Evaluation of the Effectiveness of AIDS Health Education Interventions in the Muslim Community in Uganda.

In 1992 the Islamic Medical Association of Uganda designed an AIDS prevention project based on recognition of the role of the imam (mosque leader) as the teacher of family behavior and sexual values. Over a 2-year period 23 trainers educated more than 3000 religious leaders and their assistants who in turn educated their communities on AIDS during home visits and at religious gatherings. Almost 600000 family contacts occurred. Comparison of findings of a baseline survey (n = 1907) with interviews conducted after 2 years of program implementation with both exposed (n = 1260) and nonexposed (n = 566) community members revealed significant increases in correct knowledge of transmission of HIV vertical transmission and the risk of unsterile skin-piercing instruments. Also recorded were significant increases in awareness of risks entailed in use of a common razor blade when a number of male infants are circumcised and ablution of the dead. Concurrent focus group discussions indicated weakened support for polygamy. There was a significant difference in condom use number of sexual partners and the incidence of extramarital sex reported at baseline compared with follow-up and between those exposed and not exposed to the project. The adoption of risk reduction behaviors was most marked among respondents under 45 years of age. The success of this intervention is attributed to its use of the Islamic religious organizational structure as a vehicle for HIV/AIDS education. This project demonstrates that positive collaboration between health professionals and religious leaders can be achieved and will enhance the success of community AIDS prevention efforts.