Empowering Peer Group Leaders for HIV Prevention in Malawi
Article first published online: 16 APR 2013
© 2013 Sigma Theta Tau International
Journal of Nursing Scholarship
Volume 45, Issue 3, pages 288–297, September 2013
How to Cite
McCreary, L. L., Kaponda, C. P. N., Davis, K., Kalengamaliro, M. and Norr, K. F. (2013), Empowering Peer Group Leaders for HIV Prevention in Malawi. Journal of Nursing Scholarship, 45: 288–297. doi: 10.1111/jnu.12031
- Issue published online: 3 SEP 2013
- Article first published online: 16 APR 2013
- Manuscript Accepted: 14 MAR 2013
- Fogarty International Center. Grant Number: T37 TW00057
- Fogarty International Institute. Grant Number: D43 TW001419
- National Institute for Nursing Research. Grant Number: R01 NR08058
- Community-public health-environmental health;
- primary health care;
- international health or global health;
- qualitative methodology
Behavioral change interventions using peer group leaders are effective and widely used, but few studies have examined how being a peer group leader affects the leaders. This study describes how participants felt being a peer group leader affected their lives.
This descriptive qualitative study interviewed 18 experienced peer group leaders who had conducted a multisession human immunodeficiency virus (HIV) prevention peer group intervention in rural Malawi.
We used inductive content analysis and comparisons within and between cases.
Three major themes were identified. All leaders said they experienced personal changes in their knowledge, attitudes, or HIV prevention behaviors. They described interacting with family, neighbors, and friends, and speaking at church or community meetings, to discuss HIV prevention issues. They increased their self-efficacy to engage others in sensitive HIV prevention issues, developed a self-identity as a change agent, and came to be recognized in their community as trustworthy advisors about HIV and acquired immunodeficiency syndrome. These three themes, taken together, form the meta-theme of psychological empowerment.
Being a peer group leader empowered the leaders as change agents for HIV prevention and had impacts in the community after the intervention ended, potentially increasing the long-term effectiveness and cost effectiveness of peer group interventions.
Healthcare workers and community volunteers who led HIV prevention sessions continued HIV prevention activities in the community and workplace after the program ended. Training health workers as volunteer HIV prevention leaders offers a strategy to bring HIV prevention to limited-resource settings, despite health worker shortages.