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date: 20 July 2018

Sex Ed: A Global Perspective

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article.

At the end of 2016, there were approximately 36.7 million people living with HIV worldwide with 1.6 million people being newly infected. In the same year, there were 1.0 million people who died from HIV-related causes globally. The vast prevalence of HIV calls for an urgent need to develop and implement prevention programs aimed at reducing risk behaviors.

Bronfenbrenner’s socioecological model provides an organizing framework to discuss HIV prevention interventions implemented at the individual, relational, community, and societal levels. Historically, many interventions in the field of public health have targeted the individual level only. Individual-level interventions are designed to promote behavior change by enhancing HIV knowledge, attitudes, and beliefs, and motivating the adoption of preventative behaviors. Relational-level interventions promote behavior change by using peers, partners, or family members as the target of the intervention to encourage HIV-preventative practices. At the community level, prevention interventions are designed to reduce HIV vulnerability by changing HIV-risk behaviors within schools, workplaces, or neighborhoods. Lastly, societal interventions are those that attempt to change policies and laws to enable HIV-preventative practices.

While previous interventions implemented in each of these levels have proven to be effective, a multipronged approach to HIV prevention is needed such that it tackles the complex interplay between the individual and their social and physical environment. Ideally, a multipronged intervention strategy would encompass interventions at different levels that complement each other to synergistically reinforce risk reduction while creating an environment that promotes behavior change. Multilevel interventions provide a promising avenue for researchers and program developers to consider all levels of influences on an individual’s behavior and to design a comprehensive HIV risk-reduction program.