Community-based HIV prevention can boost testing, help reduce new infections

April 16, 2014

Communities in Africa and Thailand that worked together on HIV-prevention efforts saw not only a rise in HIV screening but a drop in new infections, according to a new study in the peer-reviewed journal The Lancet Global Health. The U.S. National Institute of Mental Health's Project Accept—a trial conducted by the HIV Prevention Trials Network to test a combination of social, behavioral and structural HIV-prevention interventions—demonstrated that a series of community efforts boosted the number of people tested for HIV and resulted in a 14% reduction in new HIV infections, compared with control communities.

Much of the research was conducted in sub-Saharan Africa, which has particularly high rates of HIV. Communities were matched into pairs based on socio-demographic, cultural and infrastructure characteristics, with one community randomly assigned to the intervention and one serving as a control for comparison. The researchers were interested not just in how the clinical trial participants' behavior changed, but also in how these efforts affected the community as a whole.

Among the findings:

  • Rates of testing were 45% higher in intervention communities than in control communities, especially among men and young people.
  • Individuals in intervention communities, particularly those infected with HIV, reported a lower number of sexual partners and were less likely to have multiple partners concurrently. This was particularly true among HIV-positive men, who reported 18% fewer sexual partners overall and 29% fewer concurrent sexual partners than those in control communities.
  • HIV infections were diagnosed at a higher rate in intervention communities.
  • Social acceptance of the importance of testing was greater in intervention communities. Modest reductions in HIV incidence occurred in the intervention communities compared with the control communities, particularly among women in the 25-to-32 age range. Read the article.
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