Session: Extending the Horizon of Social Work Research: Adaptation of Evidence-Based HIV Interventions for Under-Researched, Under-Resourced, and Vulnerable Populations (Society for Social Work and Research 15th Annual Conference: Emerging Horizons for Social Work Research)

Adapting existing evidence-based interventions (EBIs)—as opposed to developing new intervention programs de novo—represents an efficient mechanism to bring efficacious interventions more quickly to bear for populations that remain at elevated risk for HIV transmission. The process of modifying an EBI while maintaining the theoretical underpinnings and core elements to address and accommodate different social, cultural, and structural factors can be challenging. This symposium presents a collection of research studies that have succeeded in adapting an existing HIV prevention EBI for populations that differ from the original EBI's target population.

Two studies focus on Central Asia, a region that is experiencing one of the fastest growing HIV epidemics in the world. Estimated rates of HIV cases in Kazakhstan have more than quadrupled since 2000. HIV cases in the region are not uniformly distributed, as evidenced by clustering of infections seen in Kazakhstan and Kyrgyzstan. These patterns are driven by geopolitical and economic factors that shape risk factors such as drug use, limited availability of drug treatment, and migration. Thus, the first presentation involves the adaptation of a social network-based EBI— Self-Help in Eliminating Life-threatening Diseases (SHIELD)—for injecting drug users (IDUs) in the Southern Kyrgyzstan region of Osh. The second presentation will describe the adaptation of a relationship-based HIV prevention EBI to include overdose prevention for IDUs and their sexual partners in Kazakhstan.

In Mongolia, the economic transition from a centrally planned to a free market economy has been accompanied by an increase in survival sex work among women, high rates of sexually transmitted infections and alcoholism, and a deteriorating health and social services delivery system. The third presentation will describe the adaptation and testing of a combination HIV sexual risk reduction and motivational interviewing intervention tailored to alcohol-abusing women engaging in sexual risk behaviors in Mongolia.

In the U.S., HIV incidence has remained at about 56 thousand new infections per year for almost two decades. At best, this signifies that prevention efforts have reached saturation, pointing to the need for new or renewed prevention approaches. At worst, such statistics indicate that certain populations are overlooked, excluded, or otherwise outside the reach of past and current prevention efforts. Men who have sex with men (MSM) and people of color remain disproportionately represented among HIV infections. In New York City, the prevalence of HIV among African American MSM exceeds many countries in Sub-Saharan Africa. The fourth presentation will describe the successful adaptation of a couple-based EBI, originally developed and tested with heterosexual couples, for a new target population consisting of at-risk African American MSM in same sex relationships.

Collectively, strategies and insights will be shared regarding adaptation of EBIs along a spectrum of salient dimensions given the national and international epidemiology of HIV: nationality/geography, race/ethnicity, co-morbid or competing health concerns, and sexual orientation. In addition, all presentations will focus on how the preliminary adaptation studies are leveraged to substantiate larger-scale efficacy and/or dissemination research studies that are extending the horizon of social work research in HIV prevention.