The paradox of HIV prevention: did biomedical prevention trials show how effective behavioral prevention can be?

The Evidence Project: Protocol for Systematic Reviews of Behavioral Interventions and Behavioral Aspects of Biomedical Interventions for HIV Prevention, Treatment, and Health Service Delivery in Low- and Middle-Income Countries

The Evidence Project conducts systematic reviews and meta-analyses of HIV behavioral interventions, behavioral aspects of biomedical interventions, combination prevention strategies, modes of service delivery, and integrated programs in low- and middle-income countries. Here, we present the overall protocol for our reviews. For each topic, we conduct a comprehensive search of five online databases, complemented by secondary reference searching. Articles are included if they are published in peer-reviewed journals and present pre/post or multi-arm data on outcomes of interest. Data are extracted from each included article by two trained coders working independently using standardized coding forms, with differences resolved by consensus. Risk of bias is assessed with the Evidence Project tool. Data are synthesized descriptively, and meta-analysis is conducted when there are similarly measured outcomes across studies. For over 20 years, this approach has allowed us to synthesize literature on the effectiveness of interventions and contribute to the global HIV response.

Research on the Necessity of AIDS Intervention for College Students Based on Cognitive Behavioral Therapy

BACKGROUND

Despite abundant research on AIDS prevention and intervention, many residual factors influence the actual impact of the intervention at a population level. Misconceptions held by subjects lead to patterns of behavior, which do not reflect levels of cognition.

METHODS

Cognition and behavioral patterns relating to HIV were investigated without intervention in freshmen before and after a two-year study period. A total of 461 freshmen studying at the university in Wuhan, Hubei Province, China, were enrolled in September 2019. Data management and analysis were performed by SPSS 25.0 software.

RESULTS

Throughout the two years' study, no significant changes in the cognitive level regarding AIDS were found while the frequency of sexual behavior increased significantly. A trend of inconsistency between cognition and behavior was identified.

CONCLUSION

During a two-year period without intervention, it was found that the sexual behavior of university students gradually increased, perceptions regarding AIDS-related subjects were incomplete and awareness of HIV infection risk was still weak. A phenomenon described as the separation of knowledge from behavior was detected. Misconceptions that influenced behavioral patterns were identified as critical factors. Therefore, we propose that cognitive behavioral therapy may change the actual impact of AIDS prevention interventions.

Behavioral and social interventions to promote optimal HIV prevention and care continua outcomes in the United States

PURPOSE OF REVIEW

This review reports on trends in behavioral and social intervention research in the United States published over the past year (2020-2021) investigating HIV prevention and care outcomes, organized by the level of intervention focus - individual, dyadic, and organizational.

RECENT FINDINGS

Researchers have continued to develop and evaluate behavioral and social interventions to reduce HIV acquisition risk and disease progression. With few exceptions, social and behavioral interventions have primarily focused on individuals as the unit of behavior change. Interventions operating at the individual-, dyadic-, and organizational-level have made strides to reduce HIV transmission risk and disease progressing by addressing mental health, substance use, stigma, peer and romantic relationships, and, to some extent, structural vulnerabilities.

SUMMARY

Social and behavioral interventions continue to be critical in addressing HIV inequities in the United States. An important gap in the literature is the need for multilevel interventions designed and implemented within existing community-based organizations and local healthcare settings. We call on researchers to continue to attend to the structural, environmental, and economic vulnerabilities that shape HIV inequities in the development of multilevel approaches necessary to realize the full potential of existing and emerging HIV prevention and care strategies.