This presentation is a summary of a study supported by HIV Prevention Trials Network and sponsored by National Institute of Allergy and Infectious Diseases, U.S. Department of Health and others on social norms, network characteristics, and HIV risk behaviors in Thailand and the United States as well as a personal reflection on study's impact on author's thinking about human sexuality and /or sexuality education.
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This study purports to examine structures of social norms pertaining to HIV risk behaviors within social networks and relationship between norms and risk behaviors. Social norms - and change thereof - are instrumental for changes in a number of health behaviors. Still, few studies have examined social structure of norms with an aim to introduce changes in health behaviors. This study examines relationship between norms as perceived by reference group members, associated risk behaviors, and actual norms within drug networks based on a cross-sectional study of injection drug users (IDUs) in Thailand and the United States. Cultural differences are also accounted for.
In an attempt to address health behavior change - a change carried out from an individual level to group level - a number of approaches are first discussed. Social diffusion is a health behavior change approach by which "early adaptors" (i.e. individuals who lead behavior change) diffuse new behavior into wider community. Though proving successful in so far as HIV risk reduction is concerned, change leaders approach has not proven significant for behavior change, not to mention identification of involved social networks.
A second approach to health behavior change is an introduction of descriptive data on group's social norms to target audience. Arguably, one critical question pertaining to interventions intended for health behavior change is whether individual perceptions of social norms shape reference group health behavior or reference group's actual social norms influence individual behaviors. This approach would require individual-based or group-based behavior change interventions depending on which impacts on which, individual or group.
In either case, identification of most influential reference group is paramount for social network analysis, a critical tool for examination of structures of social norms. Moreover, certain reference group members are more influential than other group members and hence effectual in health behavior change. Significantly, a network's structure is fundamental, according to mathematical models, to behavior change.
NORMS, NETWORK, HIV RISK BEHAVIORS IN THAILAND AND U.S.: SUMMARY 4
Data collection and pool were based on HIV Prevention Trials Network protocol 037. Prior to conduction of study approval of protocols and procedures by Institutional Review Boards at Johns Hopkins University, University of Pennsylvania, the Royal Thai Ministry of Public Health and Chaing Mai University had been secured. An independent advisory board for each site checked on outcomes and consequences. In addition, independent monitors checked and verified regularly on compliance with approved protocols and pro
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