Role of Families in Prevention and Care
4.6 Challenges for the Future
Dissemination of effective parental interventions remains a challenge, not only because there is no easy bridge between research and practice (and from practice to research), but also because HIV is a dynamic epidemic. Training should include methods for update by reinforcing parents’ roles as lifelong learners, creating com-munication routes for new fi ndings, and accommodating to new local circumstances (e.g., new trends in substance use, new ways of sexual debut). A new generation of parents, exposed to comprehensive family life and sex education, will emerge, but even then they will need to be supported as “things change.”
The current and future generations of parents include fathers (DiIorio et al. 2003 ; Peterson 2007 ) . They are an underutilized resource for intervention. Both mothers and fathers rise to the challenge if they perceive their children are at risk.
Training needs to lead to “deep” understanding. Children ask the most interesting questions: “Why do people use drugs?” “What does HIV do to the body?” Youth will
turn elsewhere for answers if parents, clinics, or schools cannot provide satisfactory explanations. These sources often give contradictory messages or have competing agendas. Consistent communication about responsible sexual and substance use behavior can impact not only HIV, but outcomes as diverse as intimate partner vio-lence, early pregnancy, and accidents, to name a few. Finally, early education sets down the template for discussion between parents and children on sensitive topics.
For example, PATH results were improved in Miami when combined with an early parenting program (Prado et al. 2007 ) . This ability to discuss sensitive topics can generalize to later relationships and can result in greater respect between genders.
More concretely, fi ndings suggest that sexual thoughts, intentions, and precoital behaviors are precursors to intercourse debut; preadolescence is a critical period when youth begin to view sexuality in a self-relevant way (Butler et al. 2006 ; O’Sullivan and Brooks-Gunn 2005 ) . In order to effectively intervene before sexual risk behaviors take hold, parents must be equipped with the tools to have early and effective communications with, and supervisory techniques for, their children.
Research shows that it is easier to prevent risk behaviors before their onset than to change established behavioral patterns once they occur (Botvin et al. 1990 ) . Parents can be HIV/AIDS educators!
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