Downloaded from http://journals.lww.com/aidsonline by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 03/31/2021 Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Selecting at-risk populations for sexually transmitted disease/HIV intervention studies Zunyou Wu a , Mary Jane Rotheram-Borus b , Roger Detels b , Li Li b , Jihui Guan d , Guojun Liang c , Lorraine Yap a and the National Institute of Mental Health (NIMH) Collaborative HIV/STD Prevention Trial Group Objective and design: This paper describes one option to select populations for randomized, controlled trials (RCT). We used a popular opinion leader intervention in Fuzhou, China, to: (1) identify population selection criteria; (2) systematically examine the suitability of potential target populations and settings; (3) briefly evaluate risk and stability in the population; and (4) evaluate regional and organizational support among administrators and government officials. Methods and results: After comparing migrant villagers, truck drivers, factory workers, construction workers, and market employees in five regions of China, market employees in Fuzhou were identified as the optimal target population. Markets were the optimal sites for several reasons: (1) the population demonstrated a sufficient base rate of sexually transmitted diseases; (2) the population was stable over time; (3) a sufficient number of sites of manageable sizes were available; (4) stable networks existed; (5) local gatekeepers/stakeholders supported the intervention; (6) there was organizational capacity in the local health department to mount the intervention; (7) the demographic profile was similar across potential sites; and (8) the sites were sufficiently distanced to minimize contamination. Conclusions: Evaluating intervention efficacy in an RCT requires a time-consuming and rigorous process that systematically and routinely documents selection criteria, evaluates multiple populations, sites, and organizations for their appropriateness. ß 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2007, 21 (suppl 8):S81–S87 Keywords: STD, HIV, intervention study, population selection Introduction Implementing an effective intervention to reduce HIV transmission and demonstrating that an intervention is efficacious, are complementary, but very different pro- cesses. Strategic selection of a population is a complex process whose details are rarely presented in research reports. The goal of this article is to describe the process of site selection for a randomized controlled trial (RCT) for a community popular opinion leader intervention [1–3] to promote safer-sex social norms, and to prevent transmission of HIVand sexually transmitted diseases (STD) in China. The number of new STD reported in China increased from 13 in 1977 to 460 000 in 1997, and to over 800 000 in 2000 [4,5]. Simultaneously, HIV has been identified in each of the 31 provinces of China, with current estimates of 700 000 HIV-infected persons [6]. Sexual contact has increased over time to become a major mode of HIV transmission [7]. China is experiencing From the a National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China, the b University of California, Los Angeles, California, USA, the c National Center for STD Control & Academy of Preventive Medicine, Nanjing,, and the d Fujian Institute of Health Education, Fuzhou, China. Correspondence to Zunyou Wu, M.D., Ph.D., Director, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, P.R. China. E-mail: wuzy@263.net or wuzunyou@gmail.com or wuzy@chinacdc.cn ISSN 0269-9370 Q 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins S81