Sharon Weir isn’t the kind of person you’d expect to find in a dark, smoky bar or late-night dance club. She’s soft-spoken, with a gentle demeanor. Yet there she is, in a bar in South Africa, asking strangers about their sex lives. 

Weir is a public-health researcher at UNC’s Carolina Population Center, and for the past 13 years she and her team have traveled the globe, combatting the spread of HIV by bringing prevention programs to the places where they’re needed most.

In the late 90s, Weir developed a unique methodology called PLACE (Priorities for Local AIDS Control Efforts). Researchers use PLACE to pinpoint the locations where HIV transmission is most likely to occur and assess the prevention programs in those areas.  

“The local epidemics are the critical piece for solving the prevention puzzle,” Weir says. “If you can find the geographic areas in a country that have the highest transmission rates, you can be strategic and target resources there.”   

PLACE begins with a national stakeholder workshop to determine which areas of the country have been hardest hit by AIDS. Then the data-collection team targets specific locations, such as bars, clubs, festivals, and other places where people find sexual partners and use injection drugs.  The team interviews about 1,200 people over the course of three to five weeks.      

But how do you conduct interviews with strangers about sensitive sexual health issues?  Weir says the phrasing of the questions is important. “We don’t ask people if they self-identify as a sex worker,” she says. “We try not to feed into known stereotypes or come across as blaming any particular group.”

Instead, PLACE uses a “venue-based” approach.  “If you’re age 15 or older, you’re socializing at this place, and you agree to do the survey, then you meet the study criteria,” Weir says. “We interview everyone.”

Conducting interviews is often the easy part, according to Weir.  The interviewers are well-trained and the survey is a brief, simple questionnaire. Gaining access to certain locations can be trickier. Weir says violence is sometimes an issue. “We never put the interviewers at risk,” she says.  “If it seems like there could be violence, we go earlier in the day. But sometimes the venue isn’t accessible to interviewers simply because the violence is so high.”

While the PLACE protocol has been used in dozens of countries, Weir says Jamaica has the longest-running program and has used the methodology in many different ways.

Peter Figueroa, the former director of the National HIV/STI Program in Jamaica, says PLACE helped to identify where commercial sex was taking place, especially in locations that he and his team did not anticipate. “Churches, bus stops, cemeteries, parks, beaches—everywhere,” Figueroa says. “We knew some of the sites but PLACE gave us a proper understanding of the scope of the work that needed to be done.”

Since identifying those problem areas, Figueroa and his team have engaged in systematic community work which includes condom distribution, condom-use education, and empowerment activities and workshops. Now, interview subjects can request to be tested for HIV and other sexually transmitted diseases.  

Another innovative component of PLACE is its accessibility. Because PLACE is designed to be used in areas with minimal resources, a community can start using it with just a computer and an internet connection. “We know people have downloaded it off our site and implemented it without any contact with UNC,” Weir says. “Then they file reports online later that it was helpful, and that’s really gratifying.”   

Sharon Weir is a research associate professor of epidemiology in the UNC Gillings School of Global Public Health and a fellow at the Carolina Population Center. Funding for PLACE has come primarily from the United States Agency for International Development through the MEASURE Evaluation project. 

Peter Figueroa is a professor of public health, epidemiology, and HIV/AIDS at the University of the West Indies. He is also an adjunct professor in the Department of Health Policy and Management in the UNC Gillings School of Global Public Health.