The process of developing distributed-efficacy and social practice in the context of ‘ending AIDS’

Abstract

Introduction: this article reflects on data that emanated from a programme evaluation and focuses on a concept we label 'distributed-efficacy'. We argue that the process of developing and sustaining 'distributed-efficacy' is complex and indeterminate, thus difficult to manage or predict. We situate the discussion within the context of UNAIDS' recent strategy -Vision 95:95:95 -to 'end AIDS' by 2030 which the South African National Department of Health is currently rolling out across the country.

The Application of Systems Thinking to the Prevention and Control of Sexually Transmissible Infections among Adolescents and Adults: A Scoping Review

“…Generally, studies examined STI prevention and control in the population at large; exceptions to this were studies concerned with people living with HIV (n = 22) [5,9,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53], people who inject drugs (n = 5) [54][55][56][57][58], women (n = 16) [5,11,[59][60][61][62][63][64][65][66][67][68][69][70][71][72], children and young people (n = 11) [43,49,57,[72][73][74][75]…”

“…Seventeen studies applied systems thinking to specific health settings such as hospitals and health clinics [10,11,43,[47][48][49][50]52,62,64,65,[68][69][70][71]74,95]. Other settings included specific non-government organizations and community groups [42,52,75,78,86], prisons [59], schools [73,77], policy communities [45,51], sex on premises venues [11], and supervised drug injecting facilities [54].…”

“…Other systems thinking methods included network analysis, which was used in ten studies to understand program reach [75,82], or the transmission of HIV and other STIs within defined social and sexual networks [36,39,[54][55][56]60,80,81]. Agent-based modelling was expressly mentioned in four studies as a method for understanding interactions between people who inject drugs and other individuals [56], incarcerated men and their female sexual partners [59,60], and young people living with HIV and HIV service providers [43].…”