An Overview of PLACE: P riorities for L ocal A IDS C ontrol E fforts
Why Use the PLACE Method? Urgent need for tools to focus local AIDS prevention efforts: ∆Every day, more and more people are getting infected with HIV, the virus that causes AIDS. ∆We need rapid, valid, low-tech, cheap, suitable for scale-up, adaptable across countries, and immediately useful prevention tools. PLACE is the tool that will identify where prevention programs should be targeted in.
How Does PLACE Work? PLACE takes place in areas of countries where people are most at risk of getting infected or infecting others: Priority Prevention Areas (PPAs)
Within each PPA, PLACE finds out where most people go to meet new sexual partners. How Does PLACE Work?
This gives local people information to decide where to target prevention programs. How Does PLACE Work?
∆PLACE targets new sexual partnerships because new partnerships are responsible for the spread of the HIV epidemic. New sexual partnership New sexual partnerships
How Does PLACE Work? ∆PLACE targets new sexual partnerships because new partnerships are responsible for the spread of the HIV epidemic.
A group of knowledgeable people in have identified as a priority prevention area in this. ∆Within this PPA, you will use the PLACE method to find out where people meet new sexual partners. ∆Your work will determine where prevention programs should focus efforts. PLACE Method Overview
PLACE Overview WHY is this study in ? was selected because: ∆the number of new cases of HIV is increasing in ; ∆many conditions that encourage the spread of HIV are present in : UrbanizationPoor housingLimited STI Care Migrant laborCrimeInjecting drug use Border stationsAlcohol abuseHigh population density
PLACE Overview 1 identified as area for PLACE study. 2-4 Conduct PLACE assessment in : 2 identify venues where people meet new partners; 3 visit, characterize, map all venues; and 4rind out if there are many new sexual partnerships formed at venues. 5 Use results to target intervention programs.
Step 2: Ask Community Informants “Where do people meet new partners?” ∆Ask where people meet new sexual partners in ∆Venues can include places like bars or events like festivals ∆Ask until no new venues are named ∆Output: List of venues with number times reported
Step 2: Ask Community Informants “Where do people meet new partners?” Community Informants Can Include: OfficialsTaxi driversBar workers Street sellersSTI patientsYouth Hostel residents TeachersSex workers Police Mobile populations Hairdressers
Step 2: Ask Community Informants “Where do people meet new partners?” Probe about new sexual partnerships in groups that are important to the spread of HIV within : ∆young women and older men ∆commercial sex workers ∆mobile and resident populations ∆military and civilian ∆
Step 2: Ask Community Informants “Where do people meet new partners?” ∆New sexual partnerships are often formed between certain groups: ∆“Mixing” (new sexual partnerships formed between members of different groups) effects how HIV spreads in.
PLACE Overview 1 identified as area for PLACE study 2-4 Conduct PLACE assessment in 2 identify venues where people meet new partners 3 visit, characterize, map all venues 4 find out if there are many new sexual partnerships formed at venues 5 Use results to target intervention programs
Step 3: Visit, Describe, Map Venues ALL reported venues are visited and mapped. A knowledgeable person on-site is interviewed about venue patrons: ∆male-to-female ratio ∆types of patrons (sex workers, gay, military, mobile, youth, locals, unemployed) ∆where patrons live ∆whether patrons meet new sexual partners at the venue.
Step 3: Visit, Describe, Map Venues A knowledgeable person onsite is also interviewed about venue characteristics to help plan HIV prevention programs: ∆ type of venue ∆ condom availability ∆ evidence of HIV prevention programs ∆ busy times ∆ maximum occupancy ∆ number of staff ∆ venue stability.
Step 3: Visit, Describe, Map Venues Eastern Cape Township, South Africa Venues ∆In about 3 weeks, 297 community informants identified 234 venues that interviewers visited and characterized. ∆We expected 50-60 venues.
Step 3 Output : Venues Located Inside Priority Prevention Area
PLACE Overview 1 identified as area for PLACE study 2-4 Conduct PLACE assessment in 2 identify venues where people meet new partners 3 visit, characterize, map all venues 4find out if there are many new sexual partnerships formed at venues. 5 Use results to target intervention programs
Step 4: Interviews with Venue Patrons ∆40 venues are selected for patron interviews at busy times. ∆Approximately 24 individuals are systematically selected and interviewed.
Step 4: Interviews with Venue Patrons ∆First, people are asked about their opinions: Do people come here to meet new partners? ∆Then, people are asked about their own behavior: Have you ever met a new partner here? Where else have you met new sexual partners? Have you ever seen an HIV prevention program here?
58 Venues Not Found, No Longer Venues, Knowledgeable Person Refused Interview, or Temporarily Closed 88 Venues Not Visited for Individual Interviews 352 Women Interviewed Step 2: Step 3: Step 4: 761 Men Interviewed 929 Community Informants 227 Venues Identified 169 Venues Verified by Interview with Knowledgeable Person at venue 81 Venues Visited for Individual Interviews with Patrons Summary of Steps 2-4 in Kampala, Uganda