India-US collaboration to prevent adolescent HIV infection
Recruitment and retention strategies
Adolescent boys and girls provided specific suggestions about how best to recruit and retain them into a family-based programme. Overall, adolescents recommended a face-to-face outreach, conducted by a recruiter who would visit the adolescents’ houses to invite them to participate. In addition, adolescents suggested that they would be receptive to hearing from youth already enrolled in a programme, and recommended using village friendship networks as a mechanism to reach large numbers of youth.
For adolescents, successful recruitment efforts would highlight the health benefits of the programme for both youth and the broader community. Both adolescent males and females believed that a family-based programme could have a larger community impact and that this was an important point to publicize.
Mothers and fathers also recommended face-to-face recruitment methods. Overall, parents endorsed a personalized approach, with recruiters going from house to house to provide information on the project. Both mothers and fathers mentioned the importance of drawing upon existing social networks to recruit families and emphasizing how a family-based programme would benefit the future of their children.
Parents also recommended that male recruiters should recruit fathers and sons, and female recruiters should recruit mothers and daughters. For example, one mother stated:
Women from a pada should tell people in the same pada that a meeting on health is organized and they should come. This information is in the context of the future of our children. If we only don’t listen then who will think about the future of our children. All this we can tell in our hamlet.
Similarly, a father recommended an approach where a recruiter could:
.... personally go and speak to them. What do they feel, one must personally try to make them understand and speak. You must tell him that come to the programme if you understand what is being said then make use of it, if not then you can leave the programme.
In addition, fathers felt it was important for recruiters to clearly state the goal of the programme so that families could easily understand its purpose and relevance for their lives.
Content and format of a family-based intervention
Both adolescent boys and girls wanted accurate, relevant and developmentally appropriate information. Many of the youth in the focus groups stressed the importance of giving “proper advice” about HIV/AIDS. In general, adolescents felt it important to have a proposed family-based intervention that is “comprehensive and includes content both related to abstinence and safer sex”. Adolescents expressed interest in knowing both about ways they could avoid becoming sexually active and ways they could protect themselves if they did in fact become sexually active.
Both adolescent boys and girls were clear that a programme had to be flexible, convenient and adolescent friendly. Youth identified a number of characteristics that would make a youth programme friendly, including the use of diverse types of materials and programme activities. Adolescents felt that programme information could be shared through a variety of methods, including skits or plays, songs, and posters, pamphlets and other print materials. Regardless of the medium, adolescents emphasized the importance of addressing illiteracy and suggested that information about a family-based programme needed to be provided orally and in writing, as many of their parents could not read.
Parents wanted current and factual information on HIV/AIDS, strategies for protecting oneself from HIV/AIDS, including correct and consistent condom use, and sexual behaviour. Parents were open to receiving information about HIV/AIDS in a variety of ways, including via written materials and visual images. For written materials, parents stressed the importance of addressing illiteracy in the village and of making materials available in multiple languages, e.g., Hindi and Marathi. As one mother stated, “Now we get paper but we can’t even read it ... what you will tell us face to face we will understand from there only.” Regardless of the format, both mothers and fathers stressed the importance of making programme materials adolescent friendly.