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  • Title: Toward reducing the spread of HIV in northeastern Thai villages: evaluation of a village-based intervention.
    Author: Elkins D, Maticka-Tyndale E, Kuyyakanond T, Miller P, Haswell-Elkins M.
    Journal: AIDS Educ Prev; 1997 Feb; 9(1):49-69. PubMed ID: 9083591.
    Abstract:
    This paper presents results of the evaluation of an intervention designed for northeastern Thai villages and particularly for village women. The intervention was based on established principles of behavior change, social learning theory, and community health promotion, and it was grounded in elicitation research. A total of 600 women and 479 men and 12 villages participated in the evaluation which used data collected from face-to-face knowledge, attitude, practices (KAP) surveys, focus groups, and village meetings in a quasi-experimental pre- and post-control group design. Eight of the nine outcome goals set for the intervention were achieved with significant increases in married women taking the initiative in reducing the risk posed to them by the sexual activities of their husbands. This paper describes and evaluates a 1994 intervention designed to reduce HIV transmission among villagers in northeastern Thailand. The report opens with an introduction which describes the progression of HIV/AIDS in the country. The HIV prevention intervention is then described as consisting of 1) an agreement between intervention providers and village leaders to establish a partnership to introduce the intervention and train volunteers as facilitators, 2) broadcast of a 5-day motivational audio-drama over village loudspeakers, and 3) a village meeting to institute village discussions of AIDS and plan further village strategies. Outcome goals for women, for men, and for the village as a whole included 1) villager identification of the program as a major source of information, 2) increased risk awareness, 3) increased reporting of risk-reduction behavior, 4) increased communication about HIV/AIDS, 5) identification with characters in audio-drama, 6) identification of HIV/AIDS as a community concern, and 7) creation by the villagers of additional strategies. Description of the evaluation methodology includes data collection from KAP interviews and focus groups and a sample survey. Results are presented for each of the preliminary goals, and it is concluded that the project intervention was successful. Modifications were made based on the evaluation results, and the strategy was adapted for large-scale intervention. Using a strategic approach guided by established theories of behavior change and community development ensured that the program was sensitive to the sociocultural framework presented by the targeted village.
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