Changing HIV Risk Behavior : Practical Strategies

The devastating course of the AIDS epidemic has shown professionals in the field that education is not enough--even though most Americans are aware of basic facts about HIV transmission, risky sexual behavior and needle use are extremely difficult patterns to change. This is a book about how to help people make changes in behavior to reduce risk for HIV infection. It features eight comprehensive, clearly written chapters that are filled with real-life examples and supplemented by informative tables. Taken together, these chapters provide help to those involved in HIV-prevention in the lifesaving task of providing and reinforcing the technical, cognitive, and interpersonal skills that are necessary for significant behavioral change.

The book opens with a thorough overview of the practical epidemiology of HIV infection and the conceptual underpinnings of this prevention approach. Delineating the major risk behaviors for contracting HIV infection, the author outlines the principles of successful intervention. Although the interventions are similar in their focus on behavior change, the author stresses the importance of tailoring them to the cultural, risk-factor, social, relationship, and lifestyle issues pertaining to different populations, as well as to individual needs.

The book then delineates a range of settings--including inner-city women's health clinics and gay bars--where HIV-prevention programs can be conducted, how HIV prevention can be integrated into the services of community programs, and the nature and format of individual and group interventions. Risk assessment procedures are described including methods to assess clients' present HIV-risk knowledge, readiness for change, situational and life circumstances that contribute to risk, skills needed to effectively implement needed changes, and current risk behavior patterns.

Aided by concrete skills assessments, role plays, and suggested client assignments, readers acquire effective strategies for motivating clients for change; helping them to learn better ways for handling "triggers" that facilitate high-risk behavior. The book also describes how to teach technical skills such as correct condom use and needle-cleaning procedures; interpersonal skills, including sexual assertiveness and safer sex negotiation; and cognitive skills for improving self-confidence about avoiding risk. Moving beyond individual interventions, the final chapter focuses on the role of prevention counselors as change agents for the community and community-level programs.

A critical text for students and professionals in mental health and counseling, substance abuse treatment, the social and health care services, public health, and the AIDS/HIV prevention field, Changing HIV Risk Behavior offers guidance, inspiration, and indispensable tools for building effective risk-reduction intervention programs in the communities where they are needed most.
 

Jeffrey A. Kelly, Ph.D., is Director of the Center for AIDS Intervention Research (CAIR), and Professor of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin in Milwaukee.