AIDS Risk Reduction Model

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The AIDS Risk Reduction Model believes change is a process individuals must go through with different factors affecting movement. This model proposes that the further an intervention helps clients to progress on the stage continuum, the more likely they are to exhibit change.

This model includes elements of several other theories/models (health belief model, self-efficacy theory, and psychological theory) and is applicable to sexually active or injecting drug using individuals.

This was developed specifically for the context of HIV perception.

Individuals must pass through three stages:

A) Labeling – one must label their actions as risky for contracting HIV (i.e. problematic). Three elements are necessary

1. Knowledge about how HIV is transmitted and prevented,

2. Perceiving themselves as susceptible for HIV and

3. Believing HIV is undesirable.

B) Commitment – this decision-making stage may result in one of several outcomes

1. Making a firm commitment to deal with the problem,

2. Remaining undecided,

3. Waiting for the problem to solve itself, or

4. Resigning to the problem. Weigh cost and benefits - giving up pleasure (high risk) for less pleasure (low risk).

Major Factors –

• 1) response efficacy (effectiveness to change),

• 2) perceived enjoyment (acts being added or eliminated),

• 3) self-efficacy, and

• 4) relevant information and social norms.

C) Enactment – This includes three stages

1. Seeking information,

2. Obtaining remedies, and

3. Enacting solutions.

   Diffusion of Innovation Model

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The Diffusion of Innovation Model looks at how new ideas are communicated to, and accepted by, members of a group or population.

The three major components of this theory are

A) Communication Channels – for dispensing an innovative or new message.

B) Opinion Leaders – visible, respected people who can assist in dispensing the message.

C) Time and Process – required to reach community or group. People receive/accept messages at different time intervals.

   Health Belief Model

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The Health Belief Model maintains that health related behaviors depend on four key beliefs that must be operating for a behavior change to occur.

A) Perceived susceptibility – personally vulnerable to the condition.

B) Perceived severity – belief that harm can be done by the condition.

C) Perceived benefits of performing a behavior – what they are going to get out of the change.

D) Perceived barriers of performing the behavior – what keeps them from changing.

   Social Cognitive Theory

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The Social Cognitive Theory maintains that behavior changes are dynamic and influenced by personal and environmental factors. People learn new behaviors through direct experience or modeling after others by observation.

A) Outcome expectations - the extent the person values the expected outcome of a specific behavior. Will it lead to a positive or negative outcome?

B) Self efficacy – a person’s belief about his/her ability and confidence in performing behaviors.

   Stages of Change Model (Transtheoretical Model)

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The Stages of Change Model maintains that behavior change occurs in stages and that movement through the stages varies from person to person.

The six stages are:

1) Pre-contemplation – no intention to change behavior; not aware of risk.

2) Contemplation - recognizes behavior puts them at risk and is thinking about changing their behavior, but not committed to the behavior change.

3) Preparation – the person intends to change the behavior sometime soon and is actively preparing.

4) Action - person has changed risky behavior recently (within the past six months).

5) Maintenance – person has maintained behavior change for a period longer than six months.

6) Termination – individuals are presumed to have no intention to relapse and possess a complete sense of self-efficacy concerning their ability to maintain healthy behavior.

   Theory of Reasoned Action

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The Theory of Reasoned Action maintains a person must have an intention to change. Intentions are influenced by two major factors.

A) Attitudes towards the behavior.

1. Belief in performing the behavior is based on positive or negative outcomes.

2. Evaluation of consequences to performing behavior.

B) Subjective norms about the behavior.

1. What significant other thinks about performing the behavior.

2. Motivation to perform behavior based on subjective norms.

   Empowerment Theory

The Empowerment Theory maintains people change through a process of coming together to share experiences, understand social influences, and develop solutions to problems.

Three core elements of this theory are

1) Populations for change – individual/group level.

2) Participatory education – listening, participatory dialogue and action.

3) Focus group strategies – gathering information and finding solutions with the community.

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