AIDS and Behavior

, Volume 13, Issue 3, pp 430–448 | Cite as

A Review of HIV/AIDS System-Level Interventions

  • José A. Bauermeister
  • Susan Tross
  • Anke A. Ehrhardt
Review Paper

Abstract

The escalating HIV/AIDS epidemic worldwide demands that on-going prevention efforts be strengthened, disseminated, and scaled-up. System-level interventions refer to programs aiming to improve the functioning of an agency as well as the delivery of its services to the community. System-level interventions are a promising approach to HIV/AIDS prevention because they focus on (a) improving the agency’s ability to adopt evidence-based HIV prevention and care programs; (b) develop and establish policies and procedures that maximize the sustainability of on-going prevention and care efforts; and (c) improve decision-making processes such as incorporating the needs of communities into their tailored services. We reviewed studies focusing on system-level interventions by searching multiple electronic abstracting indices, including PsycInfo, PubMed, and ProQuest. Twenty-three studies out of 624 peer-reviewed studies (published from January 1985 to February 2007) met study criteria. Most of the studies focused on strengthening agency infrastructure, while other studies included collaborative partnerships and technical assistance programs. Our findings suggest that system-level interventions are promising in strengthening HIV/AIDS prevention and treatment efforts. Based on our findings, we propose recommendations for future work in developing and evaluating system-level interventions.

Keywords

Systems Structural Social intervention HIV/AIDS Review 

References

  1. Alter, C., & Hage, J. (1993). Organizations working together. Thousand Oaks, California: Sage Publishers.Google Scholar
  2. Ball, A. M. (2006). Making the connections: AIDS and water. Canadian Journal of Public Health, 97(1), 56–59.Google Scholar
  3. Bastos, F. I., & Strathdee, S. A. (2000). Evaluating effectiveness of syringe exchange programmes: current issues and future prospects. Social Science & Medicine, 51, 1771–1782.CrossRefGoogle Scholar
  4. Beyer, J., & Trice, H. M. (1978). Implementing change: Alcoholism policies in work organizations. New York: Free Press.Google Scholar
  5. Bingenheimer, J. B., & Raudenbush, S. W. (2004). Statistical and substantive inferences in Public Health: Issues in the application of multilevel models. Annual Review of Public Health, 25, 53–77.PubMedCrossRefGoogle Scholar
  6. Blank, S., Gallagher, K., Washburn, K., & Rogers, M. (2005). Reaching out to boys at bars: Utilizing community partnerships to employ a wellness strategy for syphilis control among men who have sex with men in New York City. Sexually Transmitted Diseases, 32(10), S65–S72.PubMedCrossRefGoogle Scholar
  7. Blankenship, K. M., Bray, S. J., & Merson, M. H. (2000). Structural interventions in public health. AIDS, 14(suppl. 1), S11–S21.PubMedCrossRefGoogle Scholar
  8. Bluespruce, J., Dodge, W. T., Grothaus, L., Wheeler, K., Rebolledo, V., Carey, J. W., McAfee, T. A., & Thompson, R. S. (2001). HIV prevention in primary care: Impact of a clinical intervention. AIDS Patient Care and STDs, 15(5), 243–253.PubMedCrossRefGoogle Scholar
  9. Bolman, L. G. & Deal, T. E. (2003). Introduction: The Power of Reframing. In Reframing organizations: Artistry, choices, and leadership (3rd ed., pp. 3–17). San Francisco: Jossey-Bass.Google Scholar
  10. Cason, C., Orrock, N., Schmitt, K., Tesoriero, J., Lazzarini, Z., & Sumartojo, E. (2002). The impact of laws on HIV and STD prevention. The Journal of Law, Medicine & Ethics, 30(3), 139–145.Google Scholar
  11. Dill, A. (1994). Institutional environments and organizational responses to AIDS. Journal of Health and Social Behavior, 35(4), 349–369.PubMedCrossRefGoogle Scholar
  12. Druce, N., Dickinson, C., Attawell, K., White, A. C., & Standing, H. (2006). Strengthening linkages for sexual and reproductive health, HIV and AIDS: progress, barriers and opportunities for scaling up: Final Report. Health Resource Center, UK Department for International Development: London. http://www.dfidhealthrc.org/publications/srh.html. Accessed 9 April 2007
  13. Exner, T. M., Seal, D. W., & Ehrhardt, A. A. (1997). A review of HIV interventions for at-risk women. AIDS and Behavior, 1(2), 93–124.CrossRefGoogle Scholar
  14. Goodman, R. M., & Steckler, A. (1989). A framework for assessing program institutionalization. Knowledge in Society: The International Journal of Knowledge Transfer, 2(1), 52–66.Google Scholar
  15. Grosskurth, H., Mosha, F., Todd, J., Senkoro, K., Newell, J., Klokke, A. et al. (1995). A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: Baseline survey results. AIDS, 9, 927–934.Google Scholar
  16. Harshbarger, C., Simmons, G., Coelho, H., Sloop, K., & Collins, C. (2006). An empirical assessment of implementation, adaptation, and tailoring: The evaluation of CDC’s national diffusion of VOICES/VOCES. AIDS Education and Prevention, 18(Suppl. A), 184–197.PubMedCrossRefGoogle Scholar
  17. Hayes, R., Mosha, F., Nicoll, A., Grosskurth, H., Newell, J., Todd, J., et al. (1995). A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tazania: Design. AIDS, 9, 919–926.PubMedCrossRefGoogle Scholar
  18. Hoffman, S., Exner, T. M., Leu, C. S., Ehrhardt, A. A., & Stein, Z. (2003). Female condom use in a gender-specific family planning clinic trial. American Journal of Public Health, 93, 1897–1903.PubMedCrossRefGoogle Scholar
  19. Hoy, W. K., & Miskel, C. G. (1987). Educational administration: Theory, research, and practice (3rd ed.). New York: Random House.Google Scholar
  20. Janz, N. K., Zimmerman, M. A., Wren, P. A., Israel, B. A., Freudenberg, N., & Carter, R. J. (1996). Evaluation of 37 AIDS prevention projects: Successful approaches and barriers to program effectiveness. Health Education & Behavior, 23(1), 80–97.CrossRefGoogle Scholar
  21. Jenkins, R. A., & Carey, J. W. (2005). Decision making for HIV prevention planning: Organizational considerations and influencing factors. AIDS and Behavior, 9(2), S1–S8.PubMedCrossRefGoogle Scholar
  22. Johnson, W. D., Hedges, L. V., & Diaz, R. M. (2003). Interventions to modify sexual risk behaviors for preventing HIV infection in men who have sex with men. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD001230. doi:10.1002/14651858.CD001230.
  23. Johnson-Masotti, A. P., Pinkerton, S. D., Holtgrave, D. R., Valdiserri, R. O., & Willingham, M. (2000). Decision-making in HIV prevention community planning: An integrative review. Journal of Community Health, 25(2), 95–112.PubMedCrossRefGoogle Scholar
  24. Katz, D., & Kahn, R. (1978). The social psychology of organizations (2nd ed.). New York: Wiley.Google Scholar
  25. Kelly, J. A., Somlai, A. M., Benotsch, E. G., Amirkhanian, Y. A., Fernandez, M. I., Stevenson, L. Y., et al. (2006). Programmes, resources, and needs of HIV-prevention nongovernmental organizations (NGOs) in Africa, Central/Eastern Europe and Central Asia, Latin America and the Caribbean. AIDS Care, 18(1), 12–21.PubMedCrossRefGoogle Scholar
  26. Kelly, J. A., Somlai, A. M., Benotsch, E. G., McAuliffe, T. L., Amirkhanian, Y. A., Brown, K. D., et al. (2004). Distance communication transfer of HIV prevention interventions to service providers. Science, 305, 1953–1955.PubMedCrossRefGoogle Scholar
  27. Kelly, J. A., Somlai, A. M., DiFranceisco, W. J., Otoo-Salaj, L. L., McAuliffe, T. L., Hackl, K. L., et al. (2000). Bridging the gap between the science and service of HIV prevention: Transferring effective research-based HIV prevention interventions to community AIDS service providers. American Journal of Public Health, 90(7), 1082–1088.PubMedCrossRefGoogle Scholar
  28. Klein, S. J., O’Connell, D. A., Devore, B. S., Wright, L. N., & Birkhead, G. S. (2002). Building an HIV continuum for inmates: New York State’s criminal justice initiative. AIDS Education and Prevention, 14(Suppl. B), 114–123.PubMedCrossRefGoogle Scholar
  29. Koenig, S. P., Léandre, F., & Farmer, P. E. (2004). Scaling-up HIV treatment programmes in resource-limited settings: the rural Haiti experience. AIDS, 18(Suppl. 3), S21–S25.PubMedCrossRefGoogle Scholar
  30. Lazzarini, Z., & Klitzman, R. (2002). HIV and the law: Integrating law, policy, and social epidemiology. Journal of Law, Medicine & Ethics, 30, 533–547.CrossRefGoogle Scholar
  31. Lipsey, M. W., & Cordray, D. S. (2000). Evaluation methods for social intervention. Annual Review of Psychology, 51, 345–375.PubMedCrossRefGoogle Scholar
  32. Lyles, C. M., Kay, L. S., Crepaz, N., Herbst, J. H., Passin, W. F., Kim, A. S., et al. (2007). Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000–2004. American Journal of Public Health, 97(1), 133–143.PubMedCrossRefGoogle Scholar
  33. Mayaud, P., Mosha, F., Todd, J., Balira, R., Mgara, J., West, B., et al. (1997). Improved treatment services significantly reduce the prevalence of sexually transmitted diseases in rural Tanzania: Results of a randomised controlled trial. AIDS, 11, 1873–1880.PubMedCrossRefGoogle Scholar
  34. Mitchell, C. G., Perloff, J., McVicker, J., Ebbert, S., Petersen, L., & Oltean, A. (2005). Integrating prevention in residential and community care settings: A multidimensional program evaluation. AIDS Education and Prevention, 17(Suppl. A), 89–101.PubMedCrossRefGoogle Scholar
  35. Molitor, F., Kuenneth, C., Waltermeyer, J., Mendoza, M., Aguirre, A., Brockmann, K., & Crump, C. (2005). Linking HIV-infected persons of color and injection drug users to HIV medical and other services: The California Bridge Project. AIDS Patient Care, 19(6), 406– 412.CrossRefGoogle Scholar
  36. Morrill, A. C., Amaro, H., Blake, S. M., Cranston, K., Averbach, A. R., Logan, J. A., Dai, J., Krech, L., & Dunn, S. (2005). HIV prevention community planning: Enhancing data-informed decision-making. AIDS and Behavior, 9(2), S55–S70.PubMedCrossRefGoogle Scholar
  37. National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial Group (1998). The NIMH multisite HIV prevention trial: Reducing HIV sexual risk behavior. Science, 280, 1889–1894.CrossRefGoogle Scholar
  38. Parry, M. F., Stewart, J., Wright, P., & McLeod, G. X. (2004). Collaborative management of HIV infection in the community: an effort to improve the quality of HIV care. AIDS Care, 16(6), 690–699.PubMedCrossRefGoogle Scholar
  39. Peltzer, K., Mngqundaniso, N., & Petros, G. (2006). A controlled study of an HIV/AIDS/STI/TB intervention with traditional healers in KwaZulu-Natal, South Africa. AIDS and Behavior, 10, 683–690.PubMedCrossRefGoogle Scholar
  40. Perez, F., Orne-Gliemann, J., Mukotekwa, T., Miller, A., Glenshaw, M., Mahomva, A., & Dabis, F. (2004). Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe. BMJ, 329, 1147–1150.PubMedCrossRefGoogle Scholar
  41. Peterson, A. S., & Randall, L. M. (2006). Utilizing multilevel partnerships to build the capacity of community-based organizations to implement effect HIV prevention interventions in Michigan. AIDS Education and Prevention, 18(Suppl. A), 83–95.PubMedCrossRefGoogle Scholar
  42. Poindexter, C. C., Lane, T. S., & Boyer, N. C. (2002). Teaching and learning by example: Empowerment principles applied to development, delivery, and evaluation of community-based training for HIV service providers and supervisors. AIDS Education and Prevention, 14(5), 391–400.PubMedCrossRefGoogle Scholar
  43. Prochaska, J. O., Redding, C. A., & Evers, K. E. (2002). The Transtheoretical Model and Stages of Change. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 99–120). San Francisco: Jossey-Bass.Google Scholar
  44. Ramos, R. L., & Ferreira-Pinto, J. B. (2002). A model for capacity-building in AIDS prevention programs. AIDS Education and Prevention, 14(3), 196–206.PubMedCrossRefGoogle Scholar
  45. Rapkin, B., & Trickett E. (2005). Comprehensive dynamic trial designs for behavioral prevention research with communities: Overcoming inadequacies of the randomized controlled trial paradigm. In E. Trickett & W. Pequenaut (Eds.), Increasing the community impact of HIV prevention interventions (pp. 249–277). New York: Oxford University Press.Google Scholar
  46. Raudenbush, S. W., & Bryk, A. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks, California: Sage Publications.Google Scholar
  47. Richie, B. E., Freudenberg, N., & Page, J. (2001). Reintegrating women leaving jail into urban communities: A description of a model program. Journal of Urban Health: Buelleting of the New York Academy of Medicine, 78(2), 290–303.CrossRefGoogle Scholar
  48. Richter, D. L., Potts, L. H., Prince, M. S., Dauner, K. N., Reininger, B. M., Thompson-Robinson, M., et al. (2006). Development of a curriculum to enhance community-based organizations’ capacity for effective HIV prevention programming and management. AIDS Education and Prevention, 18(4), 362–374.PubMedCrossRefGoogle Scholar
  49. Rossi, P. H. (1997). Program outcomes: conceptual and measurement issues. In E. J. Mullen & J. Magnabosco (Eds.), Outcome and measurement in the human services: Cross-cutting issues and methods Washington, DC:Natl. Assoc. Social Workers.Google Scholar
  50. Shea, M. A., Callis, B. P., Cassidy-Stewart, H., Cranston, K., & Tomoyasu, N. (2006). Diffusion of effective HIV prevention interventions—Lessons learned from Maryland and Massachusetts. AIDS Education and Prevention, 18(Suppl. A), 96–107.PubMedCrossRefGoogle Scholar
  51. Shinn, M. (1990). Mixing and matching: Levels of conceptualization, measurement, and statistical analysis in community research. In P. Tolan, C. Keys, F. Chertok, & L. Jason (Eds.), Researching community psychology: Issues of theory and methods (pp. 111–126). Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
  52. Steckler, A., Goodman, R. A., & Kegler, M. C. (2002). Mobilizing organizations for health enhancement. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (pp. 335–360). San Francisco: Jossey-Bass.Google Scholar
  53. Takahasi, L. M., Candelario, J., Young, T., & Mediano, E. (2007). Building capacity for HIV/AIDS prevention among Asian Pacific Islander organizations: The experience of a culturally appropriate capacity-building program in southern California. Journal of Public Health Management and Practice, 1(Suppl.), S55–S63.Google Scholar
  54. Volmink, J., Siegfried, N. L., van der Merwe, L., & Brocklehurst, P. (2002). Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD003510. doi:10.1002/14651858.CD003510.pub2.
  55. Weimer, D. L., & Vining, A. R. (1999). Policy analysis: Concepts and practice (3rd ed.). Englewood Cliffs: New Jersey, Prentice Hall.Google Scholar
  56. Xiaoming, S., Yong, W., Choi, K. H., Lurie, P., & Mandel, P. (2000). Integrating HIV prevention education into existing family planning services: Results of a controlled trial of a community-level intervention for young adults in rural China. AIDS and Behavior, 4(1), 103–110.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • José A. Bauermeister
    • 1
  • Susan Tross
    • 1
  • Anke A. Ehrhardt
    • 1
  1. 1.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute, and Columbia UniversityNew YorkUSA

Personalised recommendations