African-American Women and HIV/AIDS, Capstone Project Example

The aggregate of Hillsborough, Florida—HIV-positive, African American women–is characterized by high poverty rates, lack of education, and the recurrence of various disease including sexually transmitted diseases, substance abuse, cardiac diseases, and chronic respiratory with marked differences amongst the communities residing in it. The strengths of the aggregate is that there are already efforts in place to combat escalating rates of HIV infection with some positive results yielded as a result. The reduction of health disparities in the aggregate has been noted, and the availability of solutions related to preventative healthcare has facilitated this process. The weaknesses include poor overall health levels, illiteracy, and poorly maintained infrastructure. Despite decent preventative health care, there is still a lack of education regarding HIV/AIDS in addition to other STDs and substance abuse behaviors that render women vulnerable to contracting HIV/AIDS. Extreme levels of poverty may account for this weakness. In order to bolster the aggregate prevention of the spread of HIV/AIDS, the promotion of education and various health services is necessary to foment an ideal situation. Reducing disparities in HIV/AIDs incurrence and expanding access to preventative education and resources is the goal for this aggregate in Hillsborough, Florida.

Peer education interventions have often been the preferred strategy for the prevention of HIV/AIDS in addition to other sexually transmitted diseases across the globe, especially in poor communities and developing countries. These interventions choose particular individuals who share common demographic traits—in this particular case, race and gender with African-American women living in Hillsborough County—as well as risk behaviors in a targeted aggregate, which in this case is unsafe sexual practices and the perils of intravenous drug use for sexual health. This intervention aimed at enhancing awareness, encouraged changes in dangerous behaviors among the members within this aggregate, and imparted useful knowledge to stem the escalating rates of HIV infections and AIDS. Peer education was delivered both in structured contexts within traditional classrooms as well as informally via quotidian interactions. This intervention was implemented based on the premise that peers profoundly influence individual behaviors. By using members of the aggregate itself as peer educators, this intervention assumes that aggregate members will feel a certain level of comfort and trust with peer educators that will facilitate a more open dialogue on topics that are considered sensitive (Cambell & MacPhail, 2002). In addition, peer educators have greater access to this aggregate—which many consider to be a “hidden” population—in relation to more traditional interventions that would limit the access of the those spearheading the intervention. Lower rates of HIV infection and AIDs diagnosis suggest that such a peer education program was empowering not only for peer educators but also for the targeted aggregate by fomenting a sense of cohesion and solidarity vis-a-vis collective action (Campbell & Mzaidume, 2001). Moreover, this intervention proved quite cost-effective due to the fact that it did not rely on professionals who had undergone extensive training, although it is difficult to approximate the costs of peer education interventions such as this one. A systematic assessment of the efficacy of this intervention in altering attitudes, behaviors, and knowledge pertaining to HIV/AIDs within the targeted aggregate in their community settings is necessary in order to see whether similar interventions can be implemented at the macro level to address this public health issue. Information on condom use, the perils of intravenous drug use and sharing needles, and STD infections at the community level within socioeconomically disadvantaged conditions was disseminated, so a systematic review of the findings in addition to interviews with members of the aggregate will help assess the efficacy of this intervention.

The purpose of this intervention was to assess how peer education affected positive outcomes related to HIV/AIDS within the aggregate of African-American women in Hillsborough County in Florida. The definition of interventions based on peer education within this particular case that was used was the sharing and dissemination of information related to HIV/AIDS within small groups or in individual interactions between educator and member of the targeted aggregate both via risk behaviors as well as according to demographic factors. This particular definition of peer education is different from interventions developed and implemented by the mass media that use peers to supervise the program but elides any interpersonal interaction in order to education and disseminate pertinent information. The intervention was conducted in Hillsborough County as a low-income community as delineated in the pre-intervention design in order to address escalating rates of HIV and AIDS within the aggregate. The HIV epidemic is far more severe in settings that are socio-economically disadvantaged and that contain various factors that directly impact the failure or success of peer education interventions. Psychological, behavioral, biological, and care outcomes related to HIV/AIDS prevention via this intervention must be taken into account and called for interviews to be conducted by members of the aggregate.

Implementation issues germinated due to the fact that peer education interventions heavily rely on the individuals picked to be the peer educators, which is why choosing peer educators is critical to the success of such a program. This intervention relied on nominations by community members for selecting and training peer educators. Youth group leaders and program supervisors were charged the responsibility of nominating and overseeing the training of the peer educators. The manner in which peer educators were recruited played an important role in how the targeted aggregate perceived the peer educators and their level of dedication to the program. One member of the targeted aggregate testified that because the peer educators were not chosen by peers of the aggregate, she was less inclined to follow through with the program since program staff members chose the members. As such, it is clear that recruitment strategies did impact both the implementation and success of this intervention. Rather than implement a snowball recruitment methodology in favor of careful selection of peer educators, this program was actually more successful due to the fact that the counselors were carefully chosen and thus viewed as influential members of the community as transformative leaders. Elsie, another member of the targeted aggregate, stated that condom use and her knowledge of HIV/AIDS information was enhanced as a result of the method of recruiting deployed therein.

The training and supervision of the counselors was also a critical factor in the efficacy of this intervention. The counselors went through a training course over a one-week period for three hours a day and a refresher training every two weeks two days a week. Outcomes related to the method of counselor training also include condom use and the enhancement of knowledge of HIV/AIDS. Intense training for one week and refresher courses that was implemented in this intervention was associated with enhanced knowledge over a protracted period of time as attested by the counselors who provided monthly reports of their sessions with particular members of the aggregate. In addition, condom use increased over the same period of time, which attests to the efficacy of the leadership within this intervention. Close supervision of the peer educators by program staff members ensured that peer educators followed protocol and were accurately reporting their findings during one-on-one and small group meetings with aggregate members on a weekly basis.

Peer education intervention was chosen for this aggregate due to the fact that it is quite cost-effective in comparison to other interventions due to the fact that counselors were minimally compensated. Studies have attested to the correlation between the compensation of counselors and the efficacy of the intervention (Wang & Keats, 2005). Because this intervention compensated counselors for travel and time expenses, supervisors noted that counselors reacted positively to monetary incentives and that there were positive outcomes related to condom use, risky behaviors, and HIV knowledge as a result. Moreover, the retention of peer educators was sustained throughout the programs, thereby enhancing its efficacy despite the fact that the aggregate has been rendered a hidden population. Studies have shown that high turnover rate has been associated with an increase in risky behaviors included unprotected sex and illicit drug use (Li et al., 2001). Both interviewees noted that having the same counselors throughout the intervention was helpful because they gained trust in their educators and were more dedicated to following through.

Comparing post-intervention outcomes with the outcomes articulated by members of the aggregate who were included in the intervention using a pre/post study elucidates the actual efficacy of the intervention. Interestingly, biological results from the intervention pertaining to rate of STDs overall were not impacted by the peer education intervention, as rates continued to slowly rise within this particular aggregate after the intervention was completed. Nonetheless, results attest to the overall efficacy of the peer education program on the targeted aggregate as an effective HIV/AIDS prevention strategy. Both knowledge about the disease and the behavioral outcomes were enhanced as a result of the intervention.

References

Campbell, C. & MacPhail, C. (2002). Peer education, gender and the development of critical consciousness: Participatory HIV prevention by South African youth. Social Science and Medicine, 55(2), 331–345.

Campbell, C. & Mzaidume, Z. (2001). Grassroots participation, peer education, and HIV prevention by sex workers in South Africa. American Journal of Public Health, 91(12),1978–1986.