High Impact Prevention

This community-level intervention involves identifying, enlisting, and training key opinion leaders to encourage safer sexual norms and behaviors within their social networks through risk-reduction conversations.

Research and Development

Popular Opinion LeaderKelly, J.A., St. Lawrence, J.S., Diaz, Y.E., Stevenson, L.Y., Et al. (1991). HIV Risk Behavior Reduction Following Intervention with Key Opinion Leaders of Population: An Experimental Analysis, American Journal of Public Health, 81 (2), 168 – 171.

Kelly, J (2004) "Popular Opinion Leaders and HIV Peer Education: Resolving Discrepant Findings, and Implications for the Implementation of Effective Community Programmes." AIDS Care 16(2): 139-150.

Abstract: A series of community-level trials undertaken in the United States over the past 10 years established the effectiveness of an HIV prevention intervention that systematically identifies, recruits, trains, and engages the popular opinion leaders (POLs) of a population to serve as behaviour change endorsers. Recently, several investigators reported unsuccessful attempts to implement peer education programmes for men who have sex with men in the United Kingdom and raised questions about whether peer-based programmes are effective or feasible. However, POL is a theory-based and very specialized intervention, and the UK peer education programmes did not incorporate many of POL's core or essential elements. Consequently, they were not evaluations of POL. In this article, core elements of the popular opinion leader model are presented; interpretations are made of possible reasons for the discrepant findings of the UK peer education and US POL interventions; and practical issues for applied programme development are discussed.

Program Review Panel Information

The CDC requires all CDC-funded agencies using the POL intervention to identify, or establish, and utilize a Program Review Panel and complete Form 0.1113 to document this activity. The intervention researchers and developers are not involved in this activity. This is a CDC requirement for their grantees, and all questions in this regard should be directed to your agency's CDC Project Officer or to the health department funding your agency's implementation of the intervention.

The Program Review Panel guidelines, instructions for completion of Form 0.113, and the form itself are available under the Related Links section of this website.

CDC Policy on Youth Peer Outreach Workers

CDC funded (directly or indirectly) agencies using youth (either paid or volunteer) in program outreach activities, it is very important that said organizations use caution and judgment in the venues/situations where youth workers are placed. Agencies should give careful consideration to the "age appropriateness" of the activity or venue. Additionally, agencies should comply with all relevant laws and regulations regarding entrance into adult establishments/environments. Laws and curfews should be clearly outlined in required safety protocols developed and implemented by agencies directly and indirectly funded by CDC.

If you have specific questions, please contact your CDC project officer.

More Info

POL Core Elements

  • Intervention is directed to an identifiable target population in well-defined community venues and where the population’s size can be estimated.
  • Ethnographic techniques are systematically used to identify segments of the target population and to identify those persons who are most popular, well-liked, and trusted by others in each population segment.
  • Over the life of the program, 15% of the target population size found in intervention venues are trained as POLs.
  • The program teaches POLs skills for initiating HIV risk reduction messages to friends and acquaintances.
  • The training program teaches POLs characteristics of effective behavior change communication messages targeting risk-related attitudes, norms, intentions, and self-efficacy. In conversations, POLs personally endorse the benefits of safer behavior and recommend practical steps needed to implement change.
  • Groups of POLs meeting together weekly in sessions that use instruction, facilitator modeling, and extensive role play exercises to help POLs refine their skills and gain confidence in delivering effective HIV prevention messages to others. Groups are small enough to provide extensive practice opportunities for all POLs to shape their communication skills and create comfort in delivering conversational messages.
  • POL’s set goals to engage in risk reduction conversations with friends and acquaintances in the target population between weekly sessions.
  • POL’s conversational outcomes are reviewed, discussed, and reinforced at subsequent training sessions.
  • Logos, symbols, or other devices are used as ‘conversation starters’ between POLs and others.

The materials on this site are designed for HIV/AIDS prevention with persons at risk for acquiring or transmitting HIV. They are meant to be resources used by HIV prevention providers such as health departments and community-based organizations so as to provide the best evidence-based HIV prevention services. These materials are not meant for the general public. They are not meant for children. They are not school-based HIV prevention strategies.

Centers for Disease Control and Prevention
1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO