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The principal objective of the International Core at the Center for AIDS Prevention Studies (CAPS) is to facilitate high quality international research by creating effective and productive partnerships between CAPS scientists and HIV prevention researchers from developing countries. The International Core brings together CAPS scientists and alumni of the Collaborative Prevention Research in Developing Countries Program, a training program for new developing country researchers (described below). CAPS has successfully developed a broad portfolio of small-scale international research projects conducted by CAPS scientists and Program alumni. Together we have made important contributions toward understanding how to prevent HIV transmission and how to care for the HIV-infected in the developing world.

Vaccines are among the most powerful and cost-effective disease prevention tools available. A vaccine that could prevent HIV infection or stop progression of the disease would greatly help in the fight against the AIDS pandemic. Vaccines have been pivotal in worldwide smallpox elimination efforts, have nearly eliminated polio and have drastically reduced the incidence of infectious diseases like measles and pertussis in the US. A crucial question is whether a vaccine based on one strain of HIV would be effective for populations in which a different strain is predominant. There are also questions about how an HIV vaccine would protect individuals: the vaccine might not be able to actually prevent infection, but could prevent or delay progression to disease, or simply reduce the infectiousness of people who do become infected with HIV. HIV prevention education and counseling are important components of vaccine programs. Even after the release of a vaccine, there will be an ongoing need for effective behavioral prevention programs. An HIV vaccine will not be a “magic bullet” but it could play an extremely powerful role as part of a package of prevention interventions.

Problem: During  the  summer  of  2009,  the  State  of  California  experienced  an  unprecedented  budget  crisis,  resulting  in  cuts  to  social  services  across  the  state.  Approximately  $85  million  was  eliminated  from the budget of the State Office of AIDS  (OA)  for  FY  2009‐2010,  about  half  of  the  allocation of $167 million in FY 2008‐2009. Following  the  cuts,  reports  in  the  local  media  and  press  releases  indicated  that  several  community‐based  organizations  (CBOs)  and  AIDS  service  organizations  (ASOs) had to close their doors or drastically  reduce  the  level  of  HIV‐related  services,  including  activities  such  as  HIV  testing  and  counseling.  The  UCSF  AIDS  Policy  Center  Rapid Response Team conducted this study  to  gather  more  details  on  the  impact  of  these budget reductions.

The Implicit Theory project was designed to capture how HIV prevention providers delivering services think behavior change in their clients happens, what we refer to as providers’ implicit theories. This is important for many reasons. To begin with, the providers work directly with clients and were often peers of these clients. They are directly interacting with their clients and may be able to even witness when change has occurred. The providers’ position as peer or former peer, as the practice of hiring from the community that one wants to serve is very popular among HIV prevention organizations, is also key. This position provides insight and familiarity about the context and complexities of clients’ lives that is unique to providers. But the most compelling reason to capture this is that this is what providers are actually doing. Regardless of what researchers are studying or what funders are funding, we found that the providers we interviewed are out in the field acting on what they believe helps change behavior. Providers’ implicit theories drive their services, and therefore, it’s important to understand these implicit theories.

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