidly, or that social networks are short-lived, or that there is serious resistance to change among influential segments of a subculture, leadershipfocused approaches might be less effective.
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From page 35... ...
Additional research is also needed to incorporate existing knowledge of large-scale social networks of subpopulations and egocentric personal social networks into HIV preventive intervention research. Finally, research is needed on what social conditions and social policies, if changed, might lead to lowerrisk social network patterns.
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From page 36... ...
Engaging in ethnographic research on drug users' organizations, and talking to users about their lives as part of this research, produces a very different picture of drug users and leads to the possibility of using organizations formed by drug users to spread the HIV prevention message. Street Voice is a drug users' organization in Baltimore that is comprised primarily of African Americans.
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From page 37... ...
In addition to local drug users' organizations, there are national and international coordinating bodies, such as the Dutch Federation of Junky Unions, the North American Users Network, the International Drug Users' Network, the Australian IV League, and the European Interest Group of Drug Users. The latter two are particularly active and effective.
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From page 38... ...
Public Communication (Media) Models Long-term HIV prevention research is likely to include planned communication efforts to shape individuals' inclination to high-risk behaviors, groups' social norms regarding safe behavior, and communities' support for HIV prevention education and services.
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From page 39... ...
Community-level campaigns are those that try to increase participation of citizens and gatekeepers of formal organizations, such as government agencies, businesses, schools, hospitals, voluntary organizations, and religious groups, in HIV prevention activities, program funding, and policy issues. Research on planned communication programs as well as on unplanned media coverage targeted to communities should increasingly test theories, such as those related to agenda setting, and systematically address outcomes related to community agenda, participation norms, and efficacy.
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From page 40... ...
This approach increases the interdependence of these at-risk persons and helps to create and strengthen self-help networks within the community. A program in Eastern Connecticut targets out-of-treatment injection drug users (IDUs)
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