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Step
1: Analysis
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First Steps: Selecting a Target Group
- Look at the epidemiological evidence in your country.
Studies done in your area may already indicate that injection
drug use is an increasing problem, or that populations of displaced
people are likely to increase HIV prevalence. Such research provides
excellent direction when deciding upon a target population. PSI's
epi
pie [PDF]
process is one manner in which to examine and utilize epidemiological
information. Conducting an epi-pie will help determine allocation
of HIV incidence by target group and allocation of HIV incidence
by behavior within a target group. Specifically this process helps
to segment by need and risk behavior.
- Maximize your program funds for the most health impact.
This may entail selecting a target population that is large enough
to justify the expense of the IPC program. For example, if there
is donor interest in developing an IPC intervention for customs
officials and police, and there are 1000 customs officials and
50,000 police officers working in the country, working with the
police could have a larger health impact, and would therefore
be the logical target group choice. This does not mean, however,
that the customs officials should necessarily be ignored. Perhaps
they are the riskier group, and IPC funds could be used to develop
highly focused intervention with them. Or perhaps, the bulk of
the intervention could focus on the police, and a small subset
of funding could be allocated to work with customs officials.
- Identify target populations that are accessible.
Target groups associated with an institution, such as a school,
or a site, such as a brothel or truck stop, at which high risk
behaviors might occur are much easier to reach. Uniformed service
personnel are often accessible because they live in barracks and
are part of structured, hierarchical organizations.
- Identify target populations that are likely to adopt positive
behaviors.
Behavior change can be more difficult for certain populations
than others. Focusing on harm reduction strategies can be helpful
in inspiring the behavior change on a level that meets the needs
and the realities of the population in question. Volunteer Counseling
and Testing (VCT) may be more acceptable to married truck drivers
who may be concerned about infecting their spouses.
It is important to remember that not all people are at equal risk
for being infected with HIV and for transmitting that infection
to others. Selecting groups who exhibit high risk sexual behavior,
such as having unprotected sex with multiple partners, is important
for a successful IPC intervention. If starting an IPC program for
the first time, it may be best to focus on one high risk group at
a time, this will allow the program to be focused adequately on
the needs of the target population and prevent resources from being
spread too
thinly [PDF].
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EXAMPLE: Selecting the right target
group:
In one West African country, research showed that commercial
sex workers had increased their condom use with their clients,
but had unprotected sex with their live-in boyfriends. An
IPC intervention was developed to reach the boyfriends and
encourage condom use and VCT.
The intervention ran into problems from the start. The women
either refused to identify their boyfriends, or the men were
not interested in meeting the IPCs. Though the men were vulnerable
to HIV infection, the fact that they were hard to reach, were
not members of a large group, were not likely to infect a
large number of other women.
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| Selecting an Approach > >
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