Lessons learned from a Yi community: Impact evaluation of an HIV/AIDS peer education project among Yi minority youths in Southwest China

Background: Since first being introduced in 1994, HIV/AIDS peer education projects have been scaled up in numerous communities and various high-risk sub-populations in China. Compared to wide applications of peer education approach, the amount of quantitative evaluations is not high. In addition, existing impact evaluations more or less ignore outcomes such as participants' self-efficacy and social norms on sexual behaviors. This study assessed short-term effectiveness of an HIV/AIDS peer education among Yi minority youths in a rural community suffering HIV/AIDS and drug epidemic, with special attention to the context of globalization and social transformation.

Methods: Baseline and follow-up data from a quasi-experimental survey were used to examine effects of project with respect to increasing knowledge of HIV/AIDS, improving self-efficacy of condom use, and developing social norms that are positive to it. Qualitative data collected by quasi-structure interviews were used to demonstrate cultural and social factors that affect the implementation.

Results: Peer education project significantly increased knowledge of HIV/AIDS and improving self-efficacy of condom use for participants in intervention villages, particularly female. Girls were empowered during participatory discussion and request their further health needs.Traffic difficulty was a main barrier to access to this intervention. Immigration waves to urban areas accounted for losing target population.

Conclusions: Traditional medical beliefs, misconceptions of condoms and HIV/AIDS influence social norms a lot. Adaption to local cultural and social context is a big challenge for a success of health promotion project. Support from government is a key to gain trust from local people during project implementation.