Using participatory methods and geographic information systems (GIS) to prepare for an hiv community‐based trial in Vulindlela, South Africa (Project Accept–HPTN 043)

Chirowodza, Admire; Rooyen, Heidi van; Joseph, Philip; Sikotoyi, Sindisiwe; Richter, Linda; Coates, Thomas J.

doi:10.1002/jcop.20294

Cited by 70 publications

(26 citation statements)

References 28 publications

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“…The innovation of combining ethnography with GIS mapping and census tract-level data helped to provide a more contextualized understanding of HIV/AIDS in the targeted communities (Chirowodza et al, 2009). For example, ethnographic findings uncovered interesting phenomena, such as “corner houses” as prime locations for drug and sex trade.…”

Section: Discussionmentioning

confidence: 99%

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

et al. 2015

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Background Unequal HIV/AIDS distribution is influenced by certain social and structural contexts that facilitate HIV transmission and concentrate HIV in disease epicenters. Thus, one of the first steps in designing effective community-level HIV/AIDS initiatives is to disentangle the influence of individual, social, and structural factors on HIV risk. Combining ethnographic methodology with geographic information systems (GIS) mapping can allow for a complex exploration of multilevel factors within communities that facilitate HIV transmission in highly affected areas. Objectives We present the formative comparative community-based case study findings of an investigation of individual-, social- , and structural-level factors that contribute to the HIV/AIDS epidemic among Black Philadelphians. Methods Communities were defined using census tracts. The methodology included ethnographic and GIS mapping, observation, informal conversations with residents and business owners, and secondary analyses of census tract-level data in four Philadelphia neighborhoods. Results Factors such as overcrowding, disadvantage, permeability in community boundaries, and availability and accessibility of health-related resources varied significantly. Further, HIV/AIDS trended with social and structural inequities above and beyond the community’s racial composition. Discussion This study was a first step to disentangle relationships between community-level factors and potential risk for HIV in an HIV epicenter. The findings also highlight stark sociodemographic differences within and across racial groups, and further substantiate the need for comprehensive, community-level HIV prevention interventions. These findings from targeted United States urban communities have potential applicability for examining the distribution of HIV/AIDS in broader national and international geosocial contexts.

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Section: Discussionmentioning

confidence: 99%

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

et al. 2015

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“…The communities were matched into pairs prior to randomization, based on socio-demographic, cultural, and infrastructure characteristics determined from formative research. 17 Within each pair, one community was randomly assigned to receive CBVCT, the other received SVCT alone. Randomization was performed centrally by the Statistical Center 18 .…”

Section: Methodsmentioning

confidence: 99%

Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial

Coates

Kulich

Celentano

et al. 2014

The Lancet Global Health

Self Cite

147

153

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Background NIMH Project Accept (HPTN 043) was a cluster-randomized trial that tested whether a multicomponent, multi-level prevention strategy (community-based voluntary counselling and testing [CBVCT]) reduced HIV incidence compared to standard voluntary counselling and testing (SVCT). Methods Forty-eight communities were enrolled at five sites in South Africa, Tanzania, Zimbabwe, and Thailand. CBVCT was designed to make testing more accessible in communities, engage communities through outreach, and provide post-test support services. SVCT comprised standard VCT services established at existing facilities. Communities were randomized in matched pairs to 36 months of CBVCT or SVCT. Data were collected at baseline (n=14,567) and post-intervention (n=56,683) by cross-sectional random surveys of 18–32 year-old community residents. HIV incidence was estimated using a cross-sectional multi-assay algorithm. Thailand was excluded from incidence analyses due to low HIV prevalence. Findings The estimated incidence in the CBVCT was 1.52% vs. 1.81% in the SVCT with an estimated reduction in HIV incidence of 13·9% (relative risk [RR]=0·86; 95% confidence interval [CI]=0·725–1·023; p=0·08). Women older than 24 years had RR=0·70 (95% CI=0·54–0·90; p=0·009). CBVCT increased testing rates by 25% overall (95% CI=12%–39%; p=0·0003), by 45% among men and 15% among women. No overall effect on sexual risk behaviour was observed. However, among HIV-infected participants, CBVCT reduced the number of sexual partners by 8% (95% CI=1%–15%; p=0.03) and the proportion of multiple partnerships by 30% (95% CI=8%-46%; p=0.01). Social norms regarding HIV testing were improved in CBVCT communities. Interpretations The intervention was effective in increasing HIV testing, particularly among men, promoted positive social norms regarding testing, and reduced behavioural risk among HIV-infected participants. A modest reduction in HIV incidence was observed. This intervention focused primarily on HIV detection. Current and future studies that include strategies for HIV treatment and viral suppression should demonstrate further incidence reductions.

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“…Need and acceptability have also been demonstrated for online decision-support tools to promote EBP by psychosocial counselors for people living with HIV/AIDS [54]. Mobile phones are being used to support peer and community health workers with their increasingly task-shifted responsibilities [55,56,57••]. Use of ICT to support implementation of manualized EBIs has great potential to enhance fidelity as well as adoption, sustainability, and effectiveness, but only one study has examined this approach, applied to teachers and substance abuse prevention EBI [58].…”

Section: Information and Communication Technology Transforms Hiv Carementioning

confidence: 99%

Innovation in sexually transmitted disease and HIV prevention: Internet and mobile phone delivery vehicles for global diffusion

Swendeman

Rotheram‐Borus

2010

Current Opinion in Psychiatry

148

113

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Purpose of review Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent findings Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Summary Information and communication technology is rapidly diffusing globally. Over the next 5–10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

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Using participatory methods and geographic information systems (GIS) to prepare for an hiv community‐based trial in Vulindlela, South Africa (Project Accept–HPTN 043)

Cited by 70 publications

References 28 publications

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

Multilevel Drivers of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Among Black Philadelphians

Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial

Innovation in sexually transmitted disease and HIV prevention: Internet and mobile phone delivery vehicles for global diffusion

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