These PowerPoint slides present an overview of the intervention and are available from the CDC Effective Interventions HIV Prevention that Works website.
Popular Opinion Leader (POL) is a community-level intervention designed to reduce HIV risk behaviors through the use of credible opinion leaders who diffuse social norms of safer sex practices throughout their social networks. The organization that implements POL identifies, recruits, and supports opinion leaders to model and promote HIV risk reduction through conversations with friends and acquaintances. Each POL initiative responds to community needs in collaboration with its members.
POL conducts formative research to identify the target population, social networks, opinion leaders, and HIV prevention-related norms. Opinion leaders recruited from the target population train on risk reduction methods and effective communication strategies to change peer norms; they also practice talking about risk reduction. Leaders are expected to engage in at least 14 conversations with friends and acquaintances. The organization implementing POL can support its leaders by hosting reunions or parties. These events encourage leaders to continue modeling positive opinions around HIV prevention.
Popular Opinion Leader is based on the Diffusion of Innovation Theory which posits that behaviors typically follow adoption by opinion leaders and then spread through a social network. The intervention was tested with men who have sex with men (MSM) in small- to medium-sized Southern towns, minority women in low-income housing developments in five geographically diverse U.S. cities, and male sex workers and patrons in Manhattan gay bars. According to the Centers for Disease Control and Prevention (CDC), POL outcomes included:
- Decrease in unprotected intercourse (MSM)
- Decrease in unprotected intercourse (minority women)
- Increase in condom use (MSM, minority women)
- Decrease in number of sex partners (MSM)
- Increase in communication with partners (minority women)
- Decrease in paid, unprotected anal intercourse (male sex workers)
- Direct intervention to an identified population in well-defined community venues
- Use ethnographic techniques to identify persons who are most popular, well-liked, and trusted by others in the community
- Train 15% of the intervention target population to be opinion leaders
- Build skills of opinion leaders to initiate risk reduction conversations with friends and acquaintances
- Teach opinion leaders the characteristics of effective behavior change communication messages targeting risk-related attitudes, norms, intentions, and self-efficacy
- Train opinion leaders to use logos, symbols, and social marketing as conversation "starters"
- Discuss outcomes of POL conversations at subsequent training sessions
- Groups of opinion leaders meet weekly for ongoing instruction, facilitation modeling, and multiple role-play exercises to refine their skills and gain confidence in delivering effective HIV prevention messages
- Opinion leaders set goals to engage in risk reduction conversations with friends and acquaintances in the target population between weekly sessions
- Friends and acquaintances participate in conversations with opinion leaders about the benefits of safe sex behavior and recommend practical steps needed to implement change