author's abstract.) In this two-stage project, the investigators will test the effectiveness of a nurse-managed peer education model for the prevention of the acquired immunodeficiency syndrome (AIDS) among Botswana women. Heterosexual transmission is the major route of the transmission of the AIDS in Botswana. The greater number of females than males among diagnosed AIDS cases shows the critical importance of targeting women and young girls for safer sex promotion. A nurse-managed peer education model offers a number of advantages, including: a grass-roots approach that is compatible with the World Health Organization (WHO) primary care model; linkage of health professionals and community members to maximize the impact of health care; low cost; and the absence of the need for high technology equipment and skills. These features make the peer education model especially promising for the prevention of AIDS among women and other groups at risk in Botswana and in other developing countries. In Phase I the investigators will identify the most important behaviors that contribute to AIDS transmission for women in Botswana, the potential of existing community leaders and women's groups to serve as peer group leaders, and changes in content and service delivery mechanisms needed to adapt the peer education model to the culture, values, and resources of Botswana. Using the Phase I results, they will adapt the specific content and delivery mechanism of a nurse-managed peer education model to the culture-specific needs and resources of Botswana. In Phase II the investigators will implement a limited pilot study of this culturally-sensitive model of peer education for AIDS prevention for women in a single urban area, and will evaluate its effectiveness, cost, and feasibility for more widespread implementation.
