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Purpose of This Module
Behavior ChangeMany approaches to STI and HIV prevention have been used to varying degrees of success. There is a general consensus, however, that successful STI and HIV prevention needs to go beyond information and awareness raising to directly address behavior change. A variety of related and overlapping behavior change theories and paradigms have been used to inform the development of prevention programs and interventions. In general, these theories and paradigms recognize the complexity of human behavior and the myriad psychological, sociocultural, and structural factors that play a role. More recently, increased attention has been given to the idea of looking beyond individual behaviors to the contextual factors (conditions) that make people vulnerable to STI infection (including HIV) and that influence behavior. These include, for example, social norms, gender inequalities, and poverty. In STI prevention, as in other areas of health and behavior, the knowledge-attitude-behavior (KAB) or knowledge-attitude-practice (KAP) continuum is often referred to. It is simply a convenient way to organize the many aspects of knowledge and attitudes that must be present before changes in behavior or practices can occur. Sexual behavior, however, is not easy to change. Simply telling clients that certain behaviors put them at risk for STIs or HIV is generally insufficient. For example, a person must know which practices can put an individual at risk (knowledge), must believe that “people like him or her” can be at risk (attitude), and must believe that he or she is at risk (attitude) before that person can take action to change his or her own behavior (practice). Interventions must be in place to address all three levels, and people must know what to do to protect themselves, must feel that they have the ability to effect change, and must have the skills and resources to do so. Most important, people must have willing partners and a supportive environment.
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In this module, we will discuss key elements of the prevention of STI/RTI
transmission, including information about behavior change, risk and vulnerability,
risk reduction, key elements of counseling, safer sex practices, and integration
of STI services.