title: Empowering peer group leaders for HIV prevention in Malawi.
abstract: OBJECTIVE
  Behavioral change interventions using peer group leaders are effective and widely used, but few studies have examined how being a peer group leader affects the leaders. This study describes how participants felt being a peer group leader affected their lives.
  
  
  METHODS
  This descriptive qualitative study interviewed 18 experienced peer group leaders who had conducted a multisession human immunodeficiency virus (HIV) prevention peer group intervention in rural Malawi.
  
  
  METHODS
  We used inductive content analysis and comparisons within and between cases.
  
  
  RESULTS
  Three major themes were identified. All leaders said they experienced personal changes in their knowledge, attitudes, or HIV prevention behaviors. They described interacting with family, neighbors, and friends, and speaking at church or community meetings, to discuss HIV prevention issues. They increased their self-efficacy to engage others in sensitive HIV prevention issues, developed a self-identity as a change agent, and came to be recognized in their community as trustworthy advisors about HIV and acquired immunodeficiency syndrome. These three themes, taken together, form the meta-theme of psychological empowerment.
  
  
  CONCLUSIONS
  Being a peer group leader empowered the leaders as change agents for HIV prevention and had impacts in the community after the intervention ended, potentially increasing the long-term effectiveness and cost effectiveness of peer group interventions.
  
  
  CONCLUSIONS
  Healthcare workers and community volunteers who led HIV prevention sessions continued HIV prevention activities in the community and workplace after the program ended. Training health workers as volunteer HIV prevention leaders offers a strategy to bring HIV prevention to limited-resource settings, despite health worker shortages.
authors.affiliation: Alpha Lambda, Research Assistant Professor, University of Illinois at Chicago College of Nursing, Chicago, IL, USA.
authors.forename: Linda L
authors.initials: LL
authors.lastname: McCreary
authors.forename: Chrissie P N
authors.initials: CP
authors.lastname: Kaponda
authors.forename: Kristina
authors.initials: K
authors.lastname: Davis
authors.forename: Mary
authors.initials: M
authors.lastname: Kalengamaliro
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; D006302:Health Services Research; D006801:Humans; D007398:Interpersonal Relations; D007857:Leadership; D008295:Malawi; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D011209:Power, Psychological; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration*; D012649:Self Concept; D020377:Self Efficacy
keywords: Community-public health-environmental health; HIV/AIDS; international health or global health; primary health care; qualitative methodology