The Centers for Disease Control and Prevention notes that HIV continues to be an important public health issue. In 2017, approximately 38,789 people in the U.S. were diagnosed with HIV. Many of the new infections took place in young teens and adults. More than half of those who acquired HIV were Black, Latino, and White men.
The good news is that new HIV diagnoses are decreasing over time. This is due in part to varying, innovative prevention programs used to address the needs of individuals at higher risk of acquiring HIV. These programs, targeting various populations and needs, are integral to slowing down and eventually eliminating HIV.
HIV is often a minimized public health issue– one that can only be fixed through sexual or injection drug use behavioral changes. However, HIV is related to broader issues that make altering sexual and injection drug use behaviors difficult, including poverty, racism, unemployment, limited social support, and stigma towards members of the LGBTQIA+ community.
Despite these difficulties, prevention programs are available to provide education, support, and encouragement to decrease HIV risk. Today, I’m outlining some of the many programs currently provided to diverse populations. Additionally, information of all the programs outlined, as well as a more comprehensive offering can be found on the CDC’s website here.
HIV Prevention Programs: A Brief Overview
Prevention Strategy: PrEP
Description: A technique safe for adults and teens to prevent acquiring HIV through sexual activity or sharing injection equipment. This technique requires a pill to be taken daily as prescribed to reduce risk. Resources for doing PrEP can be found in health departments, community-based organizations, and healthcare organizations.
Evidence: When you take PrEP as prescribed, you lower your chance of getting HIV greatly. Studies have shown that PrEP reduces HIV risk from sex by about 99% and by at least 74% among people who inject drugs, when taken daily.
Prevention Strategy: Many Men, Many Voices (3MV)
Description: A 7-session, group-level prevention program to prevent HIV and sexually transmitted diseases (STDs) among African American same gender loving (SGL) men and those who may or may not identify as gay. This program addresses many factors that influence behaviors including cultural, social and religious norms. The program seeks to enhance self-esteem related to racial identity and sexual behavior, education about HIV risk, and risk reduction strategies.
Evidence: A report in 2014 evaluated the efficacy of 3MV during a randomized control trial design. The study included 164 men who participated in the 3MV study with the intervention condition. These men showed a reduction of HIV/STD risk behaviors including: number of male partners, unprotected anal intercourse with casual male partners, and the number of episodes of unprotected anal intercourse with casual male partners. Lastly, participants also showed an increase in condom use.
Prevention Strategy: Mpowerment
Description: This is a community-level prevention program for young, SGL men of diverse backgrounds that encourages reduction of sexual risk, regular HIV testing, building positive social support among peers, and distribution of condoms and lubricants. The program includes peer-led sessions that are 3-hour meetings of 8-10 young, SGL men that focus on the need for frequent HIV testing, and safer sex behaviors.
Evidence: A study evaluating the efficacy of the Mpowerment program among 298 participants when active in three community-based organizations from 2009 to 2012 showed improved behavioral outcomes at follow-up. These included increased HIV testing and self-efficacy for safer sex, and self-acceptance as young, SGL men. This study also showed that the program was associated with improved perceived positive social norms about safer sex and safer sex messages among gay/bisexual/transgender friends.
Prevention Strategy: Sister to Sister
Description: This is a 20-minute, one-on-one, HIV/STD risk-reduction behavioral intervention. Delivered during the course of a routine medical visit for sexually active African American women 18 to 45 years old, the intervention provides culturally sensitive health information to empower and educate these women and to help them understand behaviors that put them at increased risk. The goals of the program is to increase knowledge, motivation, confidence, and skills in making changes to behaviors that will reduce risk.
Evidence: One study notes that women engaged in the Sister to Sister intervention in the northeast reported greater protected sexual intercourse and were less likely to test positive for an STD at a 12-month follow-up of participating.
The list above, while not exhaustive, show programs that are variable to specific populations and approaches in delivery.
While these interventions are innovative, digital health coaching has a lot to offer in the HIV prevention space. Through this approach, individuals can gather information and support through Health Advisors via phone call, email and text messaging. This type of care and support can provide an alternative to existing HIV prevention programs.
The strengths of digital health coaching in this space is the ability to care for people who might deal with issues related to poverty, racism, unemployment, and stigma, as noted on the outset.
Communication via phone, email or text provides a person who desires more education about how to prevent HIV a layer of anonymity, allowing them to ask questions and start conversations regarding sexual health or drug use that they might not feel comfortable engaging in a face-to-face clinical setting. This approach can also be useful to those who have limited medical resources available to them because of where they live (e.g. rural versus urban).
The outstanding empathy and knowledge of Health Advisors add another layer of support to those seeking to prevent HIV, but who might be struggling to understand what areas of their health they are able to control.
These knowledgeable coaches attend to broader issues that may influence decision-making for a person engaging in HIV risk behaviors. For example, Health Advisors can empower an individual with financial issues to obtain PrEP by assisting in finding a low or no-cost medication option.
With so many prevention options available, it certainly does not hurt to have another viable alternative through digital health coaching that will help serve the needs of those interested in preventing HIV.
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