Modeling and reinforcement to combat HIV: The MARCH approach to behavior change

Theory and research suggest that behavioral interventions to prevent HIV/AI DS may be most effective when they are personalized and affectively compell ing, when they provide models of desired behaviors, and when they are linke d to social and cultural narratives. Effective strategies must also take in to account the opportunities and obstacles present in the local environment . The Modeling and Reinforcement to Combat HIV (MARCH) projects combine key aspects of individual behavior change with efforts to change social norms. There are 2 main components to the program: entertainment as a vehicle for education (long-running serialized dramas on radio or television portray ro le models evolving toward the adoption of positive behaviors) and interpers onal reinforcement at the community level (support from friends, family mem bers, and others can help people initiate behavior changes; support through changes in social norms is necessary for behavioral effects to be sustaine d over time). Both media and interpersonal intervention activities should b e linked to existing resources in the community and, wherever possible, pro vide increased access to preventive services, supplies, and other supportin g elements.