Peer Education Circles

HIV/AIDS prevention programs based on what urban experts think rural target groups ought to know? They don't work. From 1995-1998, The Rural AIDS Action Network (RAAN) -- a community-based nonprofit that coordinates volunteer service networks across Minnesota -- conducted a community prevention planning project for the Minnesota Department of Health. RAAN assessed HIV/STD prevention needs among two endangered populations in southern Minnesota: at-risk youth and men who have sex with men. Using confidential surveys, focus groups, and discussions with community peer leaders, RAAN went out to these "target groups" and talked to them as individuals -- asking not "what did you know and when did you know it?," but "what would you like to know and how would you like to learn it?" Prevention Education Circles emerged from the detailed concerns and creative suggestions of our rural constituents, and find support in academic research on successful HIV/STD prevention interventions.

The idea of social and political education circles has long history in both European and indigenous American cultures, as well as in many different religious traditions. Gathering a circle is really about building community. And that's just what the doctor ordered.
Gay and bisexual men, youth, and Latinos in both categories, face similar challenges in the rural midwest. While RAAN has identified and developed strong supportive networks of aids-compassionate individuals in small towns across the state, rural communities often exert tremendous pressures to conform. People living with HIV/AIDS, homosexuals, minorities and drug users are the other, and they live with a near-constant fear of stigma and ostracism.
The resulting isolation, depression and denial are deadly co-factors in rural HIV transmission. To combat these pathogens, RAAN's prevention education circles provide access to culturally relevant HIV/std education materials in a "safe" -- confidential and peer-defined -- environment.

Preventing HIV/AIDS requires more than delivering information on condoms and clean needles. Circles are at once social and educational, meeting regularly to explore a holistic curriculum -- one that cultivates communication, negotiation, and decision-making skills, and offers the tools necessary to achieve self respect, emotional and sexual health.
Gathering a circle takes time and patience and persistence. You have to identify and train key community leaders and peer educators, who then build bridges to at-risk populations via word of mouth. You also have to develop and distribute rural-sensitive outreach materials in well-researched locations -- truck stops, grain elevators, bars, schools, libraries, churches, laundromats, grocery stores (anywhere regularly frequented by your audience where folks can get information without going to a place associated with AIDS or gays). And you must develop a culturally appropriate curriculum, using a language and a process designed for a specific rural audience: if participants cannot relate culturally to the educational approach, they deny that the content and relates to them. Finally, you have to arrange the logistics for small circles to meet regularly outside of formal health and education service sites, offering consistent social and emotional support from peers in informal settings.

Cultural competence is critical to our mission: RAAN trains rural volunteers and service providers in cross-cultural communication -- how to respect and communicate with their Latino, glbt, and HIV-positive neighbors. We believe, however, that if rural individuals are to adopt and maintain long-term risk-reduction behaviors, they need to support and educate one another outside of any professional system. To this end, we encourage all communities to initiate prevention education circles.