Enhancing community-based organizations’ capacity for HIV/AIDS education and prevention

The catalytic potential of community-based organizations to promote health, prevent disease, and address racial, ethnic, and socio-economic disparities in local communities is well recognized. However, many CBOs, particularly, small- to medium-size organizations, lack the capacity to plan, implement, and evaluate their successes. Moreover, little assistance has been provided to enhance their capacity and the effectiveness of technical assistance to enhance capacity is likewise limited. A unique private–academic partnership is described that simultaneously conducted program evaluation and addressed the capacity needs of 24 CBOs funded by the Pfizer Foundation Southern HIV/AIDS Prevention Initiative. Assessments of key program staff members at 12 and 18 months after the initial cross-site program assessment survey indicated a significant improvement in the CBOs’ knowledge, skills, and abilities and a substantial reduction in their technical assistance needs for HIV/AIDS prevention. Full participation of CBOs in technical assistance and a concurrent empowerment evaluation framework were necessary to enhance prevention capacity.     

SAMHSA refers to streamlining in proposed budget cuts

Last week, the Substance Abuse and Mental Health Services Administration (SAMHSA) released its Congressional Justification (CJ), issued by agencies in conjunction with the White House budget request for the next fiscal year. For FY 2020, the White House budget did not request additional money for SAMHSA's Substance Abuse Prevention and Treatment (SAPT) block grant, and included cuts to substance abuse prevention (see ADAW, March 18).     

The Value of Cultural Adaptation Processes: Older Youth Participants as Substance Abuse Preventionists

This National Institutes of Health (National Institute on Drug Abuse) funded study employed focus groups to explore the value of: (a) engaging youth as experts in their own drug culture to engage them in open, honest discussion around substance use in their communities; and (b) allowing youth within a range of settings to systematically recreate unique workbook and video scenarios while maintaining the core components of an evidence-based substance abuse prevention program. Researchers collaborated with community based agencies that serve high risk youth, including youth who were incarcerated, homeless, in alternative high schools, in low-income housing programs, and on the US-Mexico border. The research indicates that high-risk youth in community settings can be actively engaged in adapting evidence-based prevention curricula. Youth emphasized their reasons for using drugs, as well as the salient consequences, and the value of tailored scenarios that incorporate their life experiences, language, drugs of choice, and relevant motivators. Serendipitous findings noted attitude changes related to dissonance between the adaptation component participants’ behaviors and their input as “Preventionists.” Findings have implications for developing prevention strategies that may be helpful for older, high-risk youth.     

White House budget request decimates substance use prevention

The White House budget request for fiscal year 2021 for the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes to zero out a major prevention program — the Strategic Prevention Framework State Incentive Grant — Partnerships for Success program. This is a cut of $109 million. It recommends using the prevention set‐aside (20%) from the Substance Abuse Prevention and Treatment (SAPT) block grant instead. But it doesn't give any more money to the block grant.     

Senate Appropriations Committee hears about funding needs for SAPT block grant

The opioid epidemic is persisting, calling for the need for more funding, according to testimony on Capitol Hill last month. Mark Stringer, director of the Missouri Department of Mental Health and single state authority (SSA) for the state's Substance Abuse Prevention and Treatment (SAPT) block grant. In addition, it's important to transition from opioid‐focused funding to general funding for substance use prevention and treatment in general, via increasing the block grant, he said.     

Structuring a multi-site evaluation for youth mentoring programs to prevent teen alcohol and drug use

Despite mentoring's rapidly increasing popularity as an intervention for the prevention of teen alcohol and drug abuse and associated problems, there is little research consensus on its overall effectiveness or on the core principles and components that define effective mentoring. To advance knowledge concerning this important prevention intervention, the Center for Substance Abuse Prevention has designed and funded a multi-site cooperative agreement involving seven mentoring programs. The programs are designed to provide a rigorous outcome evaluation that allows comparisons of differing approaches to organizing and delivering mentoring services to adolescents at high risk for substance abuse. The cooperative agreement guidelines set service parameters and options that focus on issues that are grounded in past research on mentoring prevention interventions. The cooperative agreement includes a quasi-experimental, longitudinal multi-site evaluation that provides evidence-based recommendations to advance the effective use of mentoring as a prevention strategy.     

President's proposed budget would slash treatment and prevention funding

We had a feeling of déjà vu when the White House sent its proposed budget to Congress last week. Similar to past years, the Office of National Drug Control Policy (ONDCP) would be decimated, moving the $100 million Drug‐Free Communities program to the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). There's no additional money in the Substance Abuse Prevention and Treatment (SAPT) block grant and cuts to the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, CSAP and SAMHSA's Center for Substance Abuse Treatment.     

Civil Citations for Cannabis Possession: Alternatives to Arrest for Adolescent Substance Use

Results from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) have indicated that approximately 8% of responding adolescents ages 12–17 engaged in illicit substance use during the past year; the most commonly reported substance used was marijuana (Substance Abuse and Mental Health Services Administration (SAMHSA), NSDUH series H-44, HHS publication no. (SMA) 12-4713, Substance Abuse and Mental Health Services Administration, Rockville, MD, 2012). Importantly, marijuana use places adolescents at risk of arrest when found in possession of cannabis. Drug abuse violations are associated with multiple consequences for the youth, their families, and communities. Policy makers, therefore, have encouraged the use of civil citations to reduce drug abuse related arrests for youth. Purpose: The current study sought to identify and describe civil citations use for youth marijuana possession. Methods: Using a secondary dataset, we examined aggregate arrests in a Central Florida county. Results: During a 3-year period, 1635 arrests were made for cannabis possession. The vast majority of such arrests were for multiple charges (n?=?1272; 78%). For those arrested due to cannabis possession alone (n?=?363; 22%), over 75% were adults (n?=?281). Therefore, only 82 youth were arrested under the charge, accounting for less than one quarter of all arrests for F.S. §893.13.6b (2013). However, the majority of these youth were detained in juvenile assessment centers (65%, n?=?59); a rate markedly higher than their adult counterparts (37%, n?=?105). Discussion: Due to the concerns associated with arrest and detainment, the authors contend efforts should be made to increase use of civil citations for youth with cannabis possession when possible. Implications for policy are presented.     

AIDS Prevention via Computer-Based Intervention

The dangers posed by AIDS and the human immunodeficiency virus (HIV) are well known. Government, media, and medical organizations have provided extensive information on AIDS and on how to protect oneself against infection. Nevertheless, this fatal and irreversible disease continues to claim new victims. Clearly, there is an urgent need to develop new methods of educating the public about AIDS prevention. This paper reviews a new, interactive microcomputer approach to educating at-risk adolescents about AIDS. Emphasizing culturally sensitive and interactive approaches to prevention, the authors describe, illustrate, and assess interactive strategies and computer-based content for reducing the risks of AIDS and HIV among Black and Hispanic youth.     

Adaptation to unemployment: Effects of a mine closure on husbands and wives

The purpose of this study was to increase understanding of how individuals/couples respond to the unemployment of the primary breadwinner. Data were collected from 66 individuals (33 couples) shortly after becoming unemployed and again one year later. Results determined that the significant predictor variables of economic satisfaction, marital adjustment, and depression were primarily economic, marital, and emotional variables, respectively. Findings also showed that interaction existed among economic, marital, and emotional variables in predicting the three well-being outcomes. Additionally, differences were found in the pattern of results for husbands and for wives. Based on these findings, areas and hypotheses for future study are proposed.Carl A. Ridley received his Ph.D. from Florida State University. He is a Professor in the Division of Child Development and Family Relations, University of Arizona, Tucson, AZ 85721. His research interests include relationships and conflict management.Mari S. Wilhelm received her Ph.D. from Michigan State University. She is an Assistant Professor in the School of Family and Consumer Resources, University of Arizona, Tucson, AZ 85721. Her research interests include financial management, socio-economic stress, financial stress and problems.     

Transferring a University-Led HIV/AIDS Prevention Initiative to a Community Agency

Summary

Given the urgent need for HIV/AIDS interventions that will reverse current infection trends among urban minority youth, identifying effective and socially relevant approaches is of primary concern. HIV/AIDS prevention initiatives that are housed in, and led by, communities may address the limits of laboratory-based inquiry for this complex and socially-situated health issue. In this article, we describe the process of moving a researcherled, HIV/AIDS prevention research program—the Collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP)—from a university laboratory to a community mental health agency with the goal of strengthening program access, effectiveness, and sustainability over time. We outline the framework, timeline, and responsibilities involved in moving the program, research, and technology from its original university base to a local community agency. From the challenges faced and lessons learned during this complex transfer process, we hope to enhance understanding of ways in which we can narrow the gap between academic and community leadership of HIV/AIDS prevention research.     

Disseminating science-based prevention: lessons learned from CSAP's CAPTs

A wide variety of prevention approaches that reduce substance use and associated problems have been developed and tested. But successes have been limited in promoting the use of these scientific advances by the policy makers, practitioners, and concerned citizens. The Center for Substance Abuse Prevention's six regional Centers for the Application of Prevention Technologies (CSAP's CAPTs) are a major mechanism by which CSAP brings research to practice. This article synthesizes the issues that the CAPTs have faced, the solutions they have developed, and conclusions concerning the work that still needs to be done to increase the application of science-based approaches to prevention. These discussions highlight the particular importance of addressing issues related to the larger systems in which prevention programs and strategies operate.     

Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their Families

Summary

This article describes a family-based HIV prevention and mental health promotion program specifically designed to meet the needs of perinatally-infected preadolescents and their families. This project represents one of the first attempts to involve perinatally HIV-infected youth in HIV prevention efforts while simultaneously addressing their mental health and health care needs. The program, entitled CHAMP+ (Collaborative HIV Prevention and Adolescent Mental Health Project-Plus), focuses on: (1) the impact of HIV on the family; (2) loss and stigma associated with HIV disease; (3) HIV knowledge and understanding of health and medication protocols; (4) family communication about puberty, sexuality and HIV; (5) social support and decision making related to disclosure; and (6) parental supervision and monitoring related to sexual possibility situations, sexual risk taking behavior and management of youth health and medication. Findings from a preliminary evaluation of CHAMP+ with six families are presented along with a discussion of challenges related to feasibility and implementation within a primary health care setting for perinatally infected youth.     

Exploring the implementation of justice-based alcohol and drug intervention strategies with juvenile offenders: Reclaiming Futures,enhanced adolescent substance abuse treatment,and juvenile drug courts

There is a need for practice models to match young people in the juvenile justice system with timely and effective alcohol and drug intervention services. This paper reports on a new demonstration effort in which three practice approaches currently operating in the United States are being combined to maximize the potential of each. This public–private partnership combines juvenile drug courts (funded by the Office of Juvenile Justice and Delinquency Prevention), adolescent treatment improvement efforts (funded by the Center for Substance Abuse Treatment) and the Reclaiming Futures initiative (funded by the Robert Wood Johnson Foundation). Benefits of combining the three strategies are discussed, emergent implementation challenges and lessons are presented, and suggestions for further evolution are provided.     

Senators call for $2 billion in supplemental SAMHSA funding

As the fourth stimulus bill, the HEROES Act, awaits action by the Senate, 19 senators sent a letter last week to Senate and House leadership calling for increased investments in substance use disorder programs during the COVID‐19 pandemic. The letter, from Senators Tammy Baldwin (D‐Wisconsin) and Jeanne Shaheen (D‐New Hampshire), along with 17 other senators (all Democrats), calls for “$2 billion in funding for the Substance Abuse and Mental Health Services Administration (SAMHSA) to administer supplemental grant allocations under the Substance Abuse Prevention and Treatment (SAPT) Block Grant program and the State Opioid Response (SOR) grant program.”     

Treatment is Prevention

The past 15 years have seen the waning of both cultural analysis and activism dedicated to HIV/AIDS prevention, especially in relation to the enduring epidemic in the United States. However, current mutations in the American HIV prevention landscape, driven by the biomedical promise of a ‘Test and Treat’ strategy, are producing potentially destructive outcomes for vulnerable and dispossessed communities, a situation that demands renewed investment from cultural critics. The aim of this article is to mobilize a specific strand of biopolitical theory (Foucault, Agamben, Esposito) to examine recent federally orchestrated prevention measures dedicated to a scale-up and integration of HIV testing, treatment and ‘linkage to care’, in order to move beyond their reductive approach to the preservation of life and advance a more capacious, politically engaged prevention model rooted in communal rather than individual forms of immunity. Based on my ethnographic fieldwork in Baltimore, MD, I attend to ways in which local HIV prevention initiatives are courting the city's precarious Ballroom community – a kinship system of black queer youth structured around competitive dance and performance – in an attempt to materialize their ‘target population’ for testing purposes. Previously neglected by governmental and medical institutions, members of the Ballroom community now find themselves addressed as responsible sexual citizens who are expected to protect their bodies by getting tested and, if tested positive, start treatment. Yet, this emphasis on the medical rights and responsibilities of HIV positive youth threatens to abandon large groups of youth who have managed to stay uninfected. I conclude by locating this problem in the incongruity between the biological life protected by current ‘Test and Treat’ strategies and the forms of life that allow the Ballroom community to persevere under often dire circumstances, constituting an indigenous resource for an alternative take on HIV prevention     

Interventions to Developing Community Partnerships for HIV Prevention Planning

Abstract

Since 1985 the Centers for Disease Control and Prevention (CDC) have entered into a series of cooperative agreements with the states and territories of the United States to fund human immunodeficiency virus (HIV) prevention activities. In 1994, the CDC mandate shifted from using a central entity to plan HIV prevention programs throughout its jurisdictions to fostering partnerships among a central state or territorial agency, health departments in local counties, and community-based organizations. This article discusses and applies a model developed by social workers to facilitate HIV prevention community planning at the local level. The model used to facilitate community planning emphasizes the use of the social principles of empowerment, self-determination, ownership, and inclusion to foster the development of community-relevant HIV prevention plans. This approach resulted in the completion of a successful HIV prevention plan, and application for continuing and supplemental funds ($6.6 million and $1.2 million respectively) from the CDC for HIV prevention efforts, the continued use of the model in HIV prevention planning, and the ability to use the principles of the model as a basis for providing future technical assistance in community planning.     

Adolescent Substance Use Prevention Interventions Outside of Classroom Settings

Substance use prevention programs empowering individual adolescents to resist substance use through education and skills training are crucial to reducing substance use within this population. However, existing programs of this type are designed primarily for classroom use, and may not meet the needs of social workers intervening with adolescents outside classroom settings. A literature review identified six programs that have demonstrated statistically significant reductions in substance use when implemented outside the classroom. The current study describes these programs, identifies their common characteristics, and draws on additional prevention research to outline recommendations for practitioners seeking to apply the field’s most current knowledge base in community settings.     

Chapter 10: Issues in HIV/AIDS Service Delivery to High Risk Youth

Homeless and runaway youth engage in behavior that puts them at risk for infection with HIV, the virus that causes AIDS. Prevalence of HIV disease in homeless and runaway youth is higher than it is among other adolescents. In addition, homeless and runaway youth are often forced to engage in sex as a means of survival. Although they engage in high risk behavior, AIDS education programs have neglected them as a target group for education. To some extent, they have been included in other more general categories of persons with AIDS risk behaviors, such as men who have sex with men or intravenous drug users. However, the number of adolescents receiving age-specific HIV/AIDS information is far below the number infected (Hein et al., 1992). Often high risk youth are disenfranchised, having been forced from home by their families after disclosing their gay or lesbian identities. Lacking a political voice and having no spokesperson, they represent a group with complex unmet needs. These youth typically have immediate needs for food, shelter, and clothing. In addition, they often need medical management, mental health and drug counseling, crisis management, and HIV/AIDS information. These needs are often overwhelming to the agencies that serve youth. This article examines the barriers and issues that exist in providing services to high risk youth. Then, suggsetions for removing those barriers by empowering both service providers and youth are offered. Some of the suggestions are based upon the authors' own experience in providing HIV/AIDS in-service training to service providers to high risk youth. The article makes recommendations for policy on youth and HIV/AIDS.     

Potential Roles of Black Churches in HIV/AIDS Prevention

Abstract

This study examines the role of Black churches in AIDS/HIV prevention. This is a pilot survey study design administered to 11 churches represented by 11 ministers and one church member. The analysis is both qualitative and quantitative. The results showed that most of the ministers had spoken with their congregation on HIV/AIDS. A few ministers had previously sponsored or taken part in HIV/AIDS workshops and disseminated HIV/AIDS educational material in the African American community. None of the churches had an established HIV/AIDS prevention program. Most of the ministers were receptive to implementing an HIV/AIDS prevention program, provided that it did not violate the church doctrines. The findings in this study suggest that Black churches represent an important potential resource for HIV/AIDS prevention. For success, the initial strategy should involve the minister in the early planning stage. Future research should focus on expanding the scope of this study and improving communication between the church, community-based organizations, and health professionals.