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|62 posts found
Novice Member
Joined: 2/06/07
Originally posted by psiicat
And it's this kind of thinking that we are stuck with the dumbed down mmo's these days. Publishers and shareholders don't want to do games they think of as risky or not enough of a money maker. They want their constantly redone call of duty games, their cookie cutter themepark mmo's.
Well screw them. With crowdsourcing you a say in what you want to see produced. Might a craptacular game come of it, sure, but I've seen plenty of abyssmal games come from the so called AAA companies to. The only people who think like you do are the big name publishers who can see the writing on the wall.
Their time of picking what games get made and how they get made is coming to an end.
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Advanced Member
Joined: 4/29/04
Originally posted by erictlewis
You are correct. 2 millions gives us the game. Chris always made it clear. The 2 mil gives us the game. But the online universe comes in 30 months.
And That is where the 4 mil come into place.
If he can get to 4 mil he'll have enough to hire more people now and launch both the single player squadron 42 and the persistent online universe all at the same time. He also will use the added funds to create better mod tools with better tutorials and so on. And also use the extra million to create a bigger universe. 50 star systems instead of 40.
You can check the stretch goals here:
They have backers that have committed support since Chris could prove there is enough interest. Project will cost more than 10 mil. The extra money will simply allow Chris to have more resources from the star to hire more people.
I understand people skepticism. But I've been following this project. Chris has been hiring people. And they 've been making comments. He has done a couple of AMA on reddit. added a lot more info to the site to answer people doubts.
there is a FAQ here :
A more detailed look into the project here :
It seams like they have a solid project. Yes they want money. But they also want to use those funds to build a great game.
Spotlight Poster
Joined: 7/15/09
Im seeing some people argue that with his name and his history, he should be able to secure any funding he wants.
its not that easy
well it is, that is if you are willing to give up somethings in return.
If im going to give someone 10 million for a game, you can bet your ass my hands will be in the development process somewhere. Investors dont just hand over a blank check and tell the dev, "Call us when its done!" no, they get involved, and when they get involved, shit gets changed, and when shit gets changed, you get vanilla, because vanilla always sells and you cant go wrong with vanilla.
He can pitch star citizen to an investor and the investor (given today's path games are following) will ask for something similar to EVE online except a F2P model completely nullfiying the original idea (see the original idea for Horizons before it was butchered).
Giving SC to EA will result in Chris Roberts being fired 5 months in, the game being handed off to BioWare, and the entire concept reworked into a mass effect MMO.
In short, an investor handing over millions of dollars will have immense pull and say over the direction of the game, people who chip in $10-100 do not. And yes, while kickstart is a sort of scam, it does allow developers much much more freedom and allows them to create the product they want, not what a suit wants.
Advanced Member
Joined: 8/12/09
Good lord, pay to beta test, pay for box, pay to play, cash shops...geez, i guess we might as well pay to develop the games too.
Apprentice Member
Joined: 1/24/12
Originally posted by Renoaku
Actually, the video was rendered with the in-game engine. So the gameplay will have the same level of fidelty the video shows. (Depending on your gaming rig) There's a video where Chris Roberts flies the ship around and shoots some alien ships, so it isn't just a movie:
Also, Star Citizen is going to be Buy2Play, where you buy the game and have access to the online part of it for free, without paying a sub, just like GW2. So your whole F2P rant is based on nothing.
Advanced Member
Joined: 3/16/12
Never played a space sim, but man the immersion, scaling of this game this man is doing is amazing. What sold me was when he hopped in the cockpit started pressing all them buttons and they all aren't there for looks, but can be used is as close as realistic as I've ever seen. He said that they'll be using not 10,000 but 100,000 polygons on main charachters thats just nuts. My only problem is with this game is being able to run it at the setting I want, I have a 6 core processor 3.30 Ghz, 8gb ram, and a 660 ti. I know this isn't a MMO but will be ran by third party servers and have 3rd party mods cause that's what he wants and allowed. I'm definetly funding this since it's reached it's goal and then some but the 4 mill benchmark will add for a rich story and possibly greater stuff than that.
Spotlight Poster
Joined: 7/15/09
Originally posted by kabitoshin
Since the game is in space, it allows for much higher polys. you dont have to render grass, trees, dirt, on top of structures, players, hair, etc. You are only rendering ships, the interior, and players.
Hard Core Member
Joined: 8/08/03
Originally posted by psiicat
Sorry but this is BS, most invetstors are suits, not gamers they are in it for a return on thier money and could care less if a enjoyable game is ever released. EA/Bioware is a good example of the souless investor in gaming. Keep churning out the same sport game year after year with a slightly different skin yet at full price or take a IP like SW and try and make a WoW in space. Make big promises about a game where your choices effect things and daramticall different endings just to have the same ending in red, green, or blue colors. Seriously these are the people you put your trust in to produce quality games gamers actually want, rather then games mass produced that their think tanks believe will deliver the most money for investment?
Think for a minute! No really think! What big name game developers put money to actual creat a decent game like kickstarters are willing to try rather then wasting half their budget on expensive add campaigns full of dishonest hype about their games like SOE, EA etc?
What if when the games made, the money thats not repaid to greedy souless suit investors is instead put into funding the next game sequal or new game? We already know who the disgustingly greedy people in game developement are the current Big names Like EA, SOE, and yes Blizzard somewhat. Don't be a shameless shill for the big name soulless companys that make games only for most profit dispite what unmigated crap their final product is.
Kickstarter and such funding is the true wave of the future for decent games. Do you think and big name company will make a high end PC only game, when instead they can dumb it down to sell even more on consul? Hell no. Most big named companies are about making the most casual, most dumbed down to play on any rig or consule to get the biggest return on thier investment, and if that means making a buggy game where they skimped on product developement or testing to pay for mass marketing adds they will
Hard Core Member
Joined: 8/08/03
Originally posted by DarkOmega
Amen! ^^
Hard Core Member
Joined: 7/09/04
If you can't kill it, don't make it mad.
Originally posted by Ramonski7
Unfortunately it doesn't work that way. At least not any more. If you are happy to keep being fed WoW clones and other such, you are more than welcome to stick to the formula thats produces them. I'm more than willing to risk some money on the off chance that we might get something different. If you aren't, thats entirely up to you. But then don't complain when what we see produced is what publishers/investors think will make them the most money.
Advanced Member
Joined: 4/29/04
I understand many of the people skepticism over here, bu I made this post because I would love to see a true AAA space sim with this features come true.
We could all debate theories the mechanics of funding but in the end it comes down to this.
- Publishers aren't willing to invest in AAA space sims. And there are plenty of articles talking about this.
So question is. Where do people go if they have a cool project but can't get support from big companies?
- Most crowdfunding projects have one problem. They have little to show.
At least Chris made the effort of creating a tech demo to show what he wants to do. A real-time in engine tech demo. There are plenty of interviews and game footage. He has shown the physics engine working. The landing and launching of a ship. And all that. That tech demo was made by a very small team that invested their own free time and money.
- Mentioning how Chirs Roberts Wing Commander movie sucked leads to nothing. He was/is a great game developer but Wing Commander was his first big screen movie. And he did a bad job. You can be a great game developer and a bad movie director. Nothing wrong with that. But if people want to discuss his career in the movies then they should also mention his successes. He was the producer of great movies such as Lord Of War and Lucky Number Slevin. And you just need to look at his IMDB page to know more about his movie career. Wing Commander was NOT the only hollywood project he was in. IT simply was his first.
We pay $10 to watch a movie in the cinema that sometimes suck (wing commander :P)
We buy games that cost a lot and that well..suck.
This guy has a proven track record making great games. Every single Wing Commander game under his wing was a success.
And as far as doing groundbreaking stuff, let me put it this way. Chris was the first game developer to create a multiplayer online universe set in space with real-time combat. And you can check the game yourself to see how good it was/is. So much so that people are still actively playing that game this days. And there are multiple mods created for Freelancer.
Chris and his team, are doing a great job answering the community questions. If you have any question just send them an email and they will answer.
If you think their lieing than how would they have the support of companies like Alienware, NVIDIA, Oculus and Logitech?
They're even working closly with Crytek since their using their engine. They have bought a CryEngine license and that doesn't come out cheap.
Yes this companies have seen their tech demo and have offered some of their products as prices for the community. We all know no company wants their name tied to vaporware.
They are in their first year. Obviously they can't show you a full game because there is none. And obviously they can't work on a multi-million $ project without initial funding to pay the developer wages.
But if there is crowdfunding project you can trust, it's this one.
With Chris track record and past successes he doesn't need any money from any of us. He is a rich man already.
Obviously not rich enough to fund a game like this all alone. He would be insane. He is doing this because he trully wants to bring a new AAA space sim.
Hard Core Member
Joined: 9/26/08
"Before I speak, I have something important to say."
I'll gladly pay you Tuesday for an mmorpg today.
"There are certain queer times and occasions in this strange mixed affair we call life when a man takes this whole universe for a vast practical joke, though the wit thereof he but dimly discerns, and more than suspects that the joke is at nobody's expense but his own."
Spotlight Poster
Joined: 5/21/03
"A wise man has something to say, but a fool just has to say something."
Originally posted by Wraithone
I can understand if you think that on the surface, industry is littered with shit. Gold sinks, shit floats in water. So if you want to take the easy way out, by all means keep skimming the surface. I'll head down below and search hard for what I want. And if that means I have to research more or dive a little deeper to find it, then I'll do just that. But for me, this is a hobby not a political race. I liken myself as a voter, not a superPAC. I'm not throwing my money behind something hoping to hit it big. Especially not behind a pseudo mmo. So I'll keep using my money to find what I like and you can use yours to pay someone to hopefully make it for you. Funny thing is is that if they do make a awesome game we're both winners! I would have just paid less than you. Like I said I'm always willing to pay for a good game.
But truth be told, I'm quite happy investing a month or two from one game to another and enjoying them for what they are. Not looking for a deeper meaning of how the suits of the genre don't understand me anymore.
I'm a gamer and a mmo fan. Nothing more, nothing less.
Advanced Member
Joined: 12/21/07
I played WC games back in the 80s/90s. But knowing how to make a game then, does not necessarily means knowig how to do it now.
Look at Richard Garret .. he has done nothing good after ultima.
And why should anyone pay for a promise of a game? If the game is released, i will take a look at the reviews or demo.
And the point about paying for bad movies/games is just silly. That can be avoided by reading reviews and/or playing demos. I have not spent money on a bad movie or a bad game for a long long time.
There is so much entertainment out there that simply there is no need to pay for promises, no matter who is doing the promising.
Hard Core Member
Joined: 1/02/08
"Always borrow money from a pessimist. They won't expect it back."
Originally posted by psiicat
Well said.
What happens when you log off your characters????.....
Hard Core Member
Joined: 1/02/08
"Always borrow money from a pessimist. They won't expect it back."
Originally posted by Cometer
There's a reason publishers aren't willing to invest in space sims for an mmo. It will not sell well, it will not turn enough profit for them to invest money in it, so why bother. Just because a few people would love to see it as an mmo, doesn't mean they will make it a good one. Begging for money to make an mmo, with promises, always makes me suspiscious. I mean, we already have AAA companies with mmos that have came out the past few years promising the world and then not delivering on it, what's to make us think a handful of people with a new mmo project begging for money are going to be an mmo savior for us all?
What happens when you log off your characters????.....
Elite Member
Joined: 1/06/05
Originally posted by psiicat
Wait what?
Are you saying that it's an intelligent thing for an investment company not to mitigate risks? Are you aware that an invesmtent company invests the money of individual shareholders who will either gain or lose depending on the investments that company makes?
Wouldn't you want any company you invest in to do the same?
Novice Member
Joined: 11/14/12
I was about to pledge and help them, but then I realized two thing.
First, the "persistant universe" mechanism they intend to make is quite far from what I was expecting. Basically, it's not a persistent world, its a matchmaking system. You are a trader - someone is a pirate - it puts you up in the same instance so the pirate can hunt you down. I know now much details have been released so far, but this sounds like a hugely beneficial system to the pirates, not to the traders. If I want to avoid combat I should be able to, automatic instancing sounds cheezy.
Second, I looked at the release dates. Alpha in a year, beta in a year and a half, persistant universe in I believe 30 months. I'm all about backing projects, but we are talking years here, I don't even know if I'll have the time to play online games by that time.
Maybe if they ask for more money when the release dates are a bit closer in the future, I might change my mind.
Elite Member
Joined: 5/06/07
Originally posted by Cometer
Simple question for you:
Why not treat the fans with the same level of respect that other investors get? Give them shares of the company for their money. This way it truly IS an investment and they can actually hope to see profit if the project comes through?
I am a HUGE fan of WingCommander and somewhere around here I have the original box signed by Chris Roberts and the hat that came with it. That said, he is not in this as a not for profit entity. He is in this to make money. That money is going to come from fans... so it has now been taken to a whole new level where he wants fans to donate money so he can make more money from fans.
Give us a share of the possible eventual profits and I am all ears though. Then at least I am an investor in a business and not donating to a for profit charity.
"I should point out that no other company has shipped out a beta on a disc before this." - Official Mortal Online Lead Community Moderator
Starvault's reponse to criticism related to having a handful of players as the official "test" team for a supposed MMO: "We've just have another 10ish folk kind enough to voulenteer added tot the test team" (SIC) This explains much about the state of the game :-)
Hard Core Member
Joined: 7/09/04
If you can't kill it, don't make it mad.
Originally posted by Slapshot1188
Normally, I'm not at all interested in investing in game companies. They tend to be high risk investments at best. But I will support a game that I find interesting and hope that it turns out to be entertaining. If you are happy with the games that the suits keep cranking out, then more power to you.
But at this time I'm much more interested in seeing what Chris Roberts can come up with. Its a matter of marginal utility. I value the possibility of getting a good game out of this, more than I do the money I used to support it. If it doesn't work out, at least I tried, and I'm not out that much at all.

subset: commoncrawl


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Robert Capa, Courtesy of Cornell Capa
News about D-Day, including commentary and archival articles published in The New York Times.
Richard C. Hottelet, CBS Newsman and Last of 'Murrow Boys,' Dies at 97
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For a few weeks after D-Day, John G. Morris, a photo editor, took pictures of French life during wartime. Seventy years later, they are being exhibited.
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Thousands of military enthusiasts in trucks, jeeps and other Army vehicles converged on Normandy, France, to mark the 70th anniversary of D-Day.
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World Leaders and Veterans to Gather at D-Day Beaches
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The 320th Anti-Aircraft Barrage Balloon Battalion, the only all-black unit in the D-Day landings, were among those being remembered on invasion's anniversary.
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President Obama led a solemn tribute to the valiant Allied soldiers who stormed the beaches at Normandy 65 years ago.
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- Willamette
- Athletics
- Teams
- Football
- Pearl Harbor
1941 Willamette Pearl Harbor Football Team
As long as Americans remember Pearl Harbor, Willamette's 1941 football team will be in the minds of Salem-area residents and followers of the University. For many people, head coach Roy S. 'Spec' Keene's Bearcat team and Pearl Harbor go hand-in-hand.
On the gridiron that year, the bearcats forged an impressive 8-2 record; including six shutouts. They easily won the Northwest Conference title; outscoring their five opponents 218-7 The team included future Willamette University Athletic Hall of Fame selections Ted Ogdahl, Marvin Goodman, Dick Weisgerber (assistant coach) and Keene.
Willamette had 11 of 23 players on the NWC first-team all-star unit: ends bill Reder and Marshall Barbour; tackles Martin Barstad, Neil Morley and George Constable; guards Anthony Jo Fraiola and Gordon Moore; and backs Al Walden, Buddy Reynolds, Gene Stewart and Ogdahl.
After losing only to the University of Idaho on the mainland, the Bearcats thought they'd be in for a treat with a trip to Hawaii. The football teams from Willamette and San Jose were to play a series of games with the University of Hawaii called the Shrine Bowl.
In the first game of the Shrine Bowl on Dec. 6 Willamette lost a 20-6 contest against the University of Hawaii in Honolulu. The next morning, the Willamette contingent was preparing for a tour of the island when Japanese forces bombed Pearl Harbor. That led to the United States' Involvement in World War II.
After the initial attack, Keene volunteered his players and male supporters for 10 days of guard duty at Punahou School while the women on the trip were sent to a Navy hospital as nurses' aides. Most of the Willamette group left Hawaii two weeks after the initial bombing, arriving on the ocean liner President Coolidge in San Francisco bay on Christmas Day.
The 1941 football team was inducted into the Willamette University Athletic Hall of Fame on Sept.13, 1997. Also inducted that year were Wayne and Shirley (McKay) Hadley, longtime supporters of Willamette athletics who were with the football squad in Hawaii.
Since the 50th reunion of Willamette's 'Pearl Harbor' football contingent in 1991, there have been numerous feature stories written in newspapers up and down the West Coast. The most prominent stories appeared in The Oregonian (Portland), Statesman Journal (Salem) and the Honolulu Advertiser.
In November of 2000 the story of the football team in Hawaii was featured on a weekly ESPN show called "NFL Films Presents." The show entitled "The Moment of Impact," aired during the week of Nov. 24-28.


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August 4, 2015
WASHINGTON - - Lawmakers are accusing the CIA of misleading the makers of the Osama bin Laden raid film, "Zero Dark Thirty," by telling them that harsh interrogation methods helped track down the terrorist mastermind.
The film shows waterboarding and similar techniques as important to finding bin Laden in Pakistan, where he was killed by Navy SEALs.
A three-year Senate investigation showed that such methods produced no useful intelligence. The CIA's acting director, Michael Morell, recently contradicted that, saying harsh techniques did produce some tips that led to bin Laden.
In a letter to the CIA this week, Sens. Dianne Feinstein of California, John McCain of Arizona and others asked Morell to back up his claim and to share documents showing what the filmmakers were told.
The CIA says it will cooperate.
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Ways to get involved in promoting the Victorious Gospel
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43 He then took up a collection among all his soldiers, amounting to two thousand silver drachmas, which he sent to Jerusalem to provide for an expiatory sacrifice. In doing this he acted in a very excellent and noble way, inasmuch as he had the resurrection of the dead in view; 44 for if he were not expecting the fallen to rise again, it would have been useless and foolish to pray for them in death. 45 But if he did this with a view to the splendid reward that awaits those who had gone to rest in godliness, it was a holy and pious thought.


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Whether you're making your list and checking it twice, or wondering what lucky recipient deserves the gift of McFarlane Toys this holiday season, here is a look at what's out there and what's coming soon.
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Google started to show a yellow warning box at the top of the search results pages if the computer is likely to be infected with malware that changes Web pages, inserts ads and sends users to other pages to download more malware.
"Recently, we found some unusual search traffic while performing routine maintenance on one of our data centers. After collaborating with security engineers at several companies that were sending this modified traffic, we determined that the computers exhibiting this behavior were infected with a particular strain of malicious software (...) that causes infected computers to send traffic to Google through a small number of intermediary servers called proxies," explains Google.
Showing a warning message is not a foolproof idea, since malicious software could easily remove it or use it to install more malware. Google links to a page titled "Your computer appears to be infected", which suggests to install an antivirus software and perform a system scan. The page doesn't suggest to install a different operating system or to buy a Chromebook.
"Some forms of malicious software will alter your computer settings to redirect some or all of your traffic through a proxy controlled by the attacker. When you use Google, the proxy forwards your query to the real Google servers to fetch the search results. If our system detects that a search came through one of these proxies, we display the warning," informs Google.
{ Thanks, Herin. }
July 20, 2011
Google's Yellow Malware Warning Box
This blog is not affiliated with Google.


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Focus Area:Prevention
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Combination Approaches: Positive Health, Dignity, and Prevention (PHDP)
I. Definition of Positive Health, Dignity, and Prevention
Positive health, dignity, and prevention (PHDP) helps people living with HIV lead a complete and healthy life and reduce the risk of transmission of the virus to others. PHDP is characterized by its systematic delivery of a range of combination, behavioral, and sociocultural services within local communities.
II. Epidemiological Justification for the Prevention Area
As of 2008, an estimated 33 million people worldwide were living with HIV. Advances in HIV treatment have dramatically improved the life expectancy and quality of life of people living with HIV (PLWH). In some settings, expanded access to HIV testing and antiretroviral therapy (ART) has helped to transform HIV into a chronic disease. These advances magnify the urgent need to decrease HIV transmission, including for serodiscordant couples in which one partner is infected with HIV and the other is not. According to a 2008 study in Uganda, 40 percent of the cohabitating PLWH had an HIV-negative spouse. Most of the HIV-infected adults had been sexually active in the last year, and the overwhelming majority reported having unprotected sex with their married or cohabiting partner. Well over half of new HIV infections occurred among serodiscordant marital or cohabiting relationships. As PLWH live longer, it becomes increasingly important to promote safer sex and drug injection practices and to reinforce the role of every individual, HIV-positive or HIV-negative, in preventing the spread of HIV. In order to best use limited resources, prevention efforts should focus on intensive efforts with smaller groups and should be integrated into clinical care for PLWH.
III. Core Programmatic Components
Behavioral interventions for PLWH include individual and community-level education and skills-building programs. The following interventions constitute the minimum package of services for PHDP:
- Condoms (and lubricant) and risk-reduction counseling
- Assessment of partner status and provision of partner testing or referral for partner testing
- Assessment for sexually transmitted infections (STIs) and provision of or referral for STI treatment (if indicated, and partner treatment if indicated)
- Assessment of family planning needs and provision of contraception or safer pregnancy counseling or referral for family planning services
- Assessment of adherence and support or referral for adherence counseling
- Referral or enrollment of PLWH to community-based programs, such as home-based care, support groups, and post-test clubs.
PHDP programs will also include alcohol counseling, psychosocial support services, and integration of prevention messages into routine clinical care. At the community level, programs will focus on HIV stigma reduction, support communication about HIV and sex, disclosure to partners, and access to services. Structural factors will include efforts to reduce and eliminate legal and regulatory barriers to care and support for PLWH. Combination interventions are also critical, such as prevention of unintended pregnancies among HIV-infected women, prevention of mother-to-child transmission, STI assessment and management, and male circumcision. Discordant couples should be identified and provided with appropriate prevention counseling and services. Effective programs for PLWH must ensure meaningful involvement of PLWH in program design, implementation, and evaluation. Prevention programs should be part of a comprehensive set of HIV prevention efforts that target both HIV-negative and HIV-positive individuals. All interventions should be approached with utmost respect and sensitivity, and must be accompanied by efforts to combat stigma against PLWH.
IV. Current Status of Implementation Experience
Although PHDP implementation experience is limited, a number of pilot and qualitative studies support the effectiveness of these interventions. A recent study in Uganda found that individuals who learned they were HIV-positive were three times as likely to use condoms as those who did not know their HIV status, suggesting that testing can aid in reducing HIV transmission. Early studies show that interventions targeted to injecting drug users and to preventing mother-to-child transmission also reduce transmission.
Updated: June 2011
The Virus Stops With Me: HIV-infected Ugandans' Motivations in Preventing HIV Transmission
King R., Lifshay J., Nakayiwa S., et al. Social Science & Medicine (2009), Vol. 68 No. 4, pp. 749-757.
In-depth interviews with 47 HIV-infected men and women in Uganda revealed that participants feel a sense of responsibility for preventing transmission of HIV. They believe that conscious transmission of HIV equals murder and could leave children orphaned. Respondents said their sense of responsibility led them to encourage partner testing and disclosure of the test results; and to be an HIV/AIDS educator to others. Obstacles to safer sex practices included sexual desire; inconsistent condom use; fear of disclosure of one's HIV status; gender-related power dynamics; and social and financial pressures. The authors state that altruism plays an important role in motivating preventive behaviors among HIV-infected persons in Uganda.
Partners at Risk: Motivations, Strategies, and Challenges to HIV Transmission Risk Reduction among HIV-infected Men and Women in Uganda
Lifshay J., Nakayiwa S., King R., et al. AIDS Care (2009), Vol. 21 No. 6, pp. 715 – 724.
Interviews with 7 women and 20 men (no couples) in Uganda who were HIV-positive found that the participants increased condom use, reduced intercourse frequency, and had fewer sexual partners after testing HIV-positive. Interviewees said they were motivated by concerns for personal health and the health of others. Decreased libido also accounted for some of the behavioral changes. Factors contributing to risk taking included gender-power inequities (sometimes manifested by forced sex), pain experienced by women while using condoms, decreased pleasure for men while using condoms, lack of social support, and desire for children. The authors recommend interventions to address domestic violence, partner negotiation, use of lubricants and alternative sexual activities could increase condom use, and/or partner reduction.
HIV Transmission Risk Behavior among HIV-infected Adults in Uganda: Results of a Nationally Representative Survey
Bunnell R., Opio A., Musinguzi J., et al. AIDS (2008), Vol. 22 No. 5, pp. 617-624.
This national cross-sectional study examined factors associated with HIV transmission risk among HIV-infected Ugandan adults. Of the approximately 1,092 HIV-infected adults in the study, 79 percent did not know they were infected; three quarters were sexually active; and most reported their last sex act as unprotected. Forty percent of those who were living with HIV and cohabiting had an HIV-negative spouse. Only 21 percent knew that it was possible to have HIV discordance within a couple. Those who knew their HIV status were three times more likely to use a condom at their last sex act than were those who did not know their status.
Clinic-based Intervention Reduces Unprotected Sexual Behavior among HIV-Infected Patients in KwaZulu-Natal, South Africa: Results of a Pilot Study
Cornman D.H., Kiene S.M., Christie S., et al. Journal of Acquired Immune Disorder Syndromes (2008), Vol. 48 No. 5, pp. 553-560.
A pilot intervention in 2004/05 in KwaZulu Natal assessed prevention messages by specially trained counselors who used motivational interview techniques to help people living with HIV to reduce their HIV-transmission risk behavior. Discussions were tailored to a specific patient's HIV risk reduction (or maintenance of safer behavior) needs. Those who received the intervention reported a significant decrease over time in the number of unprotected sexual events, compared to individuals receiving standard counseling. The authors conclude that a counselor-delivered HIV prevention intervention for people living with HIV is feasible and can reduce unprotected sexual behaviors.
New Heterosexually Transmitted HIV infections in Married or Cohabiting Couples in Urban Zambia and Rwanda: An Analysis of Survey and Clinical Data
Dunkle K., Stephenson R., Karita E. et al. Lancet (2008), Vol. 371 No. 9631, pp. 2183 – 2191.
Most HIV transmission in sub-Saharan Africa is heterosexually acquired. The degree to which HIV transmission occurs within married or cohabiting relationships is uncertain. Using data from demographic and health surveys in Zambia and Rwanda of married or cohabiting couples or non-cohabiting couples from a voluntary counseling and testing service, the study estimates that 55 to 93 percent of new, heterosexually acquired HIV infections among adults occurred within serodiscordant marital or cohabiting relationships. The authors conclude that since most heterosexual HIV transmission in urban Zambia and Rwanda takes place within marriage or cohabitation, voluntary counseling and testing for couples should be promoted.
Integrating HIV Care and HIV Prevention: Legal, Policy and Programmatic Recommendations
Remien R.H, Berkman A., Myer L., et al. AIDS (2008), Vol. 22 Supplement 2, pp. S1-S132.
The authors of this report argue for a strategic approach to controlling the HIV and AIDS epidemic involving continued expansion and integration of care, treatment, and prevention programs. The paper includes suggestions on how to better utilize opportunities created by the antiretroviral roll-out to achieve more effective prevention, particularly in sub-Saharan Africa.
Psychosocial Support for HIV-infected Populations in Developing Countries: A Key Yet Understudied Component of Positive Prevention
Sweat M., O'Reilly K., Kennedy C., et al. AIDS (2007), Vol. 21 No. 8 pp. 1070-1071.
This systematic review of quantitative studies in developing countries examined psychosocial support services for HIV-infected clients as a behavioral risk reduction intervention. Only one randomized controlled trial had an evaluation component, thereby meeting inclusion criteria for the review. The study, conducted in Tanzania, randomized people living with HIV to receive standard care or standard care with individual counseling by trained staff. Both arms improved equally from baseline with regard to disclosure of HIV-positive status to anyone, condom negotiation, use of condoms, extramarital sex, and sexually transmitted infections. The authors recommend further efficacy evaluations.
Focusing HIV Prevention on Those Most Likely to Transmit the Virus
West G.R., Corneli A.L., Best K., et al. AIDS Education and Prevention (2007), Vol. 19 No. 4, pp. 275–288.
Individuals who simultaneously have high viral loads and multiple sex or needle–sharing partners pose a disproportionate risk of transmitting HIV to others compared to individuals with chronic HIV infection and low viral loads. Yet, according to the authors, most prevention programs focus on those with chronic infection. The authors outline a variety of testing strategies to identify people with high viral loads who pose the greatest risk of transmitting HIV. They review programs in North Carolina and Malawi that use testing to identify high-risk transmitters and they review financial feasibility issues in developed and developing nations.
Do Prevention Interventions Reduce HIV Risk Behaviours Among People Living with HIV? A Meta-analytic Review of Controlled Trials
Crepaz N., Lyles C.M., Wolitski R.J. et al. AIDS (2006), Vol. 20 No. 2, pp. 143 – 157.
This meta-analysis (a study of studies) identified 12 studies conducted in the United States that tested the efficacy of interventions to reduce HIV risk behaviors. The interventions included efforts to eliminate or reduce risky drug use and/or sexual practices. Interventions that significantly reduced sexual risk behaviors were: (1) based on behavioral theory; (2) designed to change HIV transmission risk behaviors; (3) delivered by health-care providers or counselors; (4) delivered to individuals; (5) delivered in an intensive manner; (6) delivered in settings where people living with HIV receive routine services or medical care; (7) provided skills building, or (8) focused on issues related to mental health, medication adherence, and HIV-risk behavior.
Influencing Sexual Behavior among HIV-positive Zambian Women
Jones D.L., Weiss S.M., Bhat G.J. et al. AIDS Care (2006), Vol. 18 No. 6, pp 629 – 634.
The authors assess the efficacy of behavioral interventions to increase use and acceptability of sexual barrier products, including vaginal chemical barriers, among HIV-positive women in Lusaka, Zambia. Women were divided into group or individual intervention arms. They attended a baseline assessment; three intervention sessions; and follow up assessments at 6 and 12 months. The study reported that all participants increased their acceptance and use of female condoms and vaginal products. Both intervention arms sustained male condom use at 6 and 12 months. The authors conclude that group interventions are likely to be acceptable and cost-effective.
Sexually Transmitted Infection Services as a Component of HIV Care: Findings of a Demonstration Project among HIV-infected Women in Thailand
Sirivongrangson P., Bollen L.J., Chaovavanich A., et al. Journal of Acquired Immune Disorder Syndromes (2006), Vol. 41 No. 5, pp. 671-674.
A demonstration project in Bangkok, Thailand, provided screening and treatment of sexually transmitted infections (STIs) for HIV-infected women during a six month period from 2003 to 2004. Just over half of the women were sexually active during the previous three months. STI prevalence varied greatly depending on where women obtained care: 8% of HIV-positive women at infectious disease clinics had STIs, whereas 30% of such women did at the STI clinic. Over one-third of the sexually active women reported not using condoms. However, women receiving antiretroviral treatment had a higher reported use of condoms than women not receiving antiretroviral treatment. The authors report that STI services for HIV-infected people was expanded in Thailand as a result of the findings.
Effectiveness of Highly Active Antiretroviral Therapy in Reducing Heterosexual Transmission of HIV
Castilla J., del Romero J., Hernando V., et al. Journal of Acquired Immune Disorder Syndromes (2005), Vol. 40 No. 1, pp. 96-101.
This study examined 393 serodiscordant heterosexual couples to determine the effects of highly active antiretroviral therapy (HAART) on preventing transmission of HIV. The study was conducted in Madrid, Spain, between 1991 and 2003. It found that when the HIV-positive partner had not been treated with antiretroviral therapy over 8 percent of their partners became infected. By contrast, no partner of an individual who received antiretroviral therapy became infected. The authors report that when HAART became widely available, heterosexual transmission of HIV declined by 80 percent.
From Treatment to Prevention: The Interplay between HIV/AIDS Treatment Availability and HIV/AIDS Prevention Programming in Khayelitsha, South Africa
Levy N.C., Miksad R.A., & Fein O.T. Journal of Urban Health (2005), Vol. 82 No. 3, pp. 498-509.
This paper describes how public access to antiretroviral treatment in South Africa has contributed to improvements in HIV prevention. The report is based on work by Doctors Without Borders/ Médecins Sans Frontières in resource-poor clinics in the Western Cape township of South Africa. In-depth interviews and clinic data were used to gather the information. The authors state that the introduction of mother-to-child-transmission prevention programs in 1999 and three HIV treatment clinics in 2000 were turning points in the region's response to the HIV epidemic. Each of the programs provided incentives for HIV testing; expanded prevention messages and outreach to people most at risk; and contributed to reductions in HIV incidence rates compared to other areas in the province.
Field Experiences Integrating Family Planning into Programs to Prevent Mother-to-child Transmission of HIV
Rutenberg N. & Baek C. Studies in Family Planning (2005), Vol. 36 No. 3, pp. 235-245.
This article reviews experiences in integrating family planning services with services for prevention of mother-to-child transmission (PMTCT) of HIV in ten countries in Africa, Asia, and Latin America. Community openness about HIV, fertility norms, and knowledge of PMTCT programs can affect the willingness of women living with HIV to seek family planning services. No differences were observed in use of contraceptives between HIV-positive and HIV-negative women in Kenya and Zambia, but the former were more willing to use condoms. In three countries where HIV prevalence was low and sterilization rates were high, women living with HIV often accepted sterilization. The authors conclude that the rights of HIV-positive women to informed reproductive choice should be respected.
Issues in HIV Prevention with Positives in India: The Role of Stigma and Discrimination
Ekstrand M. L. Center for AIDS Prevention Studies, University of California at San Francisco (2004).
Interviews with 104 HIV-positive men in India examined risk factors associated with HIV transmission. A majority of the men were migrant workers. Over one-third of the men had sex with men. Other risk categories included drug users, truck drivers, sex workers, and, in high prevalence areas, monogamous wives. Fewer than half of men living with HIV disclosed their status to their wives. Disclosure was even lower to health care providers, family members, friends and co-workers. The authors report that stigma and discrimination were the most common barriers to disclosure and they contributed to a reluctance to use condoms; seek counseling and testing; or to obtain care and treatment services.
Prevention Interventions with Persons Living With HIV/AIDS: Challenges, Progress, and Research Priorities
Gordon C.M., Stall R., & Cheever L.W. Journal of Acquired Immune Disorder Syndromes (2004), Vol. 37 Supplement 2, pp. S53-S141.
This paper is an introduction to a set of articles arising from a 2003 meeting in the United States to examine state-of-the-science behavioral risk reduction with HIV-positive persons and to outline immediate research needs. The authors state that although most people who learn they are HIV-seropositive will take steps to reduce risk for themselves and others, safer sex practices are difficult to maintain long term. However, most studies last only 12 months, suggesting a need for longer term studies. Challenges and progress in specific programs are overviewed. The authors comment that while researchers are increasingly consulting with consumer/community members to inform research projects, the quality of consumer-informed research varies widely.
Gender Dimensions of HIV-1 Status Disclosure to Sexual Partners: Rates, Barriers and Outcomes
Maman S. & Medley A. World Health Organization (2004), Geneva.
The authors review data from 1990 to 2001 regarding disclosure of HIV status. Rates, barriers, and outcomes of disclosure by people living with HIV are examined through a review of published literature and commentary from researchers and program implementers. Major barriers to discordant-partner disclosure are identified. Policy and programmatic approaches to address those barriers are discussed. Recommendations to enhance disclosure rates and to provide support for women who have (or would like to) disclose their HIV status to their sexual partners are provided.
Rates, Barriers and Outcomes of HIV Serostatus Disclosure among Women in Developing Countries: Implications for Prevention of Mother-to-child Transmission Programmes
Medley A., Garcia-Moreno C., McGill S., et al. Bulletin of the World Health Organization (2004). Vol. 82 No. 4, pp. 299-307.
This authors review 17 studies of rates, barriers, and outcomes of serostatus disclosure and its effects on prevention of mother-to-child transmission in developing countries. Disclosure rates varied greatly. In general, women who attended voluntary counseling and testing (VCT) clinics were more likely to disclose than women who were tested as a part of antenatal care. Fear of discrimination; accusations of infidelity by a partner; and abandonment or violence by a partner were barriers to women's disclosure of their serostatus. The authors recommend broader access to VCT; targeting women most at risk of negative outcomes of disclosure; and greater involvement of communities to reduce the stigma and fear associated with HIV serostatus.
Opportunities and Pitfalls in Integration of Family Planning and HIV Prevention Efforts in Developing Countries
Shelton J.D., & Fuchs N. Public Health Reports (2004), Vol. 119, pp. 12 -15.
The authors assert that family planning clinics are a "weak platform" for the integration of HIV prevention services in developing nations for several reasons: clients tend to be older married women who are less likely to transmit HIV; the clinics do not serve men; and the addition of HIV prevention services to family planning services strains staff that are already stretched thin and programs that have few resources. The authors suggest that mass media messages can be more effective and can reach a wider audience. They state that existing HIV treatment and prevention programs can be effective platforms to assist with family planning.
Positive Health, Dignity, and Prevention: Technical Consultation Report
Bernard E.J., Bartos M., Caswell G, et al. Global Network of People Living with HIV/AIDS (GNP+), Amsterdam (2009).
This report of a consultation on positive health, dignity, and prevention held in Tunisia in 2009 included participants from around the globe who developed an international consensus on the meaning of positive health, dignity, and prevention (PHDP) with participation by people living with HIV (PLWH) who worked with civil society, government agencies, international development agencies, UNAIDS co-sponsors, and donor agencies. They agreed that PHDP "requires a human rights approach based on legal protections and a policy environment free of stigma and discrimination for PLHIV" and that "programmes must promote holistic health and wellness, including access to HIV treatment." The report concludes with recommendations for networks of PLWH, civil society, and public sector organizations and donors.
PEPFAR's Meaningful Involvement of People Living with HIV/AIDS
The Office of the U.S. Global AIDS Coordinator (2009).
This brief from the President's Emergency Program for AIDS Relief (PEPFAR) highlights the importance of involving people living with HIV (PLWH) in program efforts and notes that PLWH are "vital contributors to the success of prevention efforts; important partners in health care delivery; sources of care and support for their communities; and effective advocates who can help build in-country capacity, local ownership, and accountability to promote sustainable efforts."
PEPFAR's Prevention for Positives
The Office of the U.S. Global AIDS Coordinator (2009)
The President's Emergency Program for AIDS Relief (PEPFAR) expanded from a focus on HIV-negative individuals to include interventions for people living with HIV (PLWH). Prevention efforts with PLWH include efforts to mitigate the spread of HIV to sex partners; injecting drug use partners; and infants born to HIV-infected mothers, as well as efforts to protect the health of infected individuals. The adoption of healthy living and reduction in risk behaviors among PLWH can lead to substantial improvements in the quality of life and a reduction in HIV transmission rates.
Positive Prevention by and for People Living with HIV
The LIVING 2008 Partnership, Amsterdam (2008).
This discussion paper was prepared for the LIVING 2008 partnership summit, held in Canada in 2008. The paper calls for leadership by people living with HIV in linking prevention and treatment; working to end stigma and discrimination; and advocacy and policy changes to address social vulnerabilities of people who are living with HIV. The paper outlines a range of programmatic issues and interventions, such as clinical and biomedical issues (including antiretroviral therapy and the risk of re-infection); psychosocial and social determinants of health; community participation; and policy and advocacy.
Positive Prevention. LIVING 2008: The Positive Leadership Summit
Delegates from the LIVING 2008: The Positive Leadership Summit (2008)
This short statement from the Summit outlines the issues of living positively, including strong prevention elements. It includes messages and targets for advocacy to advance the issue with policy makers.
Essential Prevention and Care Interventions for Adults and Adolescents Living with HIV in Resource-limited Settings
World Health Organization (2008), Geneva
To promote health and reduce transmission, this report puts forward a set of "essential" prevention and care services for adults and adolescents living with HIV. Descriptions of each service include country-specific considerations. Recommendations, which include psychosocial support, vaccination, family planning, and hygiene, among others, are scored for the strength of their scientific grounding.
HIV Prevention with HIV-Infected Persons Seen in Primary Care Settings
AIDS and Behavior (2007), Vol. 11 Supplement 1, pp. S1-S137.
The journal AIDS and Behavior released this special supplemental issue focusing on prevention with people living with HIV. The articles summarize programmatic responses in the United States. While programs highlighted have not undergone outcome evaluation, the peer-reviewed articles summarize the intervention development experience, intervention content, and implementation experiences/lessons learned.
Changes in Sexual Behavior and Risk of HIV Transmission after Antiretroviral Therapy and Prevention Interventions in Rural Uganda
Bunnell R., Ekwaru J.P., Solberg P., et al. AIDS (2006), Vol. 20 No. 1, pp. 85-92.
This study examines changes in risky sexual behavior among HIV-infected Ugandan adults following initiation of antiretroviral therapy (ART) and its effects on HIV transmission to stable partners. Other prevention measures were also provided, including voluntary counseling and testing for cohabitating partners and free condoms. Nearly 900 ART-naïve people living with HIV were evaluated at baseline and quarterly following initiation of ART. Six months after initiating ART, risky sexual behavior fell by 70 percent. Over 85 percent of risky sexual acts occurred within married couples. Estimated risk of HIV transmission from cohort members declined by 98 percent. The researchers conclude that ART combined with other risk-reduction measures reduces the risk of HIV transmission. However, they acknowledged that it would be difficult to distinguish whether all, or only some, of the interventions contributed to the reduction.
HIV Prevention for a Threatened Continent: Implementing Positive Prevention in Africa
Bunnell R., Mermin J., & De Cock K.M. Journal of the American Medical Association (2006), Vol. 296 No. 7, pp. 855-858.
This advocacy article urges strong emphasis on HIV prevention efforts; the authors point to the enormous human tragedy represented by more than 2.4 million deaths and 3.2 million incident HIV infections in sub-Saharan Africa in 2005. The authors emphasize the inadequacy of current HIV prevention efforts in sub-Saharan Africa and state that despite considerable expansion of antiretroviral therapy (ART) programs, prevention efforts have not kept pace. In low-income countries, investment in prevention may be cost-effective, since future care and treatment costs will be averted. New approaches and new resources might reinvigorate underfinanced HIV prevention efforts and avoid a widening gap between the numbers of individuals needing and receiving ART.
Group Intervention to Reduce HIV Transmission Risk Behavior among Persons Living With HIV-AIDS
Kalichman S.C., Rompa D., & Cage M. Behavior Modification (2005), Vol. 29 No. 2, pp. 256-285.
Healthy Relationships, a small-group, skills-based behavioral intervention for men and women living with HIV, is comprised of five sessions delivered over two-and-a-half weeks. Although male and female groups are conducted separately, all sessions are facilitated by one male and one female, one of whom is an HIV-positive peer counselor. The intervention was developed and tested among people living with HIV in Atlanta, Georgia. At six-month follow-ups, participants showed significant reductions in the number of unprotected vaginal/anal sex acts with HIV-negative partners; overall and unprotected vaginal/anal sex acts; and had fewer non-HIV-positive partners than the comparison group. Participants were also more likely to use condoms for vaginal/anal sex and more likely to refuse unsafe sexual practices than comparison group participants.
Effect of Brief Safer-sex Counseling by Medical Providers to HIV-1 Seropositive Patients: A Multi-clinic Assessment
Richardson J.L., Milam J., McCutchan A., et al. AIDS (2004), Vol. 18 No. 11, pp. 1179-1186.
Partnership for Health (PfH) is a brief (3-5 minute), provider-delivered counseling program for individual men and women living with HIV in California, USA. The program is designed to improve patient-provider communication about safer sex, disclosure of serostatus, and HIV prevention. The model supports clinic staff "buy-in" and training. The intervention study found that patients who had two or more sex partners or at least one casual partner and who received consequences-framed messages were significantly less likely to engage in unprotected anal or vaginal sex. There was no change among those with only one partner or a main partner at baseline.
Prevention for Substance-Using HIV Positive Young People: Telephone and In-Person Delivery
Rotheram-Borus M., Swendeman D., Comulada S., et al. Journal of Acquired Immune Deficiency Syndromes (2004), Vol. 37 Suppl. 2, pp. S68-S77.
Choosing Life: Empowerment, Actions, Results (CLEAR) is an intervention comprised of three modules that is delivered individually to youth living with HIV in two major U.S. cities. Modules address physical health and antiretroviral adherence; reduction of risky sexual and substance use behaviors; and condom use and safer sex negotiation skills. Study participants received either in-person intervention, telephone-delivered intervention, or served as waitlist controls. At 15-months, intervention participants reported significantly greater increases in the proportion of protected sex acts with all sex partners and HIV-negative partners than did control participants. Participants who received the in-person intervention reported significantly greater risk reduction behaviors at 15 months compared to participants who received the telephone-delivered intervention.
A Randomized Controlled Trial to Reduce HIV Transmission Risk Behaviors and Sexually Transmitted Diseases among Women Living with HIV: The WiLLOW Program
Wingood G.M., DiClemente R.J., Mikhail I., et al. Journal of Acquired Immune Deficiency Syndromes (2004), Vol. 37 Suppl. 2, pp. S58-S67.
The Women Involved in Life Learning from Other Women (WiLLOW) intervention is a small group, skill-training for women living with HIV. Rooted in gender and power theory, the four, four-hour sessions delivered over four weeks focus on HIV awareness, safer sex communication skills, and relationship decision-making. The study was conducted among African-American women in Alabama and Georgia, USA. At 6- and 12-month follow-ups, women who participated in WiLLOW reported significantly fewer acts of unprotected vaginal sex and were significantly less likely to report never using condoms than women in the comparison group. Additionally, over 12 months, women in the WiLLOW intervention were significantly less likely to acquire new bacterial sexually transmitted infections than women in the comparison group.
Sexual Behavior of HIV Discordant Couples after HIV Counseling and Testing
Allen S., Meinzen-Derr J., Kautzman M., et al. AIDS (2003), Vol. 7 No. 5, pp. 733-740.
The authors examine the sexual behavior of 963 serodiscordant couples in Lusaka, Zambia, following voluntary HIV counseling and testing (VCT) through self-reports and biomarkers. It was found that condom use was the primary method to reduce HIV transmission to the non-infected partner. Prior to VCT, less than 3 percent of couples reported using condoms. During follow-up in the year after VCT, 80 percent used condoms. Individuals who reported always using condoms, had a 39 to 70 percent decline in sexually transmitted infection rates, including HIV. However, under-reporting of unprotected sex was common. For example, couples who reported to always use a condom still had sperm detected in vaginal smears and pregnancy was common.
Incorporating HIV Prevention into the Medical Care of Persons Living with HIV: Recommendations of CDC, HRSA, NIH, and the HIV Medicine Association of the Infectious Diseases Society
Centers for Disease Control and Prevention, Health Resources and Services Administration, National Institutes of Health, & HIV Medicine Association of the Infectious Diseases Society. Morbidity and Mortality Weekly Report (2003), Vol. 52 No. RR12, pp. 1-24.
This set of recommendations from the United States Centers for the Disease Control and Prevention proposes a role for medical providers in screening HIV-positive patients for sexual and drug-related risk behaviors; engaging them in risk-reduction; notifying and testing partners; and screening for and treating sexually transmitted infections. A table presents the relative risk of a spectrum of sexual behaviors. Patient scenarios are discussed, and tools are offered to guide screening and messaging. Ratings are given for the strength of the evidence underpinning each recommendation.
An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodia
Wilkinson D., Sovannarith S., Navy K.B., et al. International HIV/AIDS Alliance (2000).
Home-based care services for people living with HIV (PLWH) can contribute to HIV prevention efforts. Home visitors can: promote safer sex; refer PLWH and partners for services related to HIV, sexually transmitted infections, and preventing mother-to-child transmission. They can also help to decrease stigma and discrimination by supporting community response and acceptance of PLWH. In this evaluation of the Khana Home Care Program for PLWH in Cambodia, nearly half of PLWH said home-care teams increased their comfort in disclosing their HIV status to others and nearly 30 percent of PLWH reported using condoms as a result of their increased knowledge about HIV.
Advancing the Sexual and Reproductive Health and Human Rights of People Living With HIV: A Guidance Package
Global Network of People Living with HIV/AIDS (GNP+), Amsterdam (2009).
This comprehensive 63-page guide addresses key clinical, structural, legal, and policy issues to serve people living with HIV and strengthen HIV prevention efforts. Specific recommendations are offered around each of the issues, providing actionable points for planning and implementation.
Peer Education and Support in HIV/AIDS Prevention, Care, and Treatment: A Comprehensive Training Course for Expert Clients in the Kingdom of Swaziland
International Center for AIDS Care and Treatment Programs, New York (2009).
The package includes both a facilitator's and a participant's guide.
Integrating HIV Prevention in the Care Setting: Health Manager's Guide
Bachman G., Stuart L., & Schietinger H. Family Health International (2007).
The 81-page package on integrating HIV prevention in a care setting includes a facilitator's guide.
Positive Prevention: HIV Prevention with People Living With HIV: A Guide for NGOs and Service Providers
International HIV/AIDS Alliance, London (2007).
This guide offers positive prevention strategies in the areas of individual health education and support. It provides an overview of the controversy regarding the term "positive prevention" and its implications. Guidelines are provided to ensure access to care; improving service delivery; assist with community mobilization; and to enhance advocacy and policy change.
Prevention for Positives: A Course Module for Healthcare Professionals
Stuart L. & Bachman G. Family Health International (2007).
This training module for healthcare providers provides information on how to integrate HIV prevention into clinical settings in resource-constrained settings. Materials include a guide for health managers on integrating HIV prevention in the healthcare setting and a facilitator's manual and PowerPoint presentation on prevention for positives.
Chronic HIV Care with ART and Prevention: Integrated Management of Adolescent and Adult Illness, Integrated Management of Childhood Illness Interim Guidelines for Health Workers at Health Centre or District Hospital Outpatient Clinic
World Health Organization (2007).
WHO's 128-page comprehensive curriculum. See specifically the section discussing "Adult Illness-Chronic HIV Care with ARV Therapy and Prevention."
Prevention Resources for People Living with HIV Web site
This website, created by the PEPFAR Prevention with People Living with HIV Task Force, includes a database of scholarly articles, curricula, and guidelines, policies, frameworks to help program and policy planners design, develop, and deliver effective clinic or community-based HIV prevention programs to ensure that all HIV-positive persons have access to evidence-based, comprehensive HIV prevention services in order to protect their own health and the health of their partner(s) and families.
Ryan White Prevention Project: Patient Exit Interview
This 17-page document features a sample survey tool used by clinicians at government-funded clinics across the U.S. to assess the frequency and variation of prevention services among people living with HIV.
View Full Text (PDF, 276 KB)
The Global Network of People Living with HIV (GNP+)
This website offers extensive discussion of issues and current documents under four general categories: empowerment; human rights; positive health, dignity, and prevention; and sexual and reproductive health and rights.
View Website
- An Overview of Combination Prevention
- HIV Prevention for Serodiscordant Couples
- Antiretroviral Therapy as an HIV Prevention Strategy
- Contraception to Prevent Unintended Pregnancies among Women with HIV
- Infant Feeding for Mothers Living with HIV
- Prevention of Mother-to-Child Transmission of HIV (PMTCT)
Related Promising Practices
Related Pages
- USAID | Project SEARCH Fact Sheet: Positive Health, Dignity and Prevention - Behavioral Interventions with PLHIV (PDF, 1.55 MB)
- Case Study: Faith-Based Organizations and HIV Prevention with MARPs in Mexico
- Spotlight: The Astonishing Neglect of an HIV Prevention Strategy
- Stigma Action Network Website


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New England Agricultural Economics Council
New England Agricultural Economics Council Records, 1955-1966.
1 box (0.5 linear feet).
Call no.: MS 031
Call no.: MS 031
NEAEC was formed in 1955 after the dissolution of the New England Research Council on Marketing and Food Supply, in order to promote education and research on economics and the social problems relating to the production, marketing, and consumption of agricultural products.
The NEAEC Records include correspondence, minutes and proceedings, organizational and financial records, and newsletters.
- Agricultural economics--New England
- Dairy products--Marketing--New England
- Food industry and trade--New England
- Food--Marketing--New England
- New England Agricultural Economics Council


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Monday, March 11, 2013
The arts will come alive during the Town of Mount Pleasant ArtFest at Mount Pleasant Towne Centre on Saturday, March 16 from 11 a.m. to 3 p.m.
All activities and performances are free for the entire family.
The Children's Craft Village will include face painting, caricature drawings, sparkle tattoos, sidewalk chalk, hula hoops, craft activities, Sweetgrass basketry, balloon animals, bubble blowing, a jump castle, a slide and sidewalk chalk.
A variety of performers will dazzle the crowds at two stages.
"Without the participation of so many wonderful local art businesses, we simply would not be able to offer such a remarkable Craft Village," said Tracy Richter, special events assistant.
"Any children who have been considering signing up for classes at these businesses will have a chance to try them all for free."
Partners at the Craft Village will include ART BUZZ Kids, 4Cats Studio, Creative Spark, Beaded Venus, Fear No Easel, The Gibbes Museum of Art and Robin Mann Art.
"We are fortunate to have such an extraordinary line up of artists this year," said Nicole Harvey, special events planner.
"The productions are exciting and diverse. Look for an outstanding show from all of the performers."
The Main Stage Entertainment will be located in front of the Palmetto Grande Movie Theater and another stage will be on Belk Drive. Performers include the following:
• Wando Chamber Orchestra
• Laing Middle School
• Palmetto Vocal Project
• Smalls Music Lab
• LowCo Suzuki Guitar
• Mad Crow
• Dance Anatomy
• Musical Theater Center
• Once Upon a Ballet
• The Drake School of Irish Dance
• Elite Dance International Studio
• Daniel Island Hip Hop
• Encore Dance Theatre
• No Sleeves Magic
• Homespun Hoops
• Jugglestuff
• Revolve Aerial Dance
Barnes & Noble will offer Story Time at 11 a.m. and Belk Kidfest will host a fashion show. The Mount Pleasant Police Department and Fire Department will offer special exhibits.
The Mount Pleasant Artists Guild will display more than 100 entries. The entries will be judged and spectators have the chance to vote on the People's Choice Award, Best of Show, first, second and third prizes.
Mount Pleasant Towne Centre is located at 1600 Palmetto Grande Drive. For more information about ArtFest at Towne Centre, visit the town of Mount Pleasant online at www.ComeOnOverMP.com or call Nicole Harvey at (843) 884-8517.
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Quick Links
Shop All Jewelry
NL10366 In Stock Absolutely No Delay on Personalization!
The symbol marks the birthdays from December 22nd to January 19th. Capricorns are ambitious and has the aim to achieve status and are very good organizers, and can be persistent and focused. Measuring 5/8 inch this silver horoscope pendant comes on your choice of a beautiful coreana chain or a simple black silk cord. This sterling silver Capricorn zodiac pendant makes a wonderful gift!
Eve's Addiction.com wants you to be a happy customer. We want you to be completely satisfied with the sterling silver jewelry that you receive from us, as we only sell high quality silver and cubic zirconia cz jewelry. We do understand that you may not like your purchase for some reason.
You may return or exchange your jewelry within 60 days of purchase if you are not satisfied with it. The jewelry must be returned in its original condition for a refund or exchange. Engraved, personalized, photo, monogram, name and initial, chocolate and clearance items are not returnable or exchangeable.


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Tuition, Scholarships, and Finance
For information on admission requirements and deadlines, please review the MPA Admission page.
Tuition estimates are based on the number of units required by each program and may vary according to the number of classes in which a student is enrolled. The 2015-2016 year includes Summer 2015, Fall 2015, Intersession 2016, and Spring 2016. All tuition rates are subject to change.
Fees: Students pay a $25 AGUSF fee each fall and spring semester.
Tuition does not include required Student Health Insurance. For more information, please visit www.usfca.edu/hps.
Graduate Community Service Merit ScholarshipIn keeping with the University's mission to educate for a more just social order, these scholarships are awarded on a competitive basis to a limited number of MPA applicants who have demonstrated meritorious achievements in community service activities in either paid or volunteer positions. This scholarship does not require a separate application. Amounts may vary and scholarship awards are indicated in the admission letter.
Approximate Award Amounts: $2,500 - $5,000
Merit ScholarshipAwarded to graduate applicants who have shown exceptional merit academically and/or professionally. This scholarship does not require a separate application. Award amounts vary and any scholarship awards will be indicated in your admission letter.
Approximate Award Amounts: $1,000 - $5,000
Public Administration ScholarshipsAwarded to Master of Public Administration students. No separate application is required and scholarship awards are indicated in the admission letter. Amounts vary and the scholarship is applied in increments at the time of the student's class registration.
Find more School of Management scholarship resources.
*Scholarships currently not available for applicants to the Online MPA Program.
For information on federal student loans, visit www.fafsa.ed.gov or contact the USF Financial Aid Office at (415) 422-2020 or at email@example.com. You may also wish to visit the USF Financial aid website or review these helpful financial aid tutorials. The USF school code for FAFSA is 001325. We recommend that you submit your FAFSA as early as possible, even before an admission decision has been made.
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email@example.com(415) 422-2221


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Crews on Tuesday were still cleaning up at the Aiken Training Track where a man allegedly fled the scene after crashing his SUV through a fence on Saturday, snapping a utility pole in half, according to the Aiken Department of Public Safety.
William Thomas Pierron, 30, of Water Oak Drive in Windsor, was charged with careless driving and hit and run with property damage, according to Sgt. Jake Mahoney.
The wreck happened about 1:15 a.m. Saturday at the entrance to Aiken Training Track on Two Notch Road, where the paved portion of the roadway becomes dirt.
Pierron was traveling south on Two Notch Road in his 2005 Jeep when the vehicle ran off the road on the left while going through a curve, according to the accident report. The Jeep, which was traveling too fast for conditions, struck a wooden fence and a utility pole before overturning and coming to rest on its roof.
The vehicle was traveling an estimated 40 mph, according to the report.
"Officers were notified of the collision by witnesses who lived in the area," Mahoney said. "Officers responded to the scene and investigated the collision but were not able to locate the driver."
Pierron, who was not injured in the wreck, had fled the scene, Mahoney said. He turned himself in to Public Safety officers later on Saturday and accepted responsibility for the collision.
According to Aiken County court records, Pierron has multiple driving violations on his record, including speeding, reckless driving and driving too fast for conditions.
Wallace Johnson and Darryl Holloway, groundskeepers for the Aiken Training Track, said they were cleaning the scene for about two hours on Tuesday.
In addition to a section of the wooden fence and utility pole, a caution light for equestrian crossing was also damaged, they said.
Pieces of the Jeep, including a chunk of the fender and a side mirror, were still at the scene.
"It's regular, especially when it's smooth," Holloway said of motorists speeding down the dirt road. "They come through here speeding."
Johnson said he's been working at the track for 26 years and has seen at least five accidents during which a motorist crashed through the track's wooden fence.
The Aiken Training Track will host the first round of the Aiken Triple Crown on March 16.
Teddy Kulmala covers the crime beat for the Aiken Standard. He is a graduate of Clemson University and hails from Williston.
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This quilt top was hand stitched. Perfect little stitches. 928, 2x2 squares. (Oh, come on, you knew that I would count.) It measures 87"x 79".
(the five of us. july 2002. i think that i was making peanut butter and jelly sandwich # 3,192. i can't even imagine how many pb&j's that i have made in their lifetime.)
The kids keep growing. And still. It is just a top.
Until last weekend. When I decided it was time. We have a little road trip coming up and I was not going to have my family sitting on a top. Just a top. Again. So, I got busy. And I sandwiched. Three times. To try to get it right. With heavy chairs holding my huge piece of fabric that I used for the back. And the entire time I was pinning, I was thinking about the walking foot that Erin told me I needed. And about how I still hadn't purchased it. And about how there was no way that I was going to get to a store to purchase a walking foot. And I was thinking about the woman who had hand stitched all of those pieces together. And it was like that woman whispered to me, "Just hand stitch it, for goodness sakes!"
When I told my mother, she just giggled and said, "Yes, people use safety pins, and there are actually curved safety pins made just for quilting. " Who knew? Oh, besides all of you quilters. (Hmmm. Telling that story may just rank right up there with my freezer paper story.)


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Resist-A-Ball® Sweet 16 Cardio Workout DVD - This stability ball workout is packed full of fun and creative exercise ball cardio choreography that will give your body a whole new challenge! Exciting 16-count cardio combos deliver a year's worth of fun moves that can be as simple or complex as you like. This is a heart pumping, calorie burning, total body workout with Resist-Ball® Cardio like you have never seen before!! Get ready to move! Featuring: Carol Murphy with Stephanie Morris.
Stability Ball sold separately.
Shipping Included
Shipping cost included within the lower 48 states only
Ships via UPS


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Click Here to Watch the Whole Video in HD at Straight Fraternity
Me and my video camera alone with a hot straight guy. Anything can happen. Horny straight guys go gay for pay.
Matthew is a performer in straight porn and came to the shoot with his girlfriend. While she was in the other room, he agreed to go gay for an hour.
Pixels: 320X240 | Bitrate: 350K
Pixels: 640X480 | Bitrate: 700K
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love the bare dick fucking
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that was hot!
this muthafucka is soooo damn sexy i wish dat waz my bare azz
way hot
this white dude is sexy and I don't even like white guys.


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1-year limited warranty
Average Customer Review4.5 (42 reviews)
Create an online reviewand share your thoughts with other customers
Things I liked:I Like The Wood Stock and the Weight is OK.
Things I would have changed:Make It Easier to mount a scope.
What others should know:The rear sight is too far forward
Things I liked:This is a time tested classic design.
Things I would have changed:I prefer the older models (original Sheridan) where the spring actuated safety is located on the butt near the natural placement of your thumb.
Things I liked:I ordered three of these air rifle because I heard the Sheridan brand is going to be retired. This brand is fantastic in quality and accuracy. If the current ammo shortage continues i will not have to pay higher prices for 22 lr. I purchased 4 tins of JSB Diabolo Exact in the 20 caliber. The pellets are perfect, I will be ordering more of pellets in the near future to stock up. I love to target practice and now I can take 2 of my grandsons with me.
Things I would have changed:Nothing.
What others should know:Nothing
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As seen on the National Geographic Channel.
Price: $39.95
Explore some of the most remote, fascinating, and unspoiled wild locations on Earth in one definitive collection of critically acclaimed National Geographic specialsavailable on DVD for the first time.
Experience the world's last great places through stunning photography captured by award-winning National Geographic filmmakers. Delve into wild, unknown lands home to exotic, amazing wildlife...and witness magnificent vistas few humans will ever see firsthand.
Not available for shipment outside of the U.S. and Canada.
(based on 1 review)
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Good but very old
By Dan
from Connecticut
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Comments about World's Last Great Places DVD Set:
Disappointed that National Geographic markets this as worlds last great places when they were done over 20 years ago. Very misleading.
Bottom Line No, I would not recommend this to a friend
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The MLTA is a professional organization working on behalf of title industry service providers and consumers. We hope that you will consider joining the many agents, abstractors, attorneys, and underwriters who already have benefited from their membership.
This year, classes to begin the process of becoming a Licensed Title Producer are scheduled for June 8 and 11 and for August 10 and 13.
Online and Take Home CE courses are available. Look for several new courses soon.
The ALTA Webinar Video shown on our Legislative page provides a detailed discussion of the Consumer Financial Protection Bureau's new closing disclosure (CD) which will replace the HUD-1 on August 1, 2015.
Call or email MLTA for details. Many options are available -
A Sponsor Opportunities details page is coming soon.
The MLTA is holding the 8th Annual Crab Feast on June 3rd, from 4 - 8:00 pm. Click here for details.
Maryland Land Title Association
1700 King William Woods Road
Midlothian, VA 23113


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13 Signs You're Ready to Move In Together
13 Signs You're Ready to Move In Together
Moving in together can be either the dreamiest time in a relationship (a serious future with nightly snuggles and potential wedding bells!) or the scariest (fighting over the blanket, dude mess, and slamming doors, ugh). Merging spaces at the right time can be the difference between blissful cohabitation and epic disaster—these experts will help you know when to turn in your old keys for good.SEE MORE
You're ready to move in together if…you're nervous."Feeling scared is a good sign," says Tracy McMillan, author of Why You're Not Married…Yet: The Straight Talk You Need to Get the Relationship You Deserve. "You understand that it's a decision of big magnitude, and you're undertaking something that's a big deal and will impact your life." If you're not the least bit apprehensive, McMillan advises taking a step back and making sure you're not just in fantasy mode of "playing house rather than in the reality of joining lives with another person."
You're ready to move in together if…you don't feel a sense of pressure.If you feel pressure to move in from anyone (your parents, your friends, your partner—even yourself), you may not be ready. "Any time there's a big uncomfortable question mark, figure out how to take some time and make it work," says Jessica Massa, author of The Gaggle: How the Guys You Know Will Help You Find the Love You Want. She suggests finding an alternative like waiting a year, or compromising by moving closer to each other. "If it's even a question, just wait."
You're ready to move in together if…you're kind of afraid to give up your current life.Know the old cliché He's my missing piece? Kill it and never look back. McMillan says you'll know you're ready to move in with your partner when you have a fantastic life on your own that you're reluctant to give up. You won't see him as what completes you, but rather "the cherry on top of the frosting on top of the cake that is your life," she says. "You're ready when you know that he's getting as great of a deal or better than you are. Each partner should feel like he or she scored."
You're ready to move in together if…you're not committing to move in as a substitute to committing to marriage.You don't want to tie the knot, so you move in together instead. Sounds kind of nutty, but McMillan has seen it happen all the time: She compares it to an apartment search. "It's like saying, 'I don't want to buy this apartment, but I want to rent it.' Is this a guy that you're only willing to rent? Or are you willing to buy him?" Before you move in together, McMillan stresses continuing to date while figuring out if your guy is a rental, or if you're in it to buy (read: get married).
You're ready to move in together if…you've had a major disagreement and survived.Remember the fight you thought was going to end your relationship? Turns out the fact that you and your partner successfully survived the Big Blowout of 2012 makes you more ready to share a place. Professional matchmaker Amy Laurent, star of Bravo's new show Miss Advised and the author of 8 Weeks to Everlasting: A Step-by-Step Guide to Getting (and Keeping!) the Guy You Want, says knowing how to recover from a huge disagreement is essential for a couple to take the next step: "You're going to need those tools when you move in full time."
You're ready to move in together if…you have defined your relationship.Take a step back—have you actually had the "What are we?" talk? "It sounds funny and almost ridiculous, but when people are in a million different versions of sort-of-maybe relationships, if you haven't sat down and defined your relationship, that makes a big difference," says Massa. Regardless of how comfortable you are together, and how many other ready-to-move-in criteria you fit, if you haven't had the DTR talk, you're revealing a lapse in communication.
You're ready to move in together if…you've traveled together and had a great time.Laurent says the intensive time of taking a vacation as a couple is like a mini-living-together opportunity. Her test: Have you gone away for a week or two and spent 100 percent of the time together—and actually enjoyed it? If not, try it before you take the plunge. "If you haven't traveled together, you don't necessarily know each other's habits," Laurent says.
You're ready to move in together if…you don't ignore problems.The time you're spending together already can be a good barometer for whether you're ready to share space permanently. Massa says to look at the conflicts you and your partner have: Are the same issues coming up? If they are and no one is working on them, that's a bad sign. "Once you get in the space, you're on top of each other, and the problems just explode," she says. "If you see that both of you are trying to make progress, that's one thing, but if you're living together, they're only going to get a million times worse."
You're ready to move in together if…you're already simulating the situation.Are you spending four or five nights a week together? Good, Laurent says. "You should be getting a sense of what it's like to be waking up to him every day before you move in together." If you're thinking about merging your living spaces but haven't done a trial run yet, Laurent suggests giving it a go, especially if you're only used to spending a night or two together now.
You're ready to move in together if…you're beyond the honeymoon phase.Your guy should make you swoon, yes—but Laurent warns against making big decisions like moving in with your partner while you're still in the starry-eyed stages of your relationship. "The honeymoon phase is six months to a year," she says. "At that point, some girls think, Why wouldn't we move in? Why pay two rents? I hate being alone. You're not ready if these are your reasons for moving in."
You're ready to move in together if…it's not about the money.Sure, moving in together knocks one rent out of the equation and condenses two sets of utility bills, but the end of your lease doesn't automatically equal move-in time. Massa warns, "You have to say with 100-percent confidence that moving in together has nothing to do with your finances."
You're ready to move in together if…you've defined your deal-breakers.Don't move in together if you haven't discussed the things on your dude DON'T list, says McMillan. The last thing you want is to cohabitate and then find something you can't live with—like his library of porn that could rival the Penthouse archives. (Note: This goes both ways, and he should tell you his deal-breakers in advance, too.)
You're ready to move in together if…you've discussed your expectations openly and honestly.Laurent says the biggest mistake couples make before moving in together is not talking about what moving in together actually means. "Say, 'Let's sit down and discuss why we're moving in together. What's the next step? Why are we now taking the time to move in together?' That's when both people are communicating this is the next step."