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社区措施是否影响社区主导的艾滋病病毒检测干预措施的效果。津巴布韦农村社区艾滋病病毒自我检测干预措施的二次分析。

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.

机构信息

London School of Hygiene & Tropical Medicine (LSHTM), London, UK.

Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe.

出版信息

BMC Infect Dis. 2023 Oct 31;22(Suppl 1):974. doi: 10.1186/s12879-023-08695-x.


DOI:10.1186/s12879-023-08695-x
PMID:37907871
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10617038/
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.

摘要

背景:越来越多的证据表明,社区在产生有益健康结果方面可以发挥作用。人们也越来越认识到以社区为基础的干预措施在促进公共卫生工作方面的有效性和成功。本研究调查了社区层面的措施是否以及如何促进社区主导的干预措施,以实现改善艾滋病毒结果。

方法:这是对津巴布韦 40 个农村社区进行的一项集群随机试验的调查数据的二次分析。调查是在干预开始四个月后进行的。社区按照 1:1 的比例随机分为有偿分配组和社区主导组,前者由付费经销商分发艾滋病毒自检 (HIVST) 试剂盒,后者由社区成员负责组织和进行 HIVST 试剂盒的分发。我们使用混合效应逻辑回归来评估社会凝聚力、解决问题和艾滋病毒意识对艾滋病毒检测和预防的影响。

结果:我们没有发现社区措施与三个艾滋病毒结果(自我检测、新的艾滋病毒诊断以及与 VMMC 或确认检测的联系)之间存在关联。然而,交互分析强调,在社会凝聚力高的社区中,社区主导组比有偿分配组新的艾滋病毒诊断几率更高(OR 2.06 95% CI 1.03-4.19)。

结论:我们发现一些证据表明,在社会凝聚力高的地方,社区主导的干预措施能够接触到更多未被诊断出的艾滋病毒感染者。应开展更多研究,以了解社会凝聚力的影响是否在其他社区干预措施和结果中持续存在。

试验注册:PACTR201607001701788。

相似文献

[1]
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 Infect Dis. 2023-10-31

[2]
Comparison of community-led distribution of HIV self-tests kits with distribution by paid distributors: a cluster randomised trial in rural Zimbabwean communities.

BMJ Glob Health. 2021-7

[3]
Do community-level factors play a role in HIV self-testing uptake, linkage to services and HIV-related outcomes? A mixed methods study of community-led HIV self-testing in rural Zimbabwe.

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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
HIV self-testing - the path from an innovation to a necessity.

BMC Infect Dis. 2025-7-21

[2]
Do community-level factors play a role in HIV self-testing uptake, linkage to services and HIV-related outcomes? A mixed methods study of community-led HIV self-testing in rural Zimbabwe.

PLOS Glob Public Health. 2025-4-24

[3]
Community-led strategies for communicable disease prevention and management in low- and middle- income countries: A mixed-methods systematic review of health, social, and economic impact.

PLOS Glob Public Health. 2025-4-2

[4]
Feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing intervention among men in two Ugandan fishing communities, 2022.

Arch Public Health. 2025-1-24

本文引用的文献

[1]
Racial and ethnic differences in the association of social cohesion and social capital with HIV testing.

SSM Popul Health. 2022-12-22

[2]
Stigma, Social Cohesion, and HIV Risk Among Sexual and Gender Minorities in Two Cities in Zimbabwe.

AIDS Behav. 2022-9

[3]
Peer- and community-led responses to HIV: A scoping review.

PLoS One. 2021

[4]
Comparison of community-led distribution of HIV self-tests kits with distribution by paid distributors: a cluster randomised trial in rural Zimbabwean communities.

BMJ Glob Health. 2021-7

[5]
Community-based HIV self-testing: a cluster-randomised trial of supply-side financial incentives and time-trend analysis of linkage to antiretroviral therapy in Zimbabwe.

BMJ Glob Health. 2021-7

[6]
Social Cohesion in Health: A Concept Analysis.

ANS Adv Nurs Sci. 2020

[7]
Use and awareness of and willingness to self-test for HIV: an analysis of cross-sectional population-based surveys in Malawi and Zimbabwe.

BMC Public Health. 2020-5-25

[8]
Community-led delivery of HIV self-testing to improve HIV testing, ART initiation and broader social outcomes in rural Malawi: study protocol for a cluster-randomised trial.

BMC Infect Dis. 2019-9-18

[9]
Association between HIV knowledge and stigmatizing attitudes towards people living with HIV in Afghanistan: findings from the 2015 Afghanistan Demographic and Health Survey.

Int Health. 2019-11-13

[10]
Participation in community groups increases the likelihood of PrEP awareness: New Orleans NHBS-MSM Cycle, 2014.

PLoS One. 2019-3-12

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