Preventing AIDS: Theories and Methods of Behavioral Interventions PDF
Preview Preventing AIDS: Theories and Methods of Behavioral Interventions
Preventing AIDS Theories and Methods of Behavioral Interventions AIDS Prevention and Mental Health Series Editors: David G. Ostrow, M.D. . Ph.D. and Jeffrey A. KeUy, Ph.D. Medical College of Wisconsin Milwaukee, Wisconsin Methodological Issues in AIDS Behavioral Research Edited by David G. Ostrow, M.D., Ph.D., and Ronald C. Kessler, Ph.D. Preventing AIDS: Theories and Methods of Behavioral Interventions Edited by Ralph J. DiOemente, Ph.D., and John L. Peterson, Ph.D. A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher. Preventing AIDS Theories and Methods of Behavioral Interventions Edited by Ralph J. DiClemente, Ph.D. University ofA labama Birmingham, Alabama and John L. Peterson, Ph.D. Georgia State University Atlanta, Georgia Foreword by Jonathan Mann, M.D., M.P.H. Springer Science+Business Media, LLC Library of Congress Cataloging-in-Publication Data Preventing AIDS : theories and methods of behavioral Interventions edited by Ralph J. DlClenente and John L. Peterson foreword by ; Jonathan Mann, p. en. Includes bibliographical references and Index. 1. HIV Infections--Prevention. 2. Health behavior I. DlClenente, Ralph J. II. Peterson, John L. RA644.A25P7534 1994 614.5'993--dc20 94-2857 CIP 109876543 ISBN 978-1-4899-1195-7 ISBN 978-1-4899-1193-3 (eBook) DOI 10.1007/978-1-4899-1193-3 © Springer Science+Business Media New York 1994 Originally published by Plenum Press, New York in 1994 Softcover reprint of the hardcover 1st edition 1994 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Contributors Albert Bandura • Department of Psychology, Stanford University, Stanford, California 94305 Marshall H. Becker • Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109- 2029 James W. Dearing • Department of Communication, Michigan State Uni versity, East Lansing, Michigan 48824-1212 Don C. Des Jarlais • Chemical Dependency Institute, Beth Israel Medical Center, New York, New York 10003 Ralph J. DiClemente • School of Public Health, Department of Health Be havior and School of Medicine, Departments of Medicine and Pediatrics, and Center for AIDS Research, University of Alabama, Birmingham, Alabama 35294 Lynda S. Doll • Division of HIV/ AIDS, National Center for Infectious Dis eases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333 Edward Dunne. Department of Psychiatry, College of Physicians and Sur geons, Columbia University, New York,New York, 10032 Julie Feldman • Division of Child Psychiatry, College of Physicians and Sur geons, Columbia University, New York, New York 10032 Martin Fishbein • Department of Psychology, University ofDlinois, Cham paign, Illinois 61820 Samuel R. Friedman • National Development and Research Institutes, 11 Beach Street, New York, New York, 10013 Joseph Guydish • Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, San Francisco, California 94143- 0936 v vi Contributors Janet S. Harrison. Division ofHIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333 Robert B. Hays. School of Medicine, University of California, San Francisco, San Francisco, California 94143, and Center for AIDS Prevention Studies, San Francisco, California 94105 Penelope J. Hitchcock • Sexually Transmitted Diseases Branch, National Institute o.f Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892 John B. Jemmott III • Department of Psychology, Princeton University, Princeton, New Jersey 08544 Loretta Sweet Jemmott. College of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey 07112 Jeffrey A. Kelly • Department of Psychiatry and Mental Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 Douglas Kirby • ETR Associates, P.O. Box 1830, Santa Cruz, California 95061-1830 Gary Meyer. Department of Communication, Michigan State University, East Lansing, Michigan 48824-1212 Susan E. Middlestadt • Social Development Program, Academy for Edu cational Development, Washington, DC 20037 Janet S. Moore • Division of HIV/ AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333 Thomas R. O'Brien • Viral Epidemiology Section, National Cancer Institute, Rockville, Maryland 20892 Nancy S. Padian • School of Medicine, University of California, San Fran cisco, and San Francisco General Hospital, San Francisco, California 94110 John L. Peterson. Department of Psychology, Georgia State University, At lanta, Georgia 30303 Laurie Roehrich • Department of Psychiatry, University of California, San Francisco, and Substance Abuse Services, San Francisco General Hospital, San Francisco, California 94110 Everett M. Rogers • Department of Communication and Journalism, Uni versity of New Mexico, Albuquerque, New Mexico 87131-1171 Contributors vii Margaret Rosario. Department of Psychiatry, College of Physicians and Surgeons, and School of Public Health, Columbia University, New York, New York 10032 Irwin M. Rosenstock. Department of Health Behavior and Health Educa tion, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109-2029, and College of Health and Human Services, California State University, Long Beach, Long Beach, California 90840 Mary Jane Rotheram-Borus • Division of Social Psychiatry, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, California 90024- 1759 James L Sorensen. Department of Psychiatry, University of California, San Francisco, and Substance Abuse Services, San Francisco General Hospital, San Francisco, California, 94110 Victor J. Strecher • Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 17599 Tamara L Wall. Department of Psychiatry, University of California, San Francisco, and Substance Abuse Services, San Francisco General Hospital, San Francisco, California 94110 Thomas P. Ward. National Development and Research Institutes, 11 Beach Street, New York, New York 10013 John K. Watters • Department of Family and Community Medicine and Institute for Health Policy Studies, School of Medicine, University of Cali fornia, San Francisco, San Francisco, California 94143-1304 Janneke H. H. M. van de Wijgert. School of Medicine, University of Cal ifornia, San Francisco, and San Francisco General Hospital, San Francisco, California 94110 Foreword Public health has a legacy of neglect regarding social and behavioral research. Too often, prompted by technical and scientific progress, we have ignored even marginalized-the vital "human element" in health thinking and prac tice. Thus, for example, while family planning programs focused on providing a choice among safe and effective contraceptive methods (a supremely worthy goal), the central issue of sexuality and sexual behavior was generally neglected. Similarly, the enormous and important efforts to develop rapid and reliable diagnostic and treatment methods for sexually transmitted diseases helped divert attention away from the crucial issues of sexual practice. In short, we seem to have difficulty addressing the fundamental behaviors-including sex, drug taking and other intoxications, and violence-that are central to the major causes of preventable morbidity, disability, and premature mortality in the world today. Our collective reluctance to examine and understand ourselves is also expressed in the oft-repeated pipedream that scientific progress will "take care of" the HIV/ AIDS pandemic by delivering a preventive vaccine, an effective cure, or both. Yet even a cursory glance at the relationship between scientific/ technical progress and health shows that meeting the scientific challenges is only one step toward effective application of the vaccine or drug. It is typical, not atypical, that hepatitis B vaccine is only now becoming relatively freely available to large populations in the developing world, more than a decade after the vaccine's licensure. It would be similarly naive to think that once the vials of an effective AIDS vaccine are in hand, our only concern will be how to make the vaccine truly available to all who need it. Simply stated, how we use the fruits of scientific research is as "behavioral"-albeit at a collective level-and as important in the future of the HIV/ AIDS pandemic as the specific life activities, individually practiced, that are usually called "behavior. " HIV/ AIDS has helped focus attention on our relatively primitive current capacity to describe usefully, understand, or modify effectively several basic behaviors, at either the individual or collective level. Therefore, this fine book, ix x Foreword edited by Ralph DiClemente and John Peterson, offers a useful contribution by presenting both a range of conceptual frameworks and practical experiences in the efforts to prevent HIV infection. But where do we go from here? Perhaps several breakthroughs are needed. First, we need a broad acknowledgment of the central, crucial, inextricable interdependence between health and behavior. Second, we need to support innovative and creative efforts to develop new conceptual frameworks where (as is most often the case) existing concepts seem inadequate. Third, we must be rigorously self-critical, to distinguish the workmanship-like efforts at routine KABP (Knowledge, Attitudes, Beliefs, Practices) surveys from research that can truly and concretely inform design and modification of prevention efforts. Fourth, we need to build bridges between the worlds of behavioral research and the world of public health. Yet in the end, we will need to recognize that changing public and political attitudes toward behavioral research is part of a larger agenda that seeks to transform society in ways that promote health. Health, thanks to the World Health Organization's definition, is now understood to involve physical, mental, and social well-being. Accordingly, a society that denies its humanness, its basic nature as a human community, a community of people, and prefers to think in terms of social or environmental engineering or modification can not be truly healthy. It may not be evident on a daily basis, but those working to understand and respond to human behavior-individual and collective are the great pioneers upon whom the future of health-and our world may well depend. Jonathan Mann, MD, MPH Fram;ois-Xavier Bagnoud Professor ofH ealth and Human Rights Harvard School ofP ublic Health Director, International AIDS Center, Harvard AIDS Institute
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