Based on WHO and UNAIDS reports in 2021, 38.4 million (33.9-43.8 million) HIV cases in the world, in Indonesia reported by 34 provinces, the number of people living with HIV found in the January-March 2022 period was 10,525 941,973 people have HIV, and 8,784 people are receiving ARV treatment. The aim of this study is to observe the literature on the clinical efficacy, safety, compliance and risk compliance of oral pre-exposure prophylaxis (PrEP) for HIV prevention in all population groups. A literature review was carried out by identifying national and international articles regarding pre-exposure prophylaxis (PrEP) for preventing HIV transmission. The database used was Google Scholar, Pubmed, Science Direct, The Lancet. There were 331 articles searched from the Pubmed online database, 14 articles, Proquest 134, Science Direct 105, The Lancet 2, Google Scholar 105. There were 20 articles that met the inclusion criteria and were processed.

This chapter begins with brief comments on the history of psychological treatment and then describes the principles upon which effective treatment relies. These empirically derived principles specify the approach to the allocation of resources according to each client’s risk to reoffend (the Risk principle), the issues that need to be targeted (the Needs principle), and the way in which treatment should be delivered (the Responsivity principle). The specific application of these principles in the treatment of sex offenders is then described. The limited evidence on the rate of entry into treatment and on treatment completion is outlined followed by a consideration of the inconsistencies in the application of these principles that is evident in the literature. Evidence supporting a limited number of treatment targets is noted followed by a consideration of the evidence on treatment effectiveness. Finally an alternative empirically-based treatment approach derived from the “positive psychology” literature is outlined followed by a review of the effectiveness of treatment.

Chapter 32 Effective Sex Offender Treatment in Correctional Settings A Strengths-Based Approach Liam E. Marshall, Liam E. Marshall Rockwood Psychotherapy & Consulting and Waypoint Centre for Mental Health Care, CanadaSearch for more papers by this author Liam E. Marshall, Liam E. Marshall Rockwood Psychotherapy & Consulting and Waypoint Centre for Mental Health Care, CanadaSearch for more papers by this author Book Editor(s):Devon L. L. Polaschek, Devon L. L. PolaschekSearch for more papers by this authorAndrew Day, Andrew DaySearch for more papers by this authorClive R. Hollin, Clive R. HollinSearch for more papers by this author First published: 03 April 2019 https://doi.org/10.1002/9781119139980.ch32Citations: 1 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary This chapter describes strength-based approach (SBA) that takes an integrated approach in which deficits are addressed, with emphasis on identifying and building the client's strengths. The responsivity principle is concerned with the way treatment is delivered. It has two components, general and specific responsivity. Positive psychology equips clients with the skills necessary to fulfill their potential while at the same time not neglecting efforts to ameliorate problems and difficulties. Perhaps the approach to sex offender treatment that most closely matches a positive psychology or strengths-based approach is the Good Lives Model (GLM). The GLM offers an approach to treatment which aims to provide sexual offenders with the skills and attitudes necessary to develop a more satisfying life through addressing unmet needs. The chapter considers some of the challenges to implementing sex offender treatment programs in correctional settings. Citing Literature The Wiley International Handbook of Correctional Psychology RelatedInformation

The problem of antimicrobial resistance (AMR) is substantial, exacerbated by excessive and inappropriate antibiotic prescribing. Approximately 60% of antibiotics issued in primary care are for respiratory tract infections (RTIs), which are mostly self-limiting and do not require antibiotics. Point-of-care testing (POCT) devices that measure C-reactive protein (CRP) – a biomarker for infection – can be used to guide and ultimately reduce prescribing. We performed a cost-effectiveness and budget impact analysis of a national programme of CRP POCT to improve antimicrobial stewardship for RTIs in primary care in Ireland. We compared CRP POCT – with and without communication skills training of General Practitioners – against usual care. We performed a network meta-analysis to establish clinical effectiveness and developed a probabilistic decision tree to investigate cost-effectiveness and budget impact from the perspective of the healthcare system. The model considered outcomes for the Irish population over five years. Inputs were synthesised from published studies. Cost-effectiveness was estimated using cost-per-prescription avoided. CRP POCT with/out communication training was more costly and effective than usual care, although some uncertainty in long-term effectiveness was observed. CRP POCT without communication training was dominated, while the combined intervention had a cost-per-prescription avoided of €111 (95% CI €45 to €243) versus usual care. The budget impact was costly over five years, estimated at €4.5 million (95% CI €-22.8 to €34.8 million) and €23.9 million (95% CI €5.1 to €43.8 million) with/out communication training. The findings were robust to sensitivity analyses. CRP POCT is most cost-effective when combined with communication training. However, the budget impact is costly, and there's limited evidence that the effect is sustained in the long-term, suggesting the device may not reflect value for money or sufficiently address the growing problem of AMR. CRP POCT should be considered alongside a suite of interventions aimed at improving antimicrobial stewardship.

This chapter describes the approach to the treatment of sex offenders in both correctional and forensic settings with differing populations. This approach is grounded in empirical evidence and is guided by current theory on risk, treatment needs and responsivity issues. If treatment providers decide to employ group therapy they must decide whether to run 'closed' or 'open' groups. Psychotherapists from a broad range of therapeutic orientations have accepted the crucial role the therapist plays in successfully treating clients. The chapter describes the Rockwood treatment programme for sex offenders and its adaptations for differing populations. Overall, this programme has been shown to be effective in addressing criminogenic targets and demonstrated significant reductions in reoffending compared to treatment as usual and untreated sex offenders in the Canadian federal correctional system. The Rockwood programme seems to be easily adapted to, and effective with, non-typical sex offender populations, such as those with a mental illness.

Purpose of Review There is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill. Recent Findings Sex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment and management. Summary This paper will review the literature on mental illness among sexual offenders, present a typology to aid in the assessment, treatment, and management of sexual offender with mental illness, and highlight important considerations when providing treatment to sexual offenders with mental illness.

Purpose - The purpose of this paper is to note the basis for the emergence of strength-based approaches (SBA) to the treatment of sex offenders and point to Tony Ward's Good Lives Model (GLM) as the impetus for these developments. Design/methodology/approach - Next, the authors outline the elements of the GLM and of other SBAs. The features of various ways to evaluate treatment programs are discussed and this is followed by an examination of the evidence bearing on the value of the GLM and other SBAs. Findings - The authors note that the effects of the GLM are limited to within treatment indices as, to date, there are no long-term outcome evaluations of the model on reducing recidivism. Indeed, there appears to be only one such study of an alternative SBA program. Originality/value - The authors conclude that additional outcome studies are needed to evaluate the utility of the switch away from deficit-focused approaches to strength-based models of treatment.

Initially, this paper notes that treatment for the paraphilias has been most thoroughly described and evaluated within the context of treating sex offenders (i.e., child molesters, rapists, and exhibitionists). We note that the literature does not always carefully distinguish "pedophiles" from other child molesters and that rapists are often identified as having a "Not Otherwise Specified" paraphilia. Both these practices appear problematic. We then outline current approaches to the treatment of sex offenders which have typically been seen as relevant to dealing with all types of paraphilias. The historical emergence of sex offender treatment is noted, leading to an outline of current approaches that address known problematic issues by employing established procedures and by delivering treatment in an empirically based manner. We conclude with a description of evaluations of the effectiveness of these treatment approaches which indicate overall positive outcomes.

Although denial takes many forms, in this review we have restricted our concerns to those sex offenders who claim to not have committed a sexual offense. We refer to these offenders as “categorical deniers”. The literature on the incidence of categorical denial, the characteristics of these offenders, and the many purposes denial seems to serve are all given consideration. We then examine the relationship of categorical denial to future risk taking into consideration the relationship of future risk to the meaning denial has for these men. Next we consider three different approaches treatment providers have taken to categorical deniers. These involve: 1) a decision to exclude them from treatment; 2) attempts to overcome denial (either by involving them in a pre-treatment program, or embedding them within a regular program); and 3) the provision of a program exclusively for deniers. Evidence for all of these approaches is limited and not yet impressive enough to allow for conclusions as to their value. Finally, we suggest that future studies include larger numbers of deniers and differentiate offender types.

This paper examines the utility of previous attempts to subcategorize child molesters. We argue that research based on these categorizations has resulted in confusion due to differences across studies concerning which offenders belong in each group. For example, there are no agreed-upon guidelines for identifying a child molester as an incest offender or as a ‘stranger’ offender. We examine research findings associated with previous attempts to subcategorize child molesters as well as the literature on modus operandi. From this, we conclude that current attempts to subcategorize child molesters are flawed. We propose that distinguishing child molesters according to new criteria – that is, whether or not they have been previously associated with their victim – should result in more productive research and provide a better guide for treatment and postdischarge supervision. In our terminology, nonaffiliative child molesters are those offenders who are truly strangers to their victims whereas affiliative child molesters are characterized by an established caregiving relationship with the child for some period prior to the offense. These men, unlike nonaffiliative offenders, engage in a protracted grooming process before offending. Finally, we outline research, treatment, and risk-management strategies relevant to each of our subcategories.

Chapter 25 Assessing and Treating Sex Offenders W. L. Marshall, W. L. MarshallSearch for more papers by this authorDouglas Boer, Douglas BoerSearch for more papers by this authorLiam E. Marshall, Liam E. MarshallSearch for more papers by this author W. L. Marshall, W. L. MarshallSearch for more papers by this authorDouglas Boer, Douglas BoerSearch for more papers by this authorLiam E. Marshall, Liam E. MarshallSearch for more papers by this author Irving B Weiner, Irving B WeinerSearch for more papers by this authorRandy K Otto, Randy K OttoSearch for more papers by this author Book Author(s):Irving B Weiner, Irving B WeinerSearch for more papers by this authorRandy K Otto, Randy K OttoSearch for more papers by this author First published: 16 December 2013 https://doi.org/10.1002/9781394260591.ch25 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onEmailFacebookTwitterLinkedInRedditWechat Summary Sex offending is an issue calling for a systematic and comprehensive response. This chapter addresses some of the pertinent available evidence. It focuses on what is known about the features of sex offenders, what has been established concerning their threat to reoffend, and the methods that have been developed to reduce that threat. 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AbstractThis chapter outlines the nature of the paraphilias and the problems attendant upon the various diagnoses. These issues are described separately for the offense‐related and nonoffending paraphilias, and an overall evaluation is made of the diagnostic reliability of these disorders. Assessments are described including the strategies for the development of a case formulation and a Therapist Rating Scale is suggested as a way to evaluate treatment progress. Treatment approaches for each of the disorders are described along with reports of meta‐analytic appraisals of treatment outcome. The final main section provides details of a “strength‐based” approach to treatment accompanied by long‐term outcome evaluations of 535 treated men over 5.4‐year and 8.4‐year follow‐ups. Finally, brief conclusions are offered with recommendations for the widespread adoption of strength‐based approaches to treatment.