Marseille 2007
| Abstract #17 - HIV prevention programs affect behavior indirectly: Implications for evaluation. | ||||
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Session: 45.8: Prevention in the new millenium (Parallel) on Tuesday @ 16.30-18.30 in PR Chaired by Yolande Obadia, Araceli Rousaud Authors: Presenting Author: Dr Marco Yzer - University of Minnesota, United States |
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| Additional Authors: Dr Martin Fishbein, Dr Michael Hennessy, Dr Wayne Johnson, | ||||
| Aim: HIV prevention programs increasingly rely on behavioral theory to identify important predictors of the relevant behavior. Changes in those predictors brought about by program messages should theoretically translate into improved behavior. Program evaluation, however, often examines only whether message exposure is associated with behavior change, assuming that if people changed their behavior, the intervention must have been effective in changing the determinants. This practice, however, leaves obscured how programs exactly work. Evaluation research needs to examine whether the program changed what it was designed to change, namely one or more behavioral determinants. This study uses data on condom use with main and non-main partners from the AIDS Community Demonstration Project (ACDP) to illustrate this important idea. | ||||
| Method / Issue: The ACDP distributed condoms and role-model stories of individuals who successfully changed their HIV-risky behavior in at-risk communities, such as female sex partners of IDUs, commercial sex workers, and high-risk youth. The role-model stories were designed to change determinants of condom use with main or casual partners. Data from over 15,000 individuals were collected within control and intervention communities over a period of three years. Regression analyses examined intervention x time interaction effects on intention, attitude, perceived norms and self-efficacy concerning condom use with main and non-main partners. | ||||
| Results / Comments: Earlier research found that the ACDP moved at-risk groups to more consistent condom use with both main and non-main partners. This study demonstrates that these behavioral effects are explained by the ACDPs ability to improve intention and self-efficacy (for condom use with both main and non-main partners), and attitude (for condom use with non-main partners). | ||||
| Discussion: An HIV prevention program can only effectively improve prevention behavior if it changes the variables that cause that behavior. To learn from HIV programs we thus must choose evaluation criteria wisely; knowledge of what works is advanced when we can demonstrate that a program changed a variable, and that this change subsequently led to preventive behavior. | ||||
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