A conceptual framework to analyze contextual variables associated with HIV/AIDS and to develop a comprehensive intervention strategy in developing countries.
Int Conf AIDS 1996 Jul 7-12; 11:488 (abstract no. Pub.D.1322) Thomas J, Britto GA, Charles M, Nair KS; Bhardawadi Hospital, Andheri, Bombay, India. Fax: 6249388. E-mail: narc@soochak.ncst.ernet.in.
This paper presents a conceptual framework for analyzing the contextual and behavioral factors that influence the spread of HIV infection and its social and economic impact and to develop a comprehensive intervention strategy. This framework was developed by reviewing the existing literature on contextual and behavioral factors associated with HIV infection and the result of prevention intervention strategies. Also in-depth interviews with field practitioners, persons living with the infection, health activists, field visit to several countries and the field work of the authors have contributed to the development of the framework. The framework presents the interrelationship among the spatial, temporal, biological context and the socio-economic impact of these conditions. Application of this framework in developing a comprehensive intervention program suggests that considering the prolonged nature of the window period of HIV infection and the subsequent bouts of opportunistic infections, care for the infected should also be part of the intervention. All efforts to contain the spread of HIV infection must consider intervention in relation to the distant and immediate factors. These efforts must a) reduce the chances of risk behavior, b) alter the conditions contributing towards risk behavior c) enhance the capacity of the target population to alter the contextual variables and d) programs to reduce the affliction of infection and to enhance the quality of life. It appears that several existing interventions are to be modified to achieve desired effect. The proposed frame work integrating a) information, education, and communication b) health and social services c) supportive social environment d) a strong commitment to human rights and e) community participation are likely to produce better results.
Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Developing Countries, HIV Infections, Risk-Taking, Consumer Participation, Health Services Needs and Demand, Learning, Thinking, Human, nursing, ICA11
