Jean J. E. Bonhomme, MD, MPH, Behavioral Sciences and Health Education Department, Rollins School of Public Health of Emory University, 3915 Cascade Road, Suite 350, Atlanta, GA 30331, (404) 691-7818, jbonhom@sph.emory.edu, Sherene Brown, MPH, Information Technology Support Contract (CITS), CDC, 1600 Clifton Road NE, MS E-46, Atlanta, GA 30333, Sterling Brunson, Program Coordinator, PHIPP Project, AIDS Administration, 500 No. Calvert St., 3rd Floor, Baltimore, MD 21202, Linda S. Danavall, MPH, BSHE, Emory University, Rollins School of Public Health, 3915 Cascade Road, Suite 350, Atlanta, GA 30331, Fred Molitor, ETR Associates, 2210 21st Street, Sacramento, CA 95818, and Damaris A. Richardson, LSW, Division of Health Communications, Maryland Department of Health and Mental Hygiene, 500 N. Calvert Street 5th Floor, Baltimore, MD 21221.

Objective: To examine Prevention with Positives (PWP) as a potentially important strategy for preventing new AIDS cases. As a national demonstration project funding health departments providing PWP interventions from 1998-2003, PHIPP has been able to glean valuable lessons.

Methods: Promising PHIPP PWP strategies include identifying previously unknown HIV+ persons; engaging and retaining persons living with HIV/AIDS (PLWHA) in appropriate healthcare; and risk reduction education designed to empower PLWHA to live fully without spreading HIV.

Results: Risk reduction with PLWHA must be conducted with considerable sensitivity and skill to address their prevention needs supportively and non-judgmentally. Providers and agencies must examine their own attitudes regarding working with diverse PLWHA when engaging them in services. Definition of terms such as PWP, prevention case management, harm reduction, and risk reduction appear to lack standardization among PWP providers and clients, resulting in possible misinterpretation in PWP settings. Public and professional reaction to PWP efforts may question how PWP could benefit persons already infected and how to best motivate PLWHA’s participation in prevention efforts. PLWHA desire and require greater input into PWP program design and implementation. Community-level interventions involving PLWHA can meaningfully address critical PWP issues including stigma and disclosure.

Conclusions: PWP has emerged as an innovative concept for limiting the spread of HIV. Studies measuring effectiveness of specific PWP interventions in different behavioral risk groups, locales and racial/ethnic/gender demographic strata are warranted. Appropriate measures of association could then delineate the relationship between these variables and behavioral risk reduction / health outcomes.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify at least three promising and effective PWP interventions.
• Recognize at least three commonly encountered barriers to PWP implementation.
• Identify at least three approaches that could potentially circumvent existing attitudinal and implementation barriers to PWP activities.

Keywords: HIV/AIDS, Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.