Fathers and HIV/AIDS: A Missing Factor in Developing Interventions But Not in the Lives
6.7 Conclusions
Reports reveal that Americans’ impressions of HIV/AIDS as a national health prob-lem have declined drastically over the past 15 years (Singh 2009 ) . Declining public interest in HIV/AIDS would be less troublesome if the rates of infection were also declining. However, the fact is that not only are new HIV infections higher than
expected, a greater number of youth are becoming infected. Additionally, HIV infection continues to occur predominantly among men. In this discussion, we have highlighted reports from several sources suggesting the importance of fathers in developing more effective responses to the HIV/AIDS epidemic. The changing demographics of families in the U.S. signal a decline in the traditional two-parent household. Single-headed male households are increasing at a faster rate than sin-gle- headed female households. There is documented evidence that fathers do play a unique role in the socialization of their children. We must examine fatherhood via the lenses of diversity in order to add understanding and bring clarity to the concept of fatherhood in the prevention, treatment, and care of HIV/AIDS today.
This shift requires focusing on race/ethnicity, class, sexual orientation, residency, and HIV status. The fi ndings from risk-reduction interventions focusing on fathers are promising. The information presented in this discussion underscore the fact that fathers can and do play a signifi cant role in confronting HIV/AIDS.
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Abstract This chapter focuses on three areas. First, it discusses the state of science on couple-based modalities to reduce HIV risk and STIs and improve adherence to HIV treatment. Second, it discusses the potential advantages of such a modality in both HIV prevention and treatment adherence. Third, it highlights the signifi cant gaps and limitations of couple-based HIV prevention and treatment and makes sug-gestions for future directions. Fourth, it examines the status of dissemination research and transportability of effective couple-based HIV prevention and treat-ment to real-world settings. Although advances have been made in HIV prevention science, until a short time ago, HIV prevention approaches did not adequately focus on couples. Effective couple-based intervention strategies are needed for primary prevention for serodiscordant couples, couples who do not know their HIV status, or who are both HIV negative but vulnerable. To date, few couple-focused ART adherence interventions have been tested; even though it is well established that social support is one of the most consistent correlates of adherence across a wide range of populations and diseases. So far all couplebased studies have been effi -cacy trials rather than effectiveness ones. It has yet to be determined whether any of the interventions is capable of widespread effectiveness under real-world conditions.