AEGiS-NHIVPC: The Process of Adapting and Translating an HIV Prevention Intervention: A Cross-cultural Journey from North Carolina to South Africa

National HIV Prevention Conference

Atlanta, Georgia, USA — July 27 - 30, 2003

The Process of Adapting and Translating an HIV Prevention Intervention: A Cross-cultural Journey from North Carolina to South Africa

Natl HIV Prev Conf 2003 July 27-30:abstract no. T1-C1003
Hall GJ, Wechsberg WM, Zule WA, Lam W, Middlesteadt-Ellerson R, Luseno W; RTI International, Research Triangle Park, NC

ISSUE: Community-based interventions to reduce HIV risk among women who abuse drugs.

SETTING: Community-based studies in Raleigh Durham, North Carolina and Pretoria, South Africa.

PROJECT: The NC Women's CoOp is a community-based randomized field experiment conducted in North Carolina to compare the effectiveness of a culturally specific, woman-focused HIV prevention intervention with the NIDA standard HIV intervention. Both are designed to reduce HIV risk among women who use drugs by providing risk-reduction information, demonstrating proper condom use, enhancing sex-related negotiation skills, and emphasizing the positive health impact of reducing drug use. The woman-focused intervention included contextual issues related to ethnicity and gender in a culturally specific framework. Participants randomized into the woman-focused intervention developed personal goals and a plan to achieve them based on their specific circumstances. Based on initial findings of effectiveness, an administrative supplement was awarded to study the adaptability of these interventions in South Africa. After formative work to gain a greater understanding of women's specific needs and risks related to HIV, a small pilot study was conducted in Sunnyside/Pretoria, South Africa.

RESULTS: Results from both community-based studies will be presented. Of the 762 NC participants who completed intake procedures, 562 (74%) returned and completed the first follow-up at three months. Results from the 3-month follow-up indicate a significant reduction in the use of crack cocaine and alcohol, and decreases in the total number of unprotected sex acts in the past 30 days. Comparably, 80 (86% of the 93) South Africa participants who returned and completed their follow-up at one month also demonstrated notable reductions in crack and alcohol use, and increased use of both male and female condoms. These findings illustrate that a culturally specific HIV intervention can be adapted and translated into another culture and have positive effects.

LESSONS LEARNED: To adapt and translate culturally based HIV prevention interventions successfully, they must be constructed on a strong foundation of risk-reduction strategies and be flexible enough to incorporate salient elements of the cultural context. The process of adapting and getting community "buy-in" from stakeholders and participants is essential. Finally, planning stages including recruitment, mapping resources, and securing human subjects review are critical components of a successful intervention.

Keywords: Adapt, Acquired Immunodeficiency Syndrome, HIV Infections, North Carolina, HIV Seropositivity, Ethnic Groups, Health Services Needs and Demand, South Africa, Human, Female, Male, ethnology, nursing, prevention & control

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T1-C1003