ABSTRACT

This chapter focuses on an ethnographic process evaluation of an HIV prevention programme among injecting drug users in Baltimore, USA to illustrate the benefits of using this approach to improve HIV intervention efforts. During the step into Action' HIV prevention programme in Baltimore, USA, ethnographic methods were used to identify and evaluate the factors that facilitated HIV prevention message diffusion among injecting drug users. The chapter focuses on process evaluation, and particularly on how ethnographic methods can be used to inform the redesign of an intervention programme during pilot implementation. It presents illustrative findings of those aspects of the intervention that did not work well in training sessions or the community settings, and how they were altered in light of evaluation findings. The chapter presents how to use a systematic ethnographic data collection strategy consisting of participant observation, in-depth interviews and group discussions. The programme success and sustainability depended on the dissemination of the harm reduction messages through social networks.