Panel Discussion

HIV prevention is urgently needed in Malawi and other sub-Saharan African countries, especially in rural areas where over 80% of the population resides. However, few rural HIV prevention interventions have been offered. Barriers include lack of trained personnel, transportation difficulties, and rural residents’ lack of influence on health policy. This symposium presents results of a peer group intervention for HIV prevention in Malawi. Two years ago we presented a symposium at APHA describing the development, implementation, and evaluation plans for the Mzake ndi Mzake (Friend to Friend) Peer Groups for HIV Prevention program. Trained volunteer health workers and community residents collaborated to provide the intervention. We also expanded the intervention to health workers at a large urban referral hospital. This symposium presents four papers regarding the impact of the intervention on the personal HIV-related knowledge, attitudes and behaviors of rural health workers, rural adults and adolescents and urban health workers. Occupation-related HIV prevention activities of the rural health workers are also described. The peer group intervention had positive impacts for all groups. Health workers have the potential to be HIV prevention leaders in their workplace and communities. Peer group intervention based on social-cognitive learning can enhance their capacity to be role models and leaders. Collaboration of rural health workers and communities provides an effective, affordable and acceptable way to deliver HIV prevention interventions to rural Malawi, overcoming many barriers to rural HIV prevention programs. Urban health workers also benefited.

Session Objectives: 1. Recognize that trained volunteer health workers can provide a peer group intervention for rural residents in a way that is feasible, affordable, acceptable and effective. 2. Discuss the multi-method quasi-experimental design to evaluate intervention effects for both health workers and rural adults. 3. Compare the impacts of the intervention for three different groups: urban health workers, rural health workers, and rural adults. 4. Describe the shared benefits of international collaboration.

CE Credits: CME, Health Education (CHES), Nursing