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Problem/Need statement:
An estimated 1.2 million Americans are living with HIV, and 1 out of 8 people with HIV do not
know they have it.1 HIV infections in the United States continue to be a major public health
crisis. HIV has remained in the top 10 global leading causes of death.1 Although annual HIV
infections have declined by 18% in the United States from 2008 to 2014, HIV continues to
spread and progress has been uneven and diagnoses are still increasing among groups, such as
youth, young adults, African Americans, Hispanic/Latinos, and men who have sex with men.1 In
2015, youth aged 13 to 24 accounted for 22% of all new HIV diagnoses in the United States.2
Most of those new HIV diagnoses among youth occurred among gay and bisexual males at 81%.2
More specifically young African American and Hispanic/Latino males are especially affected
Goals:
The Be In The Know Program is a HIV prevention and education program targeting youth and
young adults to reduce the risk of transmitting HIV/AIDS. The overall goal of this program is to
create a successful health promotion program to increase HIV awareness and education among at
risk youth and young adults. The underlying goal is to reduce the transmission of HIV and
promote safe sex among the target population.
Objectives:
By June 2018, at least 75% of participants will be adequate in sexual health education, as
determined by pre and post tests.
At the end of the program, 75% of participants will retain their sexual health education.
By June 2018, 55% of program participants who have attended condom demonstration
classes will have the desire to use condoms each time they have sexual intercourse,
measured by a posttest.
At the end of the program, at least 60% of participants will have gotten tested for HIV,
measured by number of HIV test completed.
65% of participants will report consistently engaging in condom use during sex.
By 2020, more than 80% of program participants have engaged in a HIV prevention
method reducing their risk for HIV.
The Be In The Know Program is partnered with Triad Health Project, an initiative by the
Guilford County Health Department. Triad Health Project is a local initiative established to
advocate locally, regionally, and nationally for individuals and groups infected with or affected
by HIV/AIDS. Triad Health Project provides emotional and practical support to individuals
living with HIV/AIDS, to their loved ones, and to those at risk for HIV/AIDS; and implements
strategies to educate the community of HIV/AIDS.
For more information on the Be In The Know Program and ways to become involved, contact
Jessica Lineburg at jrlineburg@liberty.edu or visit the website at
www.hivbeintheknow.weebly.com.
The primary target audience of the Be In The Know Program is youth and young adults at risk for
contracting HIV in Guilford County, North Carolina. More details on this population are
provided below:
Behavioral: Youth and young adults potentially have higher rates in risky sexual health
behaviors (unprotected sex, higher number of sex partners, drinking); In 2015 data, nearly
half of sexually active students did not use a condom the last time they had sex.2
Cultural: Ages 13 to 24 accounted for more than 1 in 5 new HIV diagnoses in 2015.2
Young black/African American and Hispanic/Latino males are affected by HIV the most.
Black/AA represented 62.1% of HIV infections in North Carolina in 2016.3
Demographic: Young adults employed are more affected than individuals undeployed.
43% of young adults employed in the U.S. have HIV, 44% are high school graduates.4
Physical: Males seem to be more affected by HIV than females. In Guilford County, males
had 79.3% HIV infection cases.5
Psychographic: Youth and young adults at risk for HIV perceive they are not susceptible
to HIV. Spontaneity of sexual encounters, not feeling at risk of HIV, and partner-related
perceptions are associated with not using a condom during sexual intercourse.
Audience: The Be In The Know Program will focus on youth and young adults at high-risk for
HI, including young men who have sex with men (YMSM).
Action (Message): The program offers a combination of street outreach, counseling, free
HIV/STI screenings and risk reduction techniques to promote safer and healthier behavior. Once
the intended audience has been introduced to the program, participants should have the skills and
willingness to practice safe sexual behaviors to prevent the spread of HIV.
Barriers: Perceived susceptibility, stigma, lack of condom use, inadequate sex education and
misinformation are barriers that may stand in the way of the young and young adults practicing
safer sex or reducing their risk of HIV.
Benefits: A major benefit for the participants of the program is increasing knowledge on how to
prevent contracting HIV, a virus that affects the immune system.
Credentials: Taking action, like using a condom consistently and correctly can lower the chances
of transmitting HIV. Increasing knowledge on HIV prevention and using those prevention
methods can increase quality of life for at risk individuals, despite the barriers that may stand in
the way.
Channel: To reach the youth and young adults, the program will use popular social media sites
such as Facebook, Twitter, Instagram, and Snapchat to convey intended messages.
The secondary target audience for this intervention is the direct support of friends and family
members. The environment and social relationships with family and friends has the potential to
influence an individuals behavior and experiences. Support from loved ones can enhance an
individuals perceived self-efficacy towards engaging in safe sexual health behaviors.
Audience: The secondary target audience for the Be In The Know Program will be focused on
friends and family members of youth and young adults who have an increased risk for HIV.
Action (Message): Friends and family members will help to highlight the importance of
practicing safe sex and HIV testing. The support from friends and family can be a great influence
towards an individuals health status.
Barriers: Barriers within the secondary target audience can include lack of support, perceived
severity among themselves, and lack of knowledge.
Benefits: Family and friends influence youth and young adults to take action and lower risk of
HIV. A benefit of the secondary target audience is to gain knowledge for themselves.
Credentials: Family and friends utilizing the programs services help youth and young adults
enhance self-efficacy as well as become more educated on HIV to prevent their risk of HIV.
Channel: This audience will be reach through social media sites such as Facebook, Twitter,
Instagram, as well as during promotion of events for program participants, and flyers.
Pretest strategy
Pretesting the intended audience will be performed by questionnaires and one-on-one interviews.
The questionnaire will comprise of both qualitative and quantitative components. The
questionnaire will ask the participants the number of times they engage in specific activities such
as safe or unsafe sex or how many times they have been tested for HIV. Qualitative data will be
focused on attitudes, personal beliefs, and current knowledge about HIV prior to the start of the
program. Results from the questionnaires and interviews will be used to collect data of
participants risk level and knowledge of HIV to provide effective program strategies.
Theoretical foundation
Be in The Know will use the health belief model as a framework for the program. The health
belief model (HBM), was designed to explain individual-level theory of health behavior change.6
Variables that impact health-related behaviors of the intended audience for this program include,
age, gender, environment, and other social variables. Be in The Know will apply core concepts of
the health belief model to increase the number of youth and young adults engaging in safe sexual
behaviors by changing their beliefs about their perceived susceptibility and the severity of HIV.
The perceptions that make up the health belief model include:6
The HBM is designed to motivate individuals to act to avoid a negative health consequence (i.e.
HIV/AIDS).6 To take action, motivation to change is needed to avoid the development and
progression of HIV.
Management chart
The program intervention will last 24 months, including planning, development stages, program
implementation and evaluation. Personnel involved with the Be In The Know Program includes,
Health Care Professionals (Community Health Educators, Phlebotomist, HIV Counselors),
Administration Staff, staff from Guilford County Health Department, Triad Health Project, and
Getting to Zero, and volunteers. The following tasks are to be completed within the 24-month
timeframe:
Budget
Program estimated budget for 24 months is $853,835.00. The budget below includes personnel,
accommodations, equipment/supplies, and marketing. Personnel includes qualified professionals
and volunteers. For an effective work environment, space with offices and meeting rooms will be
rented out monthly to accommodate all staff members and volunteers, as well as space for
community events. Vans will be purchased to accommodate staff and participants during health
education sessions and testing events. Equipment and supplies include technology equipment,
office supplies, HIV testing kits, food and beverages to be used for day to day activities,
meetings, and events. Marketing costs include radio spots, pamphlets, signs/posters, brochures
and social media. The more information that can be spread within the community, the more
successful the program will be. A greater number of youth and young adults in Guilford County
will be educated about HIV and have the ability and resources to prevent it. The printed and
published literature will serve to increase HIV awareness. Radio spots and social media will be
effective and necessary to reach the target population and help account for those who do not
encounter the signs and/or written materials.
Potential issues and concerns can be common in public health initiatives. Some of the concerns
for the Be In The Know Program may include:
Lack of funding to implement program
Lack of program participants
Adherence to projected timeline: delay in launching the program, receiving
funding on time, completing sessions on time.
Lack of community support
Policy changes, or approval delays
Evaluation strategies
The Be In The Know program will conduct process evaluations and outcome evaluations.
Process evaluation is done during the implementation of the program and monitors how well the
program is doing. Process evaluation answers the questions what, how, when, where and who to
evaluate if the program is doing what it is intended to do. Outcome evaluations determine the
impact of the program, objectives met, effectiveness and improvement.
Data from participants will be collected using pretest and posttest questionnaires and one-on-one
interviews. Information collected will be used to determine the programs effectiveness,
participants behaviors and knowledge. Qualitative and quantitative research will be used to
evaluate the outcome evaluation. Quantitative research will stem from the percentages of
program participants who has had a behavior change in their sexual health during the program.
Behavior change will be measured by the participants knowledge of HIV and attitude towards
prevention. Qualitative research will be retrieved from discussions during HIV education classes
to gather reactions, impressions, and additional issues or concerns. Qualitative research is used to
interpret quantitative data and help determine why precise outcomes were achieved or not.6
References