Evaluation of Community Outreach HIV Prevention Programs in Vietnam
Community outreach programs are a cornerstone of the U.S. government’s HIV/AIDS prevention strategy in Vietnam. These programs employ outreach workers (peer and heath educators) to bring HIV-prevention education, condoms, information about counseling and testing, and other referral information to most-at-risk populations (MARP), including injection drug users (IDU), commercial sex workers (CSW), and men who have sex with men (MSM). Stigma and discrimination make reaching MARP individuals difficult in Vietnam. Therefore, peer-driven outreach programs are critical not only to bringing prevention messages to these populations, but also to connecting those individuals most likely to be infected with HIV to essential care and treatment services.
Boston University’s Center for Global Health & Development (CGHD) conducted a comprehensive independent evaluation of PEPFAR-supported community outreach programs in order to provide important information for program improvement.
For the evaluation, over 2,200 interviews with MARP individuals in four provinces of Vietnam were conducted, including those who reported recent contact with a community outreach worker and those who did not. We supplemented these data with a survey of community outreach workers and in-depth interviews with selected MARP individuals and outreach workers in six provinces. Based on the data collected, we concluded that outreach workers were generally well-prepared to communicate effective prevention strategies and referral information to clients, though overall knowledge of HIV treatment options was low. The outreach programs appeared to be generating a ripple effect in increasing communication about HIV/AIDS beyond the clients directly targeted by outreach activities. Most importantly, they were also associated with reduced risky sexual behaviors and increased HIV testing.
The CGHD drafted specific recommendations for improving community outreach programs. These included:
- Working with other donors to ensure that MARPs have access to clean syringes and needles;
- Strengthening the training provided to community outreach workers in order to improve knowledge of HIV treatment;
- Improving staff motivation and productivity, specifically by considering offering drug cessation programs to long-serving peer educators and further analyzing staff turnover;
- Developing and utilizing new approaches for MSM, a group that revealed less satisfaction with outreach services than IDU and CSW.
This project is one activity of the CGHD’s Child and Family Applied Research project (CFAR).
|Principal Investigator||Lora Sabin|
|Boston University Co-Investigators||Mary Bachman DeSilva, Davidson Hamer, Taryn Vian|
|Dates of Research||2006–2009|
|Donor/Funder||United States Agency for International Development (USAID)|