The AIDS pandemic continues to spread at an alarming rate, particularly in Southern Africa. No vaccine is expected to become available and the cost for effective treatment is prohibitive to most developing counties which support the majority of AIDS cases. There is a clear need to prevent HIV through behavior change in developing countries where the epidemic is having devastating cultural and economic impacts. The public opinion leader community-level intervention, based on the theory of diffusion of innovation, has been shown to be effective in the US. This is an effective, self-perpetuating intervention which, if appropriately adapted, could be effective in resource poor settings with emerging HIV epidemics. Zimbabwe is one such country in southern Africa which requires immediate, innovative interventions to stem rapid spread of the virus. while overall HIV prevalence in Zimbabwe is as high as 30% among adults aged 20A9, rates among youth less than 20 years old are low (.66% nationally), creating the unique opportunity to intervene before this generation becomes infected. In collaboration with three other NIMH funded AIDS Collaborative Teams (ACTs) and a Data Coordinating Center (DCC), we intend to adapt, implement and evaluate the public opinion leader community level intervention model among youth aged 16-20 in rural areas of Zimbabwe. An ethnographic study with community assessment in 24 communities and ethnographic interviews in 8 communities will be conducted to design the intervention protocol. The intervention and surveys will be field tested in one pilot community and the protocol and instruments modified if necessary. The intervention will then be implemented in 16 communities randomized to either intervention or control conditions. Measures to assess changes in Exposure, Intermediate, Behavioral and Biologic outcomes will be collected through interviews and biologic samples from 240 youth in each of the 16 sites. Measures will be obtained pre-intervention and post-intervention at 12 and 24 months. For ethical reasons, the intervention will also be implemented in the control sites one year after the intervention sites. The process of adapting and implementing the community public opinion leader model will be documented in all four NIMH ACT study sites, increasing the generalizeability of the results. Overall, the prevention trial will provide essential information about the procedures required to successfully apply the community-based public opinion leader intervention model in a broad range of settings and cultures.
| Goodreau, Steven M; Cassels, Susan; Kasprzyk, Danuta et al. (2012) Concurrent partnerships, acute infection and HIV epidemic dynamics among young adults in Zimbabwe. AIDS Behav 16:312-22 |
| NIMH Collaborative HIV/STD Prevention Trial Group (2010) Results of the NIMH collaborative HIV/sexually transmitted disease prevention trial of a community popular opinion leader intervention. J Acquir Immune Defic Syndr 54:204-14 |
