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June 5, 2002


Emory Professor's Project Teaches South African Inmates Awaiting Release About HIV and Substance Abuse Prevention Project Models Parent Program in Four Georgia Institutions

In a country with one of the highest rates of HIV infection in the world, groups of South African inmates are being taught methods of HIV prevention and substance abuse prevention. The H.I.S. Project (Health Initiative Study), a three-year, $1 million project funded by the National Institutes of Health/National Institute on Drug Abuse, is being led by Emory public health professor Ronald Braithwaite, Ph.D., Department of Behavioral Sciences and Health Education, Rollins School of Public Health.

Dr. Braithwaite and his colleagues are seeking to provide prevention information and skills that they believe will positively impact the incidence of HIV transmission and drug use among the soon-to-be-released inmates. They are also examining the health status and concerns of inmates. Each group of participants, chosen from four South African institutions, is awaiting discharge within four to five months.

"This project provides us with a unique opportunity to provide education to a captive population," Dr. Braithwaite says. "We are arming the inmates with a repertoire of health education information that will better equip them to make a successful transition into society."

At the participating institutions, inmates in groups of eight to twelve men receive one of four intervention methods prior to their release. The intervention methods include presentations given by an HIV-positive peer educator who is an ex-offender, an ex-offender who is HIV-negative or a presentation from a traditionally trained health educator. The control group receives general health and wellness information through films and pamphlets. The intervention methods are implemented twice a week for six weeks.

"During the last session, we collect information from the inmates to determine how their knowledge and attitudes have changed since the first session," Dr. Braithwaite says. "After their release, we follow up with them at three, six and nine-month intervals to determine how they are adjusting to community living."

The project is modeled after a Georgia project that began in 2000 and is currently being conducted at three state prisons in Milledgeville as well as the Atlanta Transition Center. Torrance Stephens, Ph.D., co-principal investigator of the project, is currently in South Africa to evaluate how well the approaches used in Georgia for peer education are being adapted there.

For example, Georgia inmates who participated in the project are issued pagers following their release as part of the tracking protocol. In South Africa, however, facilitators must often rely on a former inmate's village elders or kindred to mandate that they keep in contact.

"Given the state of infrastructure as well of the state of healthcare in African countries, it's very important that you empower people to be in control of their own healthcare," Dr. Stephens said. "In South Africa particularly, given the political history, there has been very little focus on trying to maintain consistent healthcare services for the African population. You have a lot of beliefs that are based on their cultural orientations so you have to find a common ground to get the messages across."

Dr. Braithwaite will join Dr. Stephens this month in South Africa to continue to train the South African facilitators who are implementing the H.I.S. Project.

"All we're really trying to do is focus on working with other people, building bridges that will assist us in the work we're doing in Georgia, and trying to serve the healthcare needs of African-American and African men around the world," Dr. Stephens said.

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