The impact of Community Mobilisation on HIV Prevention in Middle and Low Income Countries: A Systematic Review and Critique

Abstract

While community mobilisation (CM) is increasingly advocated for HIV prevention, its impact on measurable outcomes has not been established. We performed a systematic review of the impact of CM within HIV prevention interventions (N = 20), on biomedical, behavioural and social outcomes. Among most at risk groups (particularly sex workers), the evidence is somewhat consistent, indicating a tendency for positive impact, with stronger results for behavioural and social outcomes than for biomedical ones. Among youth and general communities, the evidence remains inconclusive. Success appears to be enhanced by engaging groups with a strong collective identity and by simultaneously addressing the socio-political context. We suggest that the inconclusiveness of the findings reflects problems with the evidence, rather than indicating that CM is ineffective. We discuss weaknesses in the operationalization of CM, neglect of social context, and incompatibility between context-specific CM processes and the aspiration of review methodologies to provide simple, context-transcending answers.Electronic supplementary materialThe online version of this article (doi:10.1007/s10461-014-0748-5) contains supplementary material, which is available to authorized users.

The effect of prevention methods on reducing sexual risk for HIV and their potential impact on a large-scale: a literature review

“…The groups that are mostly affected by the epidemic have more accurate perceptions about their needs and limits related to access to health. In effect, a systematic review 102 that analyzed the impact of community mobilization identified consistent evidence that these interventions led to increasing preventive practices and reduced incidence of STIs, especially among prostitutes. Still, the felling of community belonging seems to have contributed for the behavioral change among homosexuals and prostitutes 102 .…”

“…In effect, a systematic review 102 that analyzed the impact of community mobilization identified consistent evidence that these interventions led to increasing preventive practices and reduced incidence of STIs, especially among prostitutes. Still, the felling of community belonging seems to have contributed for the behavioral change among homosexuals and prostitutes 102 . Another positive aspect of community participation is that it allows predicting possible social reactions facing proposals of context change and introduction of new prevention strategies.…”

“…However, it was unable to show the effects of intervention on sexual practices and on the incidence of HIV. Part of the difficulty 102,104 is related to the limitation of the indicators that are usually adopted, whereas it is necessary to understand the reflection of structural changes in the course of the epidemic and the difficulties to distinguish the effects of macro-structural changes and other interventions in the context of daily practices.…”

Development, validation, and performance of a scale to measure community mobilization

“…Mobilizing strategies have been employed to decrease urban violence,(2-4) prevent drug, alcohol, and tobacco use,(5-7) and for HIV prevention. (8-11) Mobilizing efforts commonly target community norms to promote healthy behaviors (e.g. decrease smoking), promote social integration and destigmatization of marginalized groups (e.g.…”

Knowledge and exercise of human rights, and barriers and facilitators to claiming rights: a cross-sectional study of female sex workers and high-risk men who have sex with men in Andhra Pradesh, India

“…The Avahan program has mobilized FSWs and HR-MSM populations to build local peer-based networks and community organizations (COs) to work collectively to address barriers to HIV prevention. The Avahan model draws on lessons from the Sonagachi project in West Bengal, which mobilized and empowered FSWs to collectively challenge the factors contributing to vulnerability, leading to the adoption of risk reduction behaviors, the development of social networks and economic empowerment [17, 34]. …”