title: Peer group intervention reduces personal HIV risk for Malawian health workers.
abstract: OBJECTIVE
  To test a peer group intervention to address personal HIV prevention needs of rural health workers in Malawi.
  
  
  METHODS
  Using a quasi-experimental design, we compared district health workers in two districts of Malawi that were randomly assigned to either the intervention or delayed control condition. We used independent sample surveys at baseline, 15 months, and 30 months postintervention. Intervention district workers received a peer group intervention after the baseline; control district workers received the delayed intervention after final data collection.
  
  
  METHODS
  The 10-session intervention for primary prevention of HIV infection was based on the primary healthcare model, behavioral change theory, and contextual tailoring based on formative evaluation. Differences in HIV-related knowledge, attitudes, self-efficacy, and behaviors were analyzed using t tests and multiple regression controlling for baseline differences.
  
  
  RESULTS
  Health workers in the intervention district had higher general HIV knowledge, more positive attitudes about condoms, higher self-efficacy for safer sex, and more involvement in community HIV prevention at both the 15-month and 30-month postintervention survey. At 30 months, intervention district workers also reported less stigmatizing attitudes toward persons living with AIDS, more HIV tests, and lower risky sexual behaviors.
  
  
  CONCLUSIONS
  The intervention should be sustained in current sites and scaled up for health workers throughout Malawi as part of a multisectoral response to HIV prevention.
  
  
  CONCLUSIONS
  Incorporating a peer group intervention focused on personal as well as work-related HIV prevention can reduce health workers' risky behaviors in their personal lives, potentially reducing morbidity and mortality and enhancing workforce retention. Reducing stigmatizing attitudes may also improve the quality of health services.
authors.affiliation: Nursing, Midwifery and Health Sciences Research Centre, Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Mbeba
authors.forename: Chrissie P N
authors.initials: CP
authors.lastname: Kaponda
authors.forename: Diana L
authors.initials: DL
authors.lastname: Jere
authors.forename: Sitingawawo I
authors.initials: SI
authors.lastname: Kachingwe
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Crittenden
authors.forename: Linda L
authors.initials: LL
authors.lastname: McCreary
authors.forename: James L
authors.initials: JL
authors.lastname: Norr
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Norr
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008295:Malawi; D008297:Male; D010379:Peer Group; D012044:Regression Analysis; D012424:Rural Population