A researcher from The University of Western Ontario and his co-investigators have been recognized by the U.S. Centres for Disease Control (CDC) for an intervention program they developed to help slow the spread of HIV/AIDS.
The program developed by William Fisher and his collaborators, the "Options/Opciones Project", has been selected to be part of the CDC’s recently released 2008 Compendium of Evidence-based HIV Prevention Interventions. The compendium is a single source of the most promising behavioral interventions in published literature, that have been demonstrated to reduce HIV or STD incidence or risk-related behaviors.
Fisher is a professor of psychology at Western and a professor of obstetrics and gynaecology at Western’s Schulich School of Medicine & Dentistry.
The CDC website outlines the program this way:
Options/Opciones is an individual-level, clinician-delivered HIV risk reduction intervention for HIV-positive persons during their routine clinical care visits and repeated at each visit. The intervention consists of a brief, patient-centered discussion (5-10 minutes) between clinician and patient at each clinic visit. Based on motivational interviewing techniques, clinicians evaluate sexual and drug-use behaviors of HIV-positive patients, assess the patient’s readiness to change risky (or maintain safer) behaviors, and elicit various methods from patients for moving toward change or maintaining safer behaviors. Clinician and patient then negotiate an individually tailored behavior change goal or plan of action, which is written on a prescription pad, for the participant to achieve by the next visit.
Fisher explains that until the late 1990s, prevention programs were aimed primarily at people who were not known to have HIV, rather than focused on supporting prevention among HIV-infected persons.
Today, as individuals with HIV are able to live long and relatively healthy lives, due to the development of effective drugs that halt progression from HIV infection to AIDS, the focus of prevention programs is shifting. The research program Fisher and his colleagues published a few years ago in the Journal of Acquired Immune Deficiency Syndromes, is among the first to link the clinical care of people with HIV, with prevention focused discussions with health care providers.
Their study, with almost 500 HIV-positive people, showed risky behaviour was reduced substantially when people were regularly and collaboratively ‘coached’ during each clinical visit on how to avoid HIV transmission risk behaviors. Their conclusion is that interventions of this kind should be integrated into routine HIV clinical care.
Fisher’s colleagues in the research were three professors from the Center for Health, Intervention, and Prevention at the University of Connecticut, Jeffrey Fisher (William’s brother), Deborah Cornman, and Rivet Amico, as well as Dr. Gerald Friedland, Director of the Yale AIDS Program.
The ‘preventions for positives’ program is now in trials in eight clinical care settings in South Africa, and Cornman has the program running in Uganda and is about to begin one in Ethiopia.