Effectiveness of a Community-level HIV/STD Prevention Intervention in Promoting Safer Sexual Behaviors in High-risk Populations
Condition: HIV Infections; Sexually Transmitted Diseases
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional
Phase: Phase 3

Summary: 
      This study will evaluate the effectiveness of a community-level HIV prevention program in
      promoting safer sexual behaviors and reducing the transmission of HIV/sexually transmitted
      diseases among at-risk populations in China, India, Peru, Russia, and Zimbabwe.
    

Detailed description: 
      The HIV/AIDS epidemic remains largely out of control in many areas of the world, with an
      estimated 2.5 million new HIV infections worldwide in 2007. Developing countries with few
      economic resources and world regions undergoing difficult social transitions have been
      particularly impacted by large increases in HIV and sexually transmitted disease (STD)
      infections. To date, effective individual prevention approaches have not been rapid enough to
      avert the epidemic in these areas and may be too resource intensive to maintain. Behavioral
      HIV prevention interventions on the community level seek to reduce the prevalence of
      high-risk sexual behaviors by reaching large numbers of vulnerable people in a cost-effective
      and feasible manner, even in areas with limited resources. The Community Popular Opinion
      Leader (C-POL) program is an HIV prevention intervention that recruits and trains trusted
      opinion leaders in the community to promote safe sex behaviors through risk-reduction
      conversations with peers. Implementing the C-POL program in world regions facing significant
      HIV/AIDS epidemics may be the most effective means of encouraging behavior change among
      members of at-risk populations and strengthening social norms to maintain these changes. This
      study will evaluate the effectiveness of the C-POL program in promoting safer sexual
      behaviors and reducing the transmission of HIV/STDs among at-risk populations in China,
      India, Peru, Russia, and Zimbabwe.

      Participation in this study will last 2 years. Initially, an ethnographic study will be
      conducted to determine the HIV/STD knowledge, attitudes, and behaviors among the population
      living in the target communities. Information collected via observation, focus groups, and
      interviews will be used to determine the social risk groups operating within the community
      and to identify and recruit the opinion leaders who are influential in these groups. Also, an
      epidemiological study will be conducted to collect information on sexual behaviors and
      HIV/STD rates.

      A cohort of members from participating communities will first undergo baseline assessments
      that will include a survey about general health and knowledge of HIV/STDs and a biological
      sampling for HIV/STD testing. Participating communities will then be assigned randomly to
      receive the C-POL intervention and HIV/STD educational materials or HIV/STD educational
      materials alone. In communities receiving the C-POL intervention, the previously recruited
      opinion leaders will be taught skills for sharing HIV risk-reduction messages in daily
      conversation with peers. This training will occur over four to five weekly sessions. At least
      15% of the community population will be trained as opinion leaders. After the initial
      training, opinion leaders will attend six to nine booster sessions over the next 2 years to
      reinforce and support continued conversation efforts. Communities assigned to receive the
      HIV/STD educational materials will receive informational materials on HIV/STDs to provide to
      community members and will provide treatment or treatment referral for people with nonviral
      STDs.

      All participants in the baseline cohort will be asked to repeat the baseline testing 1 and 2
      years later. Participants who are not able to visit a clinic for testing will be contacted by
      phone to complete the baseline survey. After the 2-year assessments, the C-POL intervention
      will be conducted in the communities that received educational materials only.
    

Intervention name(s): Community Popular Opinion Leader (C-POL); HIV/STD educational materials
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The C-POL intervention will teach identified opinion leaders to share personalized HIV prevention messages in conversations with peers in an effort to change community norms. Opinion leaders will be taught skills for sharing HIV risk-reduction messages during four to five weekly training sessions. At least 15% of the community population will be trained as opinion leaders. After the initial training, opinion leaders will attend six to nine booster sessions over the next 2 years to reinforce and support continued conversation efforts.; Communities will receive HIV/STD educational materials and treatment referral information to distribute to community members.
Other intervention name(s): Popular Opinion Leader (POL); Diffusion of Innovations
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Prevention
Keywords: HIV; Popular Opinion Leader; POL; Behavioral Intervention; STD; STI; Community; Prevention; International; Global