Feasibility of recruiting peer health leaders for an HIV and gender-based violence prevention intervention with networks of young men in Dar es Salaam, Tanzania

Background: HIV risk behaviors and gender-based violence (GBV) are prevalent among men and influenced by their social networks. A peer leader-based intervention using behavior change communication can be an effective strategy to promote HIV and GBV prevention within male networks. We report on the feasibility of recruiting and training peers to become camp health leaders (CHLs) as part of a cluster randomized controlled trial designed to prevent HIV and GBV among men belonging to "camps", which are organized groups of young men with elected leadership, paid membership, and a physical space to meet in Dar es Salaam, Tanzania.

Methods: Baseline data were collected from 1280 male camp members across 60 camps from January to March 2014. Members from the intervention camps nominated 185 CHLs within these camps in March 2014. CHLs attended an initial one-week training course and booster sessions on HIV and GBV prevention, substance abuse, and effective communication and social influence to initiate conversations with men in their networks.  We collect weekly data on CHL conversations and challenges encountered.  

Lessons Learned: CHLs reported challenges initiating conversations, not being taken seriously in their “new” role by their camp members, and not having official signs of credential. CHLs also mentioned lack of motivation to formally continue having conversations.  To address these challenges we conducted booster sessions to encourage active CHLs and motivate inactive CHLs by sharing strategies. We also printed t-shirts with HIV and GBV slogans for CHLs to wear as conversation starters. To keep CHLs motivated we made funds available for CHLs to apply to conduct specific health related activities such as substance abuse in their camps.  

Conclusion: Recruiting and training CHLs for HIV and GBV behavior change communication among men is feasible. However, regular monitoring and support for CHLs are required in order to ensure success overtime.