HIV Prevention Programs

Prevention programs are now being introduced in U.S. public schools to warn adolescents about the risks of unprotected sexual intercourse and to help instill safe-sex practices. Teenagers who are HIV+ sometimes pitch these programs, making the risk graphically clear to the audience. These is some evidence that adolescents try to distance themselves from peers who have HIV in an effort to control the threat that such an encounter produces, so interventions that stress information, motivation, and sexual negotiation skills, as opposed t peer-based interventions, may be more successful in changing adolescent behavior. Research is still exploring which element of school-based prevention programs is most successful.

When prominent public figures, such as Magic Johnson make their HIV infection public, the desire for more information about AIDs and concern about AIDS increase. This finding suggests that the effective timing and use of such announcements might be helpful in getting people tested and getting them to reduce their AIDS-related risk behaviors.

Recent interventions in schools have made use of HIV prevention videos that provide training in communication skills and condom use skills. Results suggest that this cost-effective intervention can be an effective way of decreasing risky sexual behavior. Increasing self-efficacy regarding condom use also improves he likelihood of using them.

The state model of behavior change may be helpful in guiding interventions to increase condom use. Some people have gaps in their knowledge about AIDS or about their own behaviors or their partners' behavior that may put them at risk. Therefore, they may profit from knowledge-based interventions that move them from a preconcontemplation to a contemplation phase with respect to safe-sex practices. In contrast, moving from contemplation to preparation, or from preparation to action, may require specific training in condom negotiation skills so that the individual follows through on the commitment to refrain from risky sex during specific sexual encounters.

Efforts to prevent risk-related behavior may need to target to only high-risk sexual practices themselves but also other behaviors that facilitate high-risk sex. Chief among these are drug and alcohol use. That is, people who may be otherwise aware that they should not engage in risky sexual activities may be less inhibited about doing so when under the influence of drugs or alcohol.

Interventions that address the norms surrounding sexual activity are needed as well. Any intervention that supports norms favoring more long-term relationships or decreasing the number of short-term sexual relationships and individual has is a reasonable approach to prevention.