U.S. prevention strategies focus on involving youths
Strategies include theater, youth planning groups
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With an estimated 20,000 new HIV infections in the United States each year among youth under age 25, there have been many efforts in recent years to find effective prevention programs targeting that population. Among the intervention strategies highlighted in abstracts presented at the 14th International AIDS Conference in Barcelona, Spain, was one that has been developed by AIDS Alliance for Children, Youth & Families of Washington, DC. The strategy incorporates some of the lessons HIV experts have learned about youth prevention strategies, including how to make developmentally appropriate, culturally sensitive programs that are based on science and public health policies on youth and HIV prevention.1
AIDS Alliance has been funded by the Centers for Disease Control and Prevention (CDC) of Atlanta to develop an intervention program for youth that could be easily replicated by community-based organizations (CBOs), says Scott Dano, program specialist. "We will help to improve or develop programs to reach more youths, especially those who are at higher risk for contracting HIV," he says.
The youth programs fall under AIDS Alliance’s Hope Campaign for Youth and are currently in the development and pilot stages. The idea is that CBOs could apply for CDC prevention funding and then ask to be directed to the AIDS Alliance program for assistance. All of the training and travel would be provided at no cost to the CBO, Dano says.
One of the prevention/intervention programs available is called YDREAM, which offers technical assistance and capacity building assistance to CBOs around the country. Specialists help CBOs increase their reach into youth populations, and help CBOs develop a theater-based program that uses young actors and participants.
"We do an interview over the phone and possibly a site visit," Dano says. "If it’s a service we can supply in-house with a theater group, we can do it, or we use one of the consultants we have recruited to go out to the CBO and provide the service." Assistance could be provided for one to six months, depending on the CBO’s needs.
AIDS Alliance obtains theater expertise from NiteStar, an HIV training and education program for adolescents, based in the Center for Comprehensive Care at St. Luke’s-Roosevelt Hospital Center in New York City. The theater-based intervention that NiteStar has developed is called Zip to Script, and it basically uses behavioral science to help youths make better decisions about reducing their own HIV risk, Dano explains.
NiteStar’s method provides information, stimulates thought and discussion, and teaches youth how to change their behavior.2 "I’m a co-presenter of a workshop, and we go into a group of 30 youths, doing some warm-ups, ice-breakers, and introductions," Dano says. "It’s a very active session with very little sitting around."
Other workshop moderators are employees of NiteStar, and they act in the prevention-oriented plays performed for any groups that invite them to appear, including schools, community centers, and churches. Youths attending a workshop also may participate as actors, depending on how the program is designed.
"What we do is bring several people, varying in race and age and gender, to act as moderators, and they’ll explain the exercise and what to do," Dano says. "The actual participants of the workshop will get up and do the acting scene — there’s a lot of improvisational activity in these workshops."
Another youth intervention program that can be replicated is one in which an HIV risk reduction program is combined with some other conference or program aimed at youths, such as a drug and alcohol prevention program. For example, AIDS Alliance was involved in a street outreach workers conference in Austin, TX, in which the topics that were discussed included HIV, safer sex negotiations, and condom use. "We had three groups develop full scenes for the entire group of youths and adults," Dano says. "The groups went off, wrote up their notes, and prepared scenes to present."
One of the benefits of the team approach is that individuals were taught how to be supportive, while providing critiques and recommendations. "They’d say, I really like what you did, but I’m wondering what would happen if you did it this other way,’" Dano explains. "The scenes lasted two to five minutes, and we had three groups that did great scenes."
Another AIDS Alliance program is designed strictly for capacity building as part of the Youth Corps Leadership Program. "We have assessed the needs of youth to participate in community planning groups [CPG]," says Michael Stevens, youth program coordinator. "The CPG process involves local communities having groups of community members of all different backgrounds, including HIV/AIDS prevention folks, church members, school members, and health departments," Stevens says. "What the process does is look at the epidemic in their community and develop with the community a plan to address prevention."
AIDS Alliance is writing an implementation plan for this program, and it will include specific recommendations, divided into bite-sized pieces of activities that youth can do in their communities, Stevens adds. Another aspect of the capacity building project is the Youth 4 HOPE (Health Opportunities Prevention and Education), which brings youth from all over the country together for a training session in Washington, DC.
In a training session held in June 2002, 19 youths from Seattle, San Diego, Detroit, Albany, NY, Boston, and Atlanta participated. They were diverse ethnically and were in the 15-24 age range. Both men, women, and transgender youth participated, and they represented a great deal of diversity with regard to having had prior experience working with HIV interventions.
"The three-day training was based on community mobilization and empowerment, and it had no predefined agenda," Stevens says. "We provided a venue for the youth to come together and discuss what was already going on in their communities and to define discreet action steps for them to take."
The youth decided on specific activities they’d like to do in their communities, and the next step is to implement their action plans with guidance and coordination from AIDS Alliance, Stevens says. "Then we’ll bring them all back in November for a second training session to see how things are going and to provide advanced skills training."
Eventually the Youth 4 HOPE program will be available as a model for other groups, but it’s currently in its infancy stage and will first need to be evaluated, Stevens adds.
References
1. Grosz J, Harvey DC. A new generation at risk: Youth HIV. Presented at the 14th International AIDS Conference. Barcelona, Spain; July 7-12, 2002. Abstract TuPeB4657.
2. Coleman JC, Berlin C, Brenneman J. Using theater-based prevention methods to help decrease new HIV infections in youth. Presented at the 14th International AIDS Conference. Barcelona, Spain; July 7-12, 2002. Abstract TuPeG5634.
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