The Solution Part One: Testing
The Solution Part Two: Prevention
The second leg of the solution is prevention. In general, effective prevention campaigns are those that seek out and identify the at-risk population (in this case, MSM), and through intervention sessions of some type, seek to lessen high-risk behaviors (Dilley, et al., Katzman, et al., Knauz, et al., Koo, et al., Rhodes, et al., Somerville, et al., Wheeler, et al.).
MSM are frequently targeted in campaigns for HIV prevention and education. One issue that has come up multiple times is the fact that MSM feel as though they are being patronized or criticized for their choice of lifestyle and behavior (Knauz, et al., Lombardo, et al.). It is important when creating such campaigns to keep the focus on the individual, and not to criticize any one population as whole (Lombardo, et al.). Also, short, simple, to-the-point messages seem most effective in getting a point of view across (Lombardo, et al.). A combination of strategic advertising in multiple forms of media will get people aware of the problem, and then through focused group intervention sessions, the problem can be solved (Knauz, et al.).
One effective strategy used in HIV/AIDS prevention campaigns is the popular opinion leader (POL) strategy (Kelly). This strategy seeks to identify and target those in the community to whom members of that community look up, thereby striving to change that community’s behavior by following the influence of the POL. In this case, POLs could also include popular local tech companies, such as Google, Apple, Inc., and Yahoo, all of whom have the money and resources available to aid such an effort and thus lessen the burden on the community for costs. The role of the POLs in this case would be to increase awareness through advertising campaigns, and also to recruit participants to intervention sessions organized and put on by the main HIV prevention center, the Crane Center, and its satellite sites. In terms of adapting it to different racial and ethnic communities, where there may be differences in who would be the POL, this model has also proved effective in the Hispanic/Latino population (Somerville, et al.), a large population in Santa Clara County.
The most effective prevention campaigns have involved focused, individualized modules of prevention, with specific topics for each one, and follow-up visits (Knauz, et al.).
In Santa Clara County, I would like to incorporate aspects of the Project Enhance intervention program (Knauz, et al.), for those who are already HIV positive. Project Enhance is a program that splits up issues that HIV positive MSM face in terms of drug use, social norms, relationships, depression, and partner notification. Although these men already have HIV, this prevention program focused on how these men could reduce high-risk behaviors, and thus cut down on additional infections, and re-infection/super-infection. This project qualitatively identified several men in the pilot group who changed their sexual risk-taking behaviors as a result of the modules. This program could easily be adapted to work in Santa Clara County. The same workbook and training model would be used, with an editing process to adapt it to be effective and relevant to Santa Clara County. To edit the program, people from throughout the community would be needed for input, such as HIV positive peers, doctors, members of the LGBT community in Santa Clara County, and government representatives, forming an HIV/AIDS leadership board. While building this program, care needs to be taken in encouraging men to participate in the program, as it is often difficult to get younger, employed, Caucasian males to participate in programs like these (Senn, et al.).
For those who are not yet HIV positive, the goal becomes identifying those with repeated, long-term high risk behaviors and implementing a good prevention strategy. Because an adaptation of the Project Enhance intervention would be extensive, long-term, and relatively costly, a less costly, but effective method would be used along with that for targeting prevention in Santa Clara County. A “community manifesto” was developed in Seattle (Katzman, et al., 2007), that drew on a similar leadership board to create an open letter to the community that was published in several newspapers and on television over a fifteen-month period. This manifesto’s goal was to emphasize the personal and collective responsibility of gay and bisexual men to stop the spread of STDs and HIV/AIDS.
The leadership board described for Santa Clara County that would adapt a version of Project Enhance would also help adapt a community manifesto for Santa Clara County. A print version would be placed in Santa Clara County’s LGBT center, the Billy deFrank Center (Ramirez, 2007). The manifesto would also be placed in the newsletter, with the aim of drawing in those who identify as MSM, but who may not spend time in the community LGBT center. In addition to the Billy deFrank Center and its newsletter, this manifesto would be placed in the South Bay’s LGBT newspaper, The Point Newspaper (Point Newspaper, 2007) and online at the Gay News Blog (gay news blog, 2007).