Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe
Abstract Background There is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated wh...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08695-x |
| _version_ | 1797637073570627584 |
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| author | Katherine A. Thomas Euphemia Lindelwe Sibanda Cheryl Johnson Constancia Watadzaushe Getrude Ncube Karin Hatzold Mary K. Tumushime Miriam Mutseta Nancy Ruhode Peach P. Indravudh Frances M. Cowan Melissa Neuman |
| author_facet | Katherine A. Thomas Euphemia Lindelwe Sibanda Cheryl Johnson Constancia Watadzaushe Getrude Ncube Karin Hatzold Mary K. Tumushime Miriam Mutseta Nancy Ruhode Peach P. Indravudh Frances M. Cowan Melissa Neuman |
| author_sort | Katherine A. Thomas |
| collection | DOAJ |
| description | Abstract Background There is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated whether and how community-level measures facilitate a community-led intervention to achieve improved HIV outcomes. Methods This is a secondary analysis of survey data from a cluster randomised trial in 40 rural communities in Zimbabwe. The survey was conducted four months after the intervention was initiated. Communities were randomised 1:1 to either paid distribution arm, where HIV self-test (HIVST) kits were distributed by a paid distributor, or community-led whereby members of the community were responsible for organising and conducting the distribution of HIVST kits. We used mixed effects logistic regression to assess the effect of social cohesion, problem solving, and HIV awareness on HIV testing and prevention. Results We found no association between community measures and the three HIV outcomes (self-testing, new HIV diagnosis and linkage to VMMC or confirmatory testing). However, the interaction analyses highlighted that in high social cohesion communities, the odds of new HIV diagnosis was greater in the community-led arm than paid distribution arm (OR 2.06 95% CI 1.03–4.19). Conclusion We found some evidence that community-led interventions reached more undiagnosed people living with HIV in places with high social cohesion. Additional research should seek to understand whether the effect of social cohesion is persistent across other community interventions and outcomes. Trial registration PACTR201607001701788. |
| first_indexed | 2024-03-11T12:44:09Z |
| format | Article |
| id | doaj.art-ce079130ee0b4fe6b2a8a4a3f8ba8f69 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-11T12:44:09Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ce079130ee0b4fe6b2a8a4a3f8ba8f692023-11-05T12:08:52ZengBMCBMC Infectious Diseases1471-23342023-10-0122S111110.1186/s12879-023-08695-xDo community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in ZimbabweKatherine A. Thomas0Euphemia Lindelwe Sibanda1Cheryl Johnson2Constancia Watadzaushe3Getrude Ncube4Karin Hatzold5Mary K. Tumushime6Miriam Mutseta7Nancy Ruhode8Peach P. Indravudh9Frances M. Cowan10Melissa Neuman11London School of Hygiene & Tropical Medicine (LSHTM)Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweHIV, Hepatitis and STI Department, World Health OrganisationCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweMinistry of Health and Child WelfarePopulation Services InternationalCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweDepartment of Sexual Reproductive Health Rights and Innovations, Population Services International ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweLondon School of Hygiene & Tropical Medicine (LSHTM)Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweLondon School of Hygiene & Tropical Medicine (LSHTM)Abstract Background There is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated whether and how community-level measures facilitate a community-led intervention to achieve improved HIV outcomes. Methods This is a secondary analysis of survey data from a cluster randomised trial in 40 rural communities in Zimbabwe. The survey was conducted four months after the intervention was initiated. Communities were randomised 1:1 to either paid distribution arm, where HIV self-test (HIVST) kits were distributed by a paid distributor, or community-led whereby members of the community were responsible for organising and conducting the distribution of HIVST kits. We used mixed effects logistic regression to assess the effect of social cohesion, problem solving, and HIV awareness on HIV testing and prevention. Results We found no association between community measures and the three HIV outcomes (self-testing, new HIV diagnosis and linkage to VMMC or confirmatory testing). However, the interaction analyses highlighted that in high social cohesion communities, the odds of new HIV diagnosis was greater in the community-led arm than paid distribution arm (OR 2.06 95% CI 1.03–4.19). Conclusion We found some evidence that community-led interventions reached more undiagnosed people living with HIV in places with high social cohesion. Additional research should seek to understand whether the effect of social cohesion is persistent across other community interventions and outcomes. Trial registration PACTR201607001701788.https://doi.org/10.1186/s12879-023-08695-xCommunity cohesionHIV self-testingCommunity-led |
| spellingShingle | Katherine A. Thomas Euphemia Lindelwe Sibanda Cheryl Johnson Constancia Watadzaushe Getrude Ncube Karin Hatzold Mary K. Tumushime Miriam Mutseta Nancy Ruhode Peach P. Indravudh Frances M. Cowan Melissa Neuman Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe BMC Infectious Diseases Community cohesion HIV self-testing Community-led |
| title | Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe |
| title_full | Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe |
| title_fullStr | Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe |
| title_full_unstemmed | Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe |
| title_short | Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe |
| title_sort | do community measures impact the effectiveness of a community led hiv testing intervention secondary analysis of an hiv self testing intervention in rural communities in zimbabwe |
| topic | Community cohesion HIV self-testing Community-led |
| url | https://doi.org/10.1186/s12879-023-08695-x |
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