Previous research has determined that door-to-door HIV education programs are an effective means of teaching about HIV, reducing stigma, and increasing the number of people seeking HIV testing and treatment in sub Saharan Africa. Where the population is illiterate, physical mnemonics can improve learning. GAIA Vaccine Foundation therefore developed the Hêré Bolo HIV Peer education program that uses a physical mnemonic based on the five fingers of the hand: Hope (thumb; Identity (index finger); Transmission (middle finger); Fidelity and Family (ring finger); and Community (fifth finger completing whole hand) to teach illiterate residents of a peri-urban slum in Mali about HIV disease, treatment and prevention.
The Hêré Bolo door-to-door HIV peer education campaign was initiated in the neighborhood of Sikoro, near Bamako, Mali, in July 2006. A pilot project was initiated in July/August 2006. Community members were trained by the Malian national peer education program (Groupe Pivot) and taught the Hêré Bolo teaching method in Nov-Dec 2007. Answers on the posttest HIV information survey improved following the training program. Formal training was provided to the Peer educators in November 2007 (Groupe Pivot). The program was formally initiated in February 2007. More than 6,443 contacts with community members were initiated by the 11 peer educators over the six-month period 2/2007 to 5/2007. During this period, 4,184 condoms were distributed. HIV testing requests at the Sikoro CSCOM have increased by 20%.
Testimony from a peer educator: I will put all of my energy into the fight against HIV and peer education so that all can benefit from the good news (about treatment) and know that HIV has been ravaging our neighborhood, Sikoro, and we pray to the good god so that one day we will have medicine that will cure everyone of this disease.
The next phase of the program will determine whether the physical mnemonic is “viral” by measuring transmission of the teaching to homes adjacent to the sites where the Hêré Bolo intervention took place. Thus, the Hêré Bolo five-finger simple physical mnemonic improves HIV learning in a pilot intervention. This intervention may be easily adaptable to other settings in West Africa.