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PLACE Method for Monitoring and Evaluation of HIV Prevention Programmes

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Priorities for Local AIDS Control Efforts (PLACE) is a "rapid assessment tool to monitor and improve AIDS prevention program coverage in areas where HIV transmission is most likely to occur."

"PLACE is designed for local program managers who want to know where to target resources to prevent new infections. PLACE systematically identifies gaps in current prevention programs, enhances the local use of these findings to improve program delivery, and monitors program coverage over time using over time using easy-to-understand indicators and coverage maps."

The PLACE protocol was designed to provide strategic information to prevention programmes based on the unique features and contexts of local HIV transmission networks.

The specific objectives of the PLACE method are:
  • To identify geographic areas most likely to contain key HIV transmission networks;
  • To assess HIV prevention programme coverage among groups most likely to acquire and transmit HIV; and
  • To provide specific actionable recommendations to address critical gaps in prevention programming.

The PLACE method was developed in 1999 and piloted in South Africa. Since then, the protocol has been implemented in Tanzania, Uganda, Zambia, Burkina Faso, Ghana, Madagascar, Malawi, Zimbabwe, India, Mexico, Jamaica, Russia, St Lucia, Haiti, Kazakhstan, Kyrgyzstan, and Uzbekistan.

The five steps of the method are:

Step 1) A national PLACE steering committee reviews the HIV epidemic and identifies priority prevention areas (PPAs) where HIV prevention needs are most acute.
Step 2) Local PLACE committees within each PPA take charge of local PLACE implementation. Interviewers conduct short surveys of 300-500 community informants to identify all local public venues (such as hotels, hostels, parks, and bars) where people meet new sexual partners and where injecting drug users (IDUs) socialise. The focus is on venues where people meet new sexual partners and where IDUs socialise, because reaching persons with a high rate of new sexual or needle-sharing partnerships - i.e., those who have a disproportionate role in local HIV epidemics - is critical for prevention programmes.
Step 3) Trained interviewers visit all venues identified in Step 2 and characterise each in terms of the type of venue, the type and number of people who visit the venue (including youth, IDUs, MSM, sexworkers, and clients), the existence of any current HIV/AIDS prevention programmes at the venue, and the feasibility of future on-site prevention efforts.
Step 4) A representative sample of patrons is interviewed regarding their sociodemographic characteristics, their sexual and injecting drug use behaviours, and their exposure to HIV prevention programmes, including HIV testing and condom promotion.
Step 5) The findings are locally analysed and interpreted in an action plan to address prevention gaps.

PLACE Example: Samara, Russia
The Steering Committee selected Samara, Russia, as a pilot location. 400 community informants named 320 venues where people meet new sexual partners or injecting drug users socialise. Of these, 248 were successfully located - 48% were patronised by IDUs and 92% by people seeking new sexual partners. Researchers found syringes on the ground at approximately 40% of the venues and condoms onsite at only 11%. Interviews conducted with a probability sample of 960 patrons confirmed HIV risk behaviours. Approximately 74% of the men and 68% of the women reported a new sexual partner in the past year; more than one-third reported two or more partners in the past four weeks; and about 10% of young people admitted to occasional use of intravenous drugs. Based on these findings, the steering committee recommended that prevention efforts be broadened to include venues where youth and other individuals at risk of acquiring and transmitting HIV socialise.

The Manual
The PLACE manual, including training materials, PowerPoint presentations, questionnaires, data entry templates, and Epi_info programmes, can be ordered from the MEASURE Evaluation publications database.

Click here for access to ordering this publication online.

Click here to download a PDF of this publication.