Preventing AIDS

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.

Contenu

Introduction: The Role of Behavioral Interventions for HIV Prevention; R.J. DiClemente, J.L. Peterson. Theories of Behavior Change: The Health Belief Model and HIV Risk Behavior Change; I.M. Rosenstock, et al. Interventions for Adolescents: SchoolBased Behavioral Interventions to Prevent HIV among Adolescents; D. Kirby, R.J. DiClemente. Interventions for Injection Drug Users: Behavioral Interventions for InTreatment Injection Drug Users; L. Roerich, et al. Interventions for Women: Interventions for Sexual Partners of HIV-Infected or High-Risk Individuals; N.S. Padian, et al. Interventions for Homosexual and Bisexual Men: HIV Prevention for Gay and Bisexual Men in Metropolitan Cities; R. Hays, J.L. Peterson. Conclusion: Lessons Learned from Behavioral Interventions; J.L. Peterson, R.J. DiClemente. 9 additional articles. Index.