PLACE Report Template
Priorities for Local AIDS Control Efforts
Location
<Date>
Instructions on How to Use The PLACE Report Template
These guidelines should help you in writing a preliminary PLACE report and maintain some consistency in content and format. The report guidelines may need to be modified for your PLACE study to highlight additional findings or incorporate any methodology changes. For example, this report template assumes that there is a country-level strategy for PLACE; that districts were selected for PLACE implementation; and that there are one or more priority prevention areas (PPAs) in each district. This report summarizes the findings for one PPA, however, the tables can be modified to report the findings for more than one PPA.
The report follows the five steps of the protocol and for each step describes the method and the results. A discussion of the results is encouraged.
There is an executive summary at the beginning of the report.
Tables are incorporated into the text of the report. The questions after each table can be used to guide interpretation of each table.
Understanding the Guidelines:
Brackets < > — Suggestions are written inside the brackets (horizontal carets).
Blanks______. — Fill in the blanks with the information for your study.
Text — We have included draft text that you can adapt. If you keep the text that is provided, be sure to check it for accuracy for your district. You can always delete or add to the text.
Graphs and maps — Graphs and maps can go into the text. You can click on these graphs and edit the data.
Tables — For each table there is space in the text to summarize and comment briefly on the table.
Paper size — Be aware that this template has been formatted for printing on the standard office paper size used within most countries outside North American (A4 paper). If printing this report in a country that uses the standard paper size typically used in North American countries (8½ x 11 inches), we recommend changing the paper-size formatting before working on your report. To change paper size in Microsoft Word, select “Page Setup” and the “Paper” tab, then adjust the “Paper size” choice.
Table of contents — If preparing this document in Microsoft Word, the Table of Contents, List of Tables, or List of Figures may be updated automatically by placing the cursor within each of the contents listing and using the “F9” key on your computer. Be aware that any new chapter titles, subheadings, or illustration or figure titles will not appear in the updated listings unless they were tagged to do so (any new listing that were not tagged, however, can still be typed in manually within the Table of Contents).
Instructions — Finally, remember to remove this page of instructions before printing and distributing your report.
Table of Contents
Executive Summary 1
Summary of PLACE Indicators 3
1 Step 1: PLACE Strategy 7
1.1 Background: HIV Epidemic in <Country> 7
1.2 The PLACE Protocol: Objectives 7
1.3 Ethical Review and Approval 8
1.4 Identification, Selection, and Description of <this PPA> 8
1.5 Training and Instrument Adaptation 11
2 Step 2: Where Do People Go to Meet New Sexual Partners? Findings from Community Informant Interviews 12
2.1 Methods to Identify Venues 12
2.2 Community Informant Fieldwork 12
2.3 Characteristics of Community Informants 13
3 Step 3: What Are the Characteristics of Venues Where People Meet New Sexual Partners? 15
3.1 Methods 15
3.2 Venue Verification Fieldwork 17
3.3 Types of Venues 18
3.4 Activities that Occur at Venues and Other Characteristics of Venues 20
3.5 Who Comes to the Venue? Opinions of Venue Representatives 22
3.6 When Do People Visit Venues? 23
3.7 AIDS Prevention at Venues and Condom Availability at Venues 24
3.8 Injection Drug Use in PPA 27
4 Step 4: What are the Characteristics of People Who Socialize at Venues where People Meet New Sexual Partners? Findings from Interviews with People Socializing at Venues 29
4.1 Methods 29
A Selecting Venues Where Individuals Socializing Were Interviewed 29
B Selecting Individuals at Selected Venues 29
4.2 Fieldwork for Interviews with People Socializing at Venues 30
4.3 Socio-demographic Characteristics of People Socializing at Venues 31
4.4 How Frequently Do People Visit Venues? 32
4.5 Where Do Venue Patrons Come from? Mobile Populations Are Important 34
4.6 People Report Meeting New Sexual Partners at the Venues 35
4.7 Age at First Sex 37
4.8 Number of Partners and Rate of New Sexual Partnerships 38
4.9 Key Population: Those with the Highest Rates of New Sexual Partnerships 39
4.10 Age Differences between Sexual Partners 40
4.11 Condom Use 41
4.12 Participation in HIV/AIDS Prevention Programs 42
4.13 HIV/AIDS Testing 42
4.14 Key Populations: Youth 43
4.15 Key Populations: Commercial Sex Workers, Clients, Men Who Have Sex with Men, and Injection Drug Users 44
4.16 Treatment for Sexually Transmitted Infections 46
4.17 Treatment for Tuberculosis 47
4.18 Issues of Concern in the Community 48
5 Step 5: Use Results to Improve Programs 49
5.1 Analysis and Summary of Main Results 49
A. Summary Tables 49
B. Maps of Priority Venues 49
C. Priority Venues 49
6 References 51
7 Appendices 53
7.1 Appendix 1: Documentation of Meeting Participants 53
7.2 Appendix 2: Fieldwork Documentation 53
7.3 Appendix 3: Questionnaires 53
List of Tables
Table S.1. Summary of Key PLACE Indicators 3
Table S.2. PLACE Indicators for Youth 4
Table S.3. PLACE Indicators by Level of Partnerships among Men 5
Table S.4. PLACE Indicators by Level of Partnerships among Women 6
Table 1.2.1. The Five Steps of the PLACE Protoco 8
Table 1.4.1. Description of PPA 10
Table 1.4.2. Perceived Problems in PPA According to Patrons at Venues <in PPA 11
Table 2.2.1. Community Informant Fieldwork 12
Table 2.3.1 Characteristics of Community Informants 13
Table 3.2.1. Summary of Venue Verification Fieldwork 17
Table 3.3.1. Types of Venues 18
Table 3.4.1. Characteristics of Found and Verified Venues 20
Table 3.5.1. Venue Representatives’ Descriptions of Patrons Coming to Venue 22
Table 3.6.1. Busy Times at Venues and Number of Patrons 23
Table 3.7.1. AIDS Prevention Activities at Venues 24
Table 3.7.2. Condom Availability at Venues 25
Table 3.8.1. Injection Drug Use 27
Table 4.2.1. Summary of Fieldwork for Interviews with Individuals Socializing at <Number> Venues 30
Table 4.3.1. Self-Reported Socio-demographic Characteristics 31
Table 4.4.1. Self-Reported Venue Visiting Behavior 32
Table 4.5.1. Mobile Populations 34
Table 4.6.1. Meeting a New Partner at the Venue 35
Table 4.7.1. Ever Had Sex and Age at First Sex 37
Table 4.8.1. Rate of Partnership Acquisition 38
Table 4.8.2. Percent Reporting 2+ Partners in the Past 12 Months: A Comparison of the PLACE Population with the National Population in <Country> (Demographic Health Survey Data) 39
Table 4.9.1. Gender and Rate of Sexual Partnership 39
Table 4.10.1. Oldest and Youngest Partnerships 40
Table 4.11.1. Condom Use 41
Table 4.12.1. HIV/AIDS Education and Prevention Activities 42
Table 4.13.1. HIV/AIDS Testing 42
Table 4.14.1. Characteristics of Young Adults 43
Table 4.15.1. Transactional Sex and Men Having Sex with Men 44
Table 4.15.2. Injection Drug Use 44
Table 4.16.1. STI Symptoms 46
Table 4.17.1 Tuberculosis (TB) Symptoms and Treatment 47
Table 4.18.1. Issues of Concern in the Community 48
Table 5.1.1. Priority Venues 49
List of Figures
Figure 2.3.1. Types of community informants. 14
Figure 3.1.1. Example of a map showing types of venues. 16
Figure 3.1.2. Example of a map showing condom availability at public venues where people meet new sexual partners in Kampala, Uganda. 16
Figure 3.3.1. Type of venue (C13). 19
Figure 3.4.1. On-site activities as reported by venue manager (C22). 21
Figure 3.7.1. HIV prevention activities and condom availability on-site. 26
Figure 4.4.1. Frequency of attendance at venue by gender (D26). 34
Figure 4.6.1. Partner selection reported by individuals interviewed at venues. 36
Figure 4.8.1. Number of new sexual partners during past four weeks. 39
20
Executive Summary
What is the PLACE method?
Because resources for HIV prevention programs are extremely limited, there is an urgent need to focus interventions where they are most cost-effective. To prevent new infections in a cost-effective way, AIDS prevention programs should focus on areas likely to have a higher incidence of infection. The Priorities for Local AIDS Control Efforts (PLACE) method is a new monitoring tool to identify areas likely to have a higher incidence of infection.
Within these areas, PLACE identifies specific venues where AIDS prevention programs should be focused in order to reach those most at risk of acquiring and transmitting HIV, provides indicators that monitor HIV/AIDS prevention program coverage, and identifies gaps in prevention programs. The method has been effective at mobilizing local populations to make progress in addressing gaps in prevention programs.
How was the PLACE Strategy developed?
A steering committee comprised of representatives from <organizations> decided to implement PLACE in strategically chosen districts/provinces/cities>. A total of ___ districts were selected based on <criteria such as the prevalence of HIV in the district and contextual factors in the district that suggested that the incidence of HIV infection is likely to be highest in these districts/provinces/cities>.
The results of PLACE will be used as the basis for local HIV/AIDS strategic plans and to guide prevention programming decisions. Without the PLACE assessments, these <districts/provinces/cities> would not have the information they need to target prevention efforts. Limited information is also collected on HIV/AIDS programs not directly related to prevention programs.
For which key populations should indicators be measured?
PLACE provides a description of the population socializing at venues known to be places where people meet new sexual partners. This is a critical group to reach with prevention programs. The steering committee also selected these additional key populations: ______based on______.
Why was <PPA> selected for a PLACE study?
PPA> was selected based on the criteria determined by the PLACE steering committee. Specifically, <PPA> has < for example, it has an HIV prevalence of __% among antenatal patients. This is higher than the national prevalence of ______%. >
In addition, the PPA has the following contextual factors that may be associated with a higher incidence of HIV transmission:______,______, ______.
<Describe other reasons why the particular PPA was selected>.
Where do people meet new sexual partners in <PPA> ?
Over <number> of community informants were interviewed to identify venues where people meet new sexual partners. Approximately ____ different venues were named, including <number in PPA> and <number outside the PPA. All venues reported by community informants were eligible for a site visit except <criteria for not visiting a venue>. Overall, a total of <number> venues reported by community informants were visited. Of the ______venues that were visited, _____% were bars and taverns, but many other types of venues were visited including ______.
Many people interviewed while socializing at venues reported having met a new sexual partner at the site.
At <number> of venues, <number of people interviewed at venues> people who were socializing were interviewed. Over __% of men and women reported that they believed that people meet new sexual partners at the site. Approximately ___% of the men and ___% of the women reported having met a partner at the venue of the interview.
The rate of sexual partnerships was high among venue patrons.
The rate of new sexual partnerships reported by people socializing at the venues was very high. Approximately ___ % of the men and ______% of the women interviewed reported having had a new partner in the past year; _____% of the men and ____% of the women reported having had a new partner in the past four weeks.
More than ____% of men and ___% of women socializing at venues reported having had two or more partners in the past four weeks.
Condom use was inconsistent among those who had had two or more partners in the past year or a new sexual partner in the past four weeks.
Overall, ____% of people socializing at venues had never used a condom and only __% showed a condom to the interviewer when requested to do so. Among those who had had more than two partners in the past year or a new sexual partner in the past four weeks, ___% or men and __% of women reported using a condom the last time they had sex.
Many youth aged 15-24 reported having a new sexual partner in the past four weeks.
Overall, ____% of youth aged 15-24 socializing at venues had never used a condom and only __% showed a condom to the interviewer when requested to do so. Among those who had had more than two partners in the past year or a new sexual partner in the past four weeks, ___% of men and __% of women reported using a condom the last time they had sex.
Overall, the PLACE method found a large gap in AIDS prevention programs, but a willingness to improve programs at the venues.
Overall, condoms were available on the day of the venue visit at _____% of venues and __% had not had condoms available at all during the past year. In spite of this, ___% of venue managers were willing to sell condoms at the site.
Program implications of the assessment:
With strong community involvement, interventions need to be further focused on venues where people meet new sexual partners.
Based on the findings from this PLACE assessment, we recommend that______.
<Other key findings>
Summary of PLACE Indicators
Table S.1. Summary of Key PLACE Indicators
Number of Community Informants InterviewedTotal Number of Venues Reported by Community Informants
Number of Venues Eligible for Venue Verification
Number of Venues where Venue Representative Interviewed
Of these, % of venues:
that are bars or taverns
where people meet new sexual partners
where sex workers solicit
where sex occurs onsite
where IDU’s socialize
where students or youth under 18 socialize
where non-residential/mobile populations socialize
where men who have sex with men socialize
where any AIDS prevention had occurred at the venue
where condoms were available and seen
where condoms were never available in the past year
where manager willing to have AIDS prevention at the venue
List of Key Behavioral/Socio-demographic Populations:
Number of Venues Identified with:
0 key populations
1-2 key populations
3+ key populations
Number of Venues Where Patrons Interviewed
Characteristics of Venue Patrons / Men / Women
Estimated number of patrons at all venues during most busy time
Number of venue patrons interviewed at Venues
Mean age of patrons
Percentage of Patrons Who:
Are aged 15-24
Are unemployed
Are currently a student
Do not live in the PPA
Visit the venue daily
Have injected drugs in the past 12 months
Gave or exchanged money for sex in the past 4 weeks
Had a new sexual partner in the past 4 weeks
Had a new sexual partner in the past 12 months
Of these, % using condom with last new partner
Had more than one sexual partner in the past 12 months
Of these, % using a condom at last coitus
Had sex with a man in the past 12 months (men only)
Had a sex partner 10 years older in past year
Had a sex partner 10 years younger in past year
Had a symptom of an STI in the past 4 weeks (men only)
Have ever been tested for HIV
Rate of Sexual Partnerships
High: 1+ new partners or 2+ partners past 4 weeks
Moderate: 1+ new or 2+ partners past 12 months
Low: Not sexually active or 1 sexual partner in the past 12 months
Table S.2. PLACE Indicators for Youth