Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112043

Kathleen F. Norr, MA, PhD¹, Chrissie P. N. Kaponda, PhD RN², Sitingawawa Kachingwe, MSc³, Diana Jere, MSc, RN³, Mary Mbeba, MSc RN³, Linda L. McCreary, PhD, RN¹, and Marie L. Talashek, EdD, RN¹. (1) College of Nursing (M/C 802), University of Illinois at Chicago, 845 South Damen, Chicago, IL 60612-7350, 312-996-7940, KNorr@uic.edu, (2) Kamuzu College of Nursing, U. of Malawi, Private Bag # 1, Lilongwe, Malawi, (3) Kamuzu College of Nursing, University of Malawi, Private Bag # 1, Lilongwe, Malawi

Peer groups based on social learning are effective for HIV prevention for a wide variety of target groups, but are rarely offered in rural areas. This research uses the World Health Organization's primary health care model to mobilize health workers as peer group leaders for HIV prevention in rural Malawi. The intervention is adapted from a peer group intervention for HIV prevention previously used successfully in urban Botswana and Malawi. However, no systematic evidence was available to guide adaptation of peer group interventions for different cultural contexts, types of peer leaders, or delivery modalities. This quasi-experimental study is located in an intervention and control district in Malawi, with pre and post intervention assessments of each district hospital, selected rural clinics, and their surrounding communities. To tailor the intervention to the context, we collaborated with the community of health workers, village leaders and rural adults and adolescents. Focus groups, interviews and quantitative pre-intervention assessments identified HIV risk behaviors and prevention needs. We discuss major changes made and the evidence base for each, including greater focus on couples, condom use, reducing stigma, and universal precautions. All health workers and community leaders and over 2200 rural community members have participated in the intervention. An adolescent intervention is now being piloted. Our evidence base for the intervention will facilitate dissemination of the model to other settings. Mobilizing health workers as AIDS prevention leaders can bring cost-effective evidence-based HIV prevention to rural communities in Africa.

Learning Objectives: Learning objectives

• To identify how an evidence base can be used to tailor the content, evaluation and delivery mechanisms of an HIV intervention.
• To identify strategies used to build an evidence base collaboratively with the community.
• To describe how specific aspects of an intervention for HIV prevention in rural Malawi were modified using the evidence base this project has developed.

Keywords: HIV Interventions, International

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation