Outreach as a strategy for HIV prevention: aims and practice

Abstract
Outreach health education has become a common component of wider HIV prevention strategies. As an alternative to more conventional modes of health education, outreach has much to offer. However, little evaluation has been undertaken on the feasibility and effectiveness of outreach as a strategy for HIV prevention. Drawing on the findings from a 3 year evaluation of an innovative model of HIV outreach in central London, this paper discusses the feasibility and role of outreach in providing HIV prevention services in the community. Findings highlight tensions between two key objectives of outreach work: (1) the provision of in situ prevention services directly in the community and (2) the facilitation of referral for clients into existing health services. The implications of findings for the organization and management of HIV outreach services are discussed. The paper concludes by emphasizing the complementary nature of in situ health education and referral objectives in outreach work, while suggesting that the fundamental role of outreach is to provide community based services in response to consumer needs, even if this does require a departure from normative styles of service delivery. Whether this is feasible in the light of recent National Health Service reforms remains uncertain.

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