A New Approach to Designing and Implementing Evidence-Based HIV Prevention Programs

Introduction: The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally-generated solutions. In this study, we used the concept of “common factors,” or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs.

Methods: We recruited 8 Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content, and determine whether the program met intervention criteria as taught during training.

Results: All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency’s program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs.

Conclusions: We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources.