This book brings together a number of international contributions on the research, theory and practice of developing community-based HIV prevention interventions. This is achieved in three main ways. First, by examining the implications of research for understanding how and why individuals act as they do in response to the risk of HIV transmission; second, by discussing the implications of this research for developing health and HIV prevention interventions; and third, by exploring the aims and practice of innovative community-based HIV prevention among populations most affected by HIV and AIDS. The aim is to understand how individual actions are influenced by the social, cultural and political contexts in which such actions occur, and to explore how future HIV prevention interventions can target changes at the level of the individual as well as at the level of the community and wider social environment.
HEALTH PROMOTION AND BEHAVIOUR CHANGE
Recent developments in health promotion have advocated the need to balance individual and community action as a means of facilitating and enabling changes in individual and collective health status (Bunton and MacDonald, 1992). The ‘new’ public health movement of the 1980s promised to move beyond a biomedical understanding of individual health behaviour towards a new understanding which encompassed the social and environmental influences on individuals’ health choices, perceptions and actions (Ashton and Seymour, 1990). It was recognised that not only should health interventions target individuals with the aim of encouraging individual behaviour changes, but, where necessary, interventions should also encourage changes in the communities and social environments of which these individuals were a part. In response, ‘health promotion’ became re-defined as the intersectoral activity which encourages possibilities for individual action as well as community action and changes in the social and political environment (World Health Organisational [WHO], 1986; Bunton and MacDonald, 1992).
Health promotion theory thus conceives of health as being a product not