Description Of Project Roadmap To Reduce Std Rates In Older Adults

There is a continuous trend among the vulnerable aging population, and that is the rise of STD’s rates. According to the U.S. Centers for Disease Control and Prevention (CDC), nearly half of the population are adults ages 50 and older diagnosed with human immunodeficiency virus (HIV). In the year 2016, 17% (6,812) of the 39,782 cases upon newly HIV diagnosis accounted older adults 50 years and over. Within this same year, 35% of older were in the late stage infection (AIDS) when they received an HIV diagnosis resulting in high death rates upon the older adults (CDC,2018). The growth rate in sexually transmitted diseases amongst the older adult population is prevalent and a social problem in today’s society. It is important to address this social issue to help support the elderly.

Adequate interventions and initiatives are necessary into the cause of promoting education and safe sex awareness for the vulnerable aging population. In lieu of this, in Illa et al. (2010), Project ROADMAP was created as an intervention to reduce STD rates amongst the older adults. Project ROADMAP stands for is Reeducating the Older Adults to Maintain AIDS Prevention. The intervention used was providing educational material such as brochures and four session courses to HIV positive older adults. Upon the sessions, the evidence-based practice psychosocial model primarily used was Fisher’s IMB model. This model is generalized into focusing information, motivation, behavioral skills for behavioral change on AIDS risk reduction behavior. Measures were used to test participants’ awareness upon sexual risks, HIV knowledge, & sexual self-efficacy at a 6 month and 12 month from baseline to make comparisons upon results. The target population for this program was HIV positive older adults of ages 45 and older who have been sexually active for 12 months. The purpose to the program was to reduce high risk behaviors amongst sexually active older adults.

Specifically focused on preventing elderly persons with HIV positive diagnosis from spreading it to their sex partners whom are not diagnosed with an STD. This was a clinical study for secondary HIV prevention. The theory of change would be educating and providing needed skills and tools to the older adult population with HIV diagnosis to increase awareness into practicing safe sex with their partners for secondary HIV prevention. As discussed, a lot of “Baby boomers” were at a maturity stage during sex revolution during the 1970s/80s and did not receive safe sex education and do not realize the threats that STDs may expose them to. (Benjamin Rose Institute of Aging,2016). Both older men and women are not aware of STD risks and have sexual behaviors such as not using condoms (Calvet, 2003, p.1).

The Project ROADMAP’s frame work or logic model consists of a plan to reduce high risk sexual behaviors amongst older adults diagnosed with positive HIV disease through reinforcing education; and the result expected includes a relationship to secondary HIV prevention. The resources/inputs used for this intervention includes recruitment of participants through randomization through a host site. Also creating assessments and evaluations for the selected participants. Time in which the assessments were completed that last for about 60 to 80 minutes long. Educational brochure materials regarding HIV prevention were also necessary. Scheduling appropriate and convenient times the four psychoeducational group sessions were going to take place for the participants. These sessions lasted at most 2.5 hours. Incentives were also required to engage participants. Incentives used for this particular program included rewards like $25 gift certificate to a local supermarket for each individual assessment completed. For group participation, individuals were given small tokens and a valued gift of $5. The outputs or activities completed for Project ROADMAP include conducting the individual assessments.

In these assessments, participants were asked about their sexual behaviors or risks within the last six months for example how many times they had unprotected sex through vaginal intercourse? Another type of question was based on their HIV/AIDS knowledge using true/false questions. Lastly, questions on sex self-efficacy to better understand or test each of the individual’s ability to achieve better outcomes of having protected sex. This was done by using a 4-point scale of between strongly agree and strongly disagree to questions like “Using condoms is not difficult to use.” (illa et al, 2010). The psychoeducational group sessions were also an imperative output to this Project ROADMAP framework. In the first session, participant got to know one another and were introduced to HIV education. In the second session, went into more depth upon the HIV sexual behaviors and reducing negative consequences. The third session was focused on building skills on effective communication and condom use negotiation. The final session, reviewed the useful techniques for safe sex behaviors (Illa et al, 2010).

The participants needed for this framework included stakeholders like the institutionalized review board of the University of Miami Miller School of Medicine whom approved and sponsored the intervention process. Also, the facility in which participants for the program were selected from. The urban medical facility of University of Miami/Jackson Memorial Center was where 300 participants were recruited. The participants were very important part to the intervention under the Project ROADMAP program. Number of qualifying participants of ages 45 and older, resulted in 149 persons in the intervention group and 92 persons in the comparison control group. Participants were diverse from different ethnic backgrounds like African American, Hispanic, White, and other. Along with different genders male, female, & transgender.

Also, participants had different education levels such as less than high-school, completed high-school, and higher educational level like college. Marital status was another characteristic that differed between participants whether single, married, and divorced. Sexual orientation as heterosexual, homosexual, bi-sexual, and not sure was another factor seen among the participants. Participants sexual activity and condom use was another characteristic observed among the participants. All these factors were taken into consideration in dividing a control group and an intervention group. Lastly the clinicians whom interviewed the participants were important participants to the program. The short-term goal outcomes in the Project ROADMAP can be shown as increasing the knowledge upon safe sex awareness, risky sexual behaviors, and education on STD/HIV. Also creating support groups so participants learn from one another. Discussions and ideas were developed to carrying out or practicing learned education to real life situation.

The medium goal outcomes would be older adults being honest and reporting their intimate behaviors for accurate data findings. Also identifying and comparing results between the intervention group and control group to understand the effectiveness of the educational training Project ROADMAP provided through collective data. Participants in the control group did not receive psychoeducational sessions on HIV preventions. Among the two groups comparisons were made to determine the prevalence of inconsistent use of condoms during sex with all partners, sex with HIV negative and/or HIV positive diagnosis, and sex with unknown status (Illa et al., 2010). The long-term goals would be ensuring that the educational material on HIV prevention had significance in reducing high risk sexual behaviors upon HIV positive older adults after a six-month period outcome. Also, preventing increase in STD/HIV rates.