Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand
Identifieur interne : 000F87 ( Pmc/Curation ); précédent : 000F86; suivant : 000F88Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand
Auteurs : Gertrude Khumalo-Sakutukwa [États-Unis] ; Stephen F. Morin [États-Unis] ; Katherine Fritz ; Edwin D. Charlebois [États-Unis] ; Heidi Van Rooyen ; Alfred Chingono ; Precious Modiba ; Khalifa Mrumbi ; Surasing Visrutaratna ; Basant Singh ; Michael Sweat ; David D. Celentano ; Thomas J. Coates [États-Unis]Source :
- Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2008.
Abstract
Changing community norms to increase awareness of HIV status and reduce HIV-related stigma has the potential to reduce the incidence of HIV-1 infection in the developing world.
We developed and implemented a multi-level intervention providing community-based HIV mobile voluntary counseling and testing (CBVCT), community mobilization (CM), and post-test support services (PTSS). Forty-eight communities in Tanzania, Zimbabwe, South Africa and Thailand were randomized to receive the intervention or standard clinic-based VCT (SVCT), the comparison condition. We monitored utilization of CBVCT and SVCT by community of residence at 3 sites, which was used to assess differential uptake. We also developed Quality Assurance procedures to evaluate staff fidelity to the intervention.
In the first year of the study a four-fold increase in testing was observed in the intervention versus comparison communities. We also found an overall 95% adherence to intervention components. Study outcomes, including prevalence of recent HIV infection and community-level HIV stigma, will be assessed after three years of intervention.
The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of VCT. These findings also provide early support for community mobilization as a strategy for increasing testing rates.
Url:
DOI: 10.1097/QAI.0b013e31818a6cb5
PubMed: 18931624
PubMed Central: 2664736
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Katherine Fritz<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
Le document en format XML
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<author><name sortKey="Singh, Basant" sort="Singh, Basant" uniqKey="Singh B" first="Basant" last="Singh">Basant Singh</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand</title>
<author><name sortKey="Khumalo Sakutukwa, Gertrude" sort="Khumalo Sakutukwa, Gertrude" uniqKey="Khumalo Sakutukwa G" first="Gertrude" last="Khumalo-Sakutukwa">Gertrude Khumalo-Sakutukwa</name>
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<author><name sortKey="Morin, Stephen F" sort="Morin, Stephen F" uniqKey="Morin S" first="Stephen F." last="Morin">Stephen F. Morin</name>
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<country>États-Unis</country>
<placeName><settlement type="city">San Francisco</settlement>
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<author><name sortKey="Fritz, Katherine" sort="Fritz, Katherine" uniqKey="Fritz K" first="Katherine" last="Fritz">Katherine Fritz</name>
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<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
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<author><name sortKey="Charlebois, Edwin D" sort="Charlebois, Edwin D" uniqKey="Charlebois E" first="Edwin D." last="Charlebois">Edwin D. Charlebois</name>
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<author><name sortKey="Van Rooyen, Heidi" sort="Van Rooyen, Heidi" uniqKey="Van Rooyen H" first="Heidi" last="Van Rooyen">Heidi Van Rooyen</name>
<affiliation><nlm:aff id="A3">Human Sciences Research Council</nlm:aff>
</affiliation>
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<author><name sortKey="Chingono, Alfred" sort="Chingono, Alfred" uniqKey="Chingono A" first="Alfred" last="Chingono">Alfred Chingono</name>
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<author><name sortKey="Modiba, Precious" sort="Modiba, Precious" uniqKey="Modiba P" first="Precious" last="Modiba">Precious Modiba</name>
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<author><name sortKey="Mrumbi, Khalifa" sort="Mrumbi, Khalifa" uniqKey="Mrumbi K" first="Khalifa" last="Mrumbi">Khalifa Mrumbi</name>
<affiliation><nlm:aff id="A6"> Muhimbili University</nlm:aff>
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<author><name sortKey="Visrutaratna, Surasing" sort="Visrutaratna, Surasing" uniqKey="Visrutaratna S" first="Surasing" last="Visrutaratna">Surasing Visrutaratna</name>
<affiliation><nlm:aff id="A7">Chiang Mai University</nlm:aff>
</affiliation>
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<author><name sortKey="Singh, Basant" sort="Singh, Basant" uniqKey="Singh B" first="Basant" last="Singh">Basant Singh</name>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
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<author><name sortKey="Sweat, Michael" sort="Sweat, Michael" uniqKey="Sweat M" first="Michael" last="Sweat">Michael Sweat</name>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Celentano, David D" sort="Celentano, David D" uniqKey="Celentano D" first="David D." last="Celentano">David D. Celentano</name>
<affiliation><nlm:aff id="A2">Johns Hopkins University, Bloomberg School of Public Health</nlm:aff>
<wicri:noCountry code="subfield">Bloomberg School of Public Health</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Coates, Thomas J" sort="Coates, Thomas J" uniqKey="Coates T" first="Thomas J" last="Coates">Thomas J. Coates</name>
<affiliation wicri:level="3"><nlm:aff id="A8">University of California, Los Angeles</nlm:aff>
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<placeName><settlement type="city">Los Angeles</settlement>
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</placeName>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
<idno type="ISSN">1525-4135</idno>
<imprint><date when="2008">2008</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Changing community norms to increase awareness of HIV status and reduce HIV-related stigma has the potential to reduce the incidence of HIV-1 infection in the developing world.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We developed and implemented a multi-level intervention providing community-based HIV mobile voluntary counseling and testing (CBVCT), community mobilization (CM), and post-test support services (PTSS). Forty-eight communities in Tanzania, Zimbabwe, South Africa and Thailand were randomized to receive the intervention or standard clinic-based VCT (SVCT), the comparison condition. We monitored utilization of CBVCT and SVCT by community of residence at 3 sites, which was used to assess differential uptake. We also developed Quality Assurance procedures to evaluate staff fidelity to the intervention.</p>
</sec>
<sec id="S3"><title>Findings</title>
<p id="P3">In the first year of the study a four-fold increase in testing was observed in the intervention versus comparison communities. We also found an overall 95% adherence to intervention components. Study outcomes, including prevalence of recent HIV infection and community-level HIV stigma, will be assessed after three years of intervention.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of VCT. These findings also provide early support for community mobilization as a strategy for increasing testing rates.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
<issn pub-type="ppub">1525-4135</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18931624</article-id>
<article-id pub-id-type="pmc">2664736</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0b013e31818a6cb5</article-id>
<article-id pub-id-type="manuscript">NIHMS87310</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Khumalo-Sakutukwa</surname>
<given-names>Gertrude</given-names>
</name>
<degrees>MMSc, MSSW</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Morin</surname>
<given-names>Stephen F.</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fritz</surname>
<given-names>Katherine</given-names>
</name>
<degrees>PhD, MPH</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Charlebois</surname>
<given-names>Edwin D.</given-names>
</name>
<degrees>MPH, PhD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Rooyen</surname>
<given-names>Heidi</given-names>
</name>
<degrees>MA</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chingono</surname>
<given-names>Alfred</given-names>
</name>
<degrees>MSc</degrees>
<xref rid="A4" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Modiba</surname>
<given-names>Precious</given-names>
</name>
<degrees>MA</degrees>
<xref rid="A5" ref-type="aff">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mrumbi</surname>
<given-names>Khalifa</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A6" ref-type="aff">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Visrutaratna</surname>
<given-names>Surasing</given-names>
</name>
<degrees>DDS, DrPH</degrees>
<xref rid="A7" ref-type="aff">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Singh</surname>
<given-names>Basant</given-names>
</name>
<degrees>Bsc, Msc</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sweat</surname>
<given-names>Michael</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Celentano</surname>
<given-names>David D.</given-names>
</name>
<degrees>ScD, MHS</degrees>
<xref rid="A2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Coates</surname>
<given-names>Thomas J</given-names>
</name>
<degrees>PhD</degrees>
<xref rid="A8" ref-type="aff">8</xref>
</contrib>
<on-behalf-of>NIMH Project Accept Study Team*</on-behalf-of>
</contrib-group>
<aff id="A1"><label>1</label>
University of California, San Francisco</aff>
<aff id="A2"><label>2</label>
Johns Hopkins University, Bloomberg School of Public Health</aff>
<aff id="A3"><label>3</label>
Human Sciences Research Council</aff>
<aff id="A4"><label>4</label>
University of Zimbabwe</aff>
<aff id="A5"><label>5</label>
University of the Witwatersrand</aff>
<aff id="A6"><label>6</label>
Muhimbili University</aff>
<aff id="A7"><label>7</label>
Chiang Mai University</aff>
<aff id="A8"><label>8</label>
University of California, Los Angeles</aff>
<author-notes><corresp id="FN1">Corresponding author: Gertrude Khumalo-Sakutukwa, Center for AIDS Prevention Studies, University of California, San Francisco, 50 Beale Street, Suite 1300, San Francisco, CA 94105, tel: (415) 597-9228, fax: (415) 597-9202, email: <email>gertrude.sakutukwa@ucsf.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>20</day>
<month>1</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>12</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>12</month>
<year>2009</year>
</pub-date>
<volume>49</volume>
<issue>4</issue>
<fpage>422</fpage>
<lpage>431</lpage>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Changing community norms to increase awareness of HIV status and reduce HIV-related stigma has the potential to reduce the incidence of HIV-1 infection in the developing world.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">We developed and implemented a multi-level intervention providing community-based HIV mobile voluntary counseling and testing (CBVCT), community mobilization (CM), and post-test support services (PTSS). Forty-eight communities in Tanzania, Zimbabwe, South Africa and Thailand were randomized to receive the intervention or standard clinic-based VCT (SVCT), the comparison condition. We monitored utilization of CBVCT and SVCT by community of residence at 3 sites, which was used to assess differential uptake. We also developed Quality Assurance procedures to evaluate staff fidelity to the intervention.</p>
</sec>
<sec id="S3"><title>Findings</title>
<p id="P3">In the first year of the study a four-fold increase in testing was observed in the intervention versus comparison communities. We also found an overall 95% adherence to intervention components. Study outcomes, including prevalence of recent HIV infection and community-level HIV stigma, will be assessed after three years of intervention.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of VCT. These findings also provide early support for community mobilization as a strategy for increasing testing rates.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV prevention</kwd>
<kwd>HIV voluntary counseling and testing</kwd>
<kwd>community mobilization</kwd>
<kwd>post-test support services</kwd>
<kwd>HIV-related stigma</kwd>
</kwd-group>
<contract-num rid="MH1">U01 MH066702-06</contract-num>
<contract-num rid="MH1">U01 MH066702-05</contract-num>
<contract-num rid="MH1">U01 MH066702-04</contract-num>
<contract-num rid="MH1">U01 MH066702-03</contract-num>
<contract-num rid="MH1">U01 MH066702-02</contract-num>
<contract-num rid="MH1">U01 MH066702-01A1</contract-num>
<contract-sponsor id="MH1">National Institute of Mental Health : NIMH</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>
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