From people to places: focusing AIDS prevention efforts where it matters most.
OBJECTIVE
To develop and implement a method to identify and characterize places where people meet new sexual partners and to assess HIV prevention program coverage in those places.


METHODS
In three townships (populations 60 000-100 000 each) and one business district (population < 20 000) in South Africa, interviewers asked over 250 informants per area to identify public sites where people meet new sexual partners. All reported sites were visited and mapped. A knowledgeable person onsite was interviewed about the site and its patrons. Individuals socializing at sites were interviewed about their sexual behavior.


RESULTS
More than 200 sites in each township and 64 sites in the central business district were identified and visited. The male to female ratio among site patrons was approximately 2:1. In each area, men and women socializing at sites reported high rates of new sexual partner acquisition and low condom use. Almost half of the 3085 men and 1564 women interviewed while socializing reported having a new sexual partner in the last 4 weeks. A third reported meeting a new partner at the site of the interview. Commercial sex was rare in the townships but available at 31% of central business district sites. Fewer than 15% of township and only 20% of business district sites had condoms.


CONCLUSIONS
The PLACE method successfully identified sites where people with high rates of new sexual partnerships can be reached for prevention programs. Sexual networks in these areas are extensive, diffuse, and characterized by high rates of new partnership formation and concurrency with little acknowledged commercial sex.
Weir
Sharon S
SS
Department of Epidemiology School of Public Health, University of North Carolina at Chapel Hill, 27516, USA. sharon_weir@unc.edu
Pailman
Charmaine
C
Mahlalela
Xoli
X
Coetzee
Nicol
N
Meidany
Farshid
F
Boerma
J Ties
JT
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission; D000328:Adult; D016000:Cluster Analysis; D017280:Condoms / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013019:South Africa; D014504:Urban Health / Q000706:statistics & numerical data