PLACE Method

Priorities for Local AIDS Control Efforts1

1MEASURE Evaluation, A Manual for implementing the PLACE Method

Learning Objectives & Overview

Objectives

Summarize PLACE Method1

Recognize fit of this approach within the context of special survey methods

Overview

Summarize PLACE rationale & objectives

Discuss method within Asian context

1For more detailed information on the method, refer to MEASURE Evaluation, A Manual for implementing the PLACE Method

PLACE Objectives

Provide rapid information used to target and monitor local AIDS prevention efforts

Monitor and improve AIDS prevention program coverage in areas where HIV transmission is most likely to occur

Target programmatic efforts where they are needed

Epidemiological data show geographic clustering of HIV transmission risk

Prevention efforts should focus on these areas

Team can use epidemiologic and contextual data to identify areas where transmission is likely to be high

PLACE Rationale

PLACE Focus: New Partnerships (Sexual or IDU)

LOW

No Sex or 1 Non-new Partner in Past Year

MODERATE

HIGH

Any New/Multiple Partners

Past 12Months

Past 4 WeeksAny New/

Multiple Partners

PLACE Method Overview

1. Prepare a PLACE Strategy

• Select priority prevention area (PPA) based on available data

2-4. Conduct rapid assessment in each area

2. Identify venues where people meet new partners

3. Visit, characterize, & map all venues

4. Confirm high partnership formation rates at venues

5. Use Results to improve programs

Prepare a PLACE Strategy PLACE steering committee uses available data to

identify areas with high incidence

Consider geographic convergence of risk

High unemployment, rapid urbanization, poor housing, crime, congested pop, alcohol/drug use, limited STI care, migrant labor, border stations

Output PPAs identified

Conduct rapid assessment in each area:ID venues where people meet new partners

Ask 250-1,200 community informants Where do people meet new partners?

Probe based on strata of interest for mixing Young women and older men Commercial sex workers and injecting drug users Mobile and resident populations Military and civilian

Ask until no new sites Output

List of sites with number of times reported

Conduct rapid assessment in each area:Visit, characterize and map all venues

Reported venues are visited, mapped and an interview is conducted with a knowledgeable person to obtain characteristics of the venue

Mapping can be done by hand, onto an air photo, or using GPS

Conduct rapid assessment in each area:Example characteristics of sites

Prevention Type of site

Condom availability

Evidence of AIDS prevention

Busy times

Maximum occupancy

Number of staff

Site stability

Patrons Male:Female ratio

Regular patrons

Where patrons reside

Whether patrons include commercial sex workers, gay, IDUs, military, mobile, youth, locals, unemployed

Whether people meet new partners at site

Conduct rapid assessment in each area:Interview site patrons

Opinion:

Do other people come here to meet new partners?

Behavior and socio-demographic characteristics:

- Have you ever met a new partner at this venue?

- Have you ever injected drugs?

- Number of new & total partners in past 4 weeks/year

- Where else do people meet new partners?

- Condom use & exposure to intervention Output

Cross-sectional, self-reported data from non-representative sample that defies risk group labels

Use Results to improve programs & inform interventions

Mapping leads to targeted interventions

Condom distribution when people meet new partners

Needle exchange programs targeted to places IDUs will gather

Now: PLACE cane be used to estimate the size of hard to reach populations (coming)

Limitations of PLACE

Could miss important sites

Could miss very clandestine networks – both sexual and IDU

Transitory sights

Site-based interventions need site stability

No biomedical validation of method (yet)

May not be appropriate for all contexts

MEASURE Evaluation is a MEASURE project funded by the

U.S. Agency for International Development and implemented by

the Carolina Population Center at the University of North Carolina

at Chapel Hill in partnership with Futures Group International,

ICF Macro, John Snow, Inc., Management Sciences for Health,

and Tulane University. Views expressed in this presentation do not

necessarily reflect the views of USAID or the U.S. Government.

MEASURE Evaluation is the USAID Global Health Bureau's

primary vehicle for supporting improvements in monitoring and

evaluation in population, health and nutrition worldwide.