“The difference that makes a difference”
Highlighting the role of variable contexts within an HIV Prevention Community Randomised Trial (HPTN 071/PopART) in 21 study communities in Zambia and South Africa
Bibliographic Data
| ID | 19438637 |
|---|---|
| Authors | Virginia Bond (0000-0002-6815-4239, University of Zambia, corresponding author), Chiti Bwalya (0000-0002-6110-0019, University of Zambia), Bwalya Chiti, Graeme Hoddinott (0000-0001-5915-8126, Desmond Tutu HIV Foundation), Lyn Reynolds (0000-0003-4980-6876, Stellenbosch University), Lindsey Reynolds, Ab Schaap (0000-0002-5959-526X, University of Zambia), Melvin Simuyaba (0009-0003-2135-2435, University of Zambia), Rhoda Ndubani (University of Zambia), Lario Viljoen (0000-0003-4039-6639, Desmond Tutu HIV Foundation), Musonda Simwinga (0000-0002-0684-6897, University of Zambia), Sarah Fidler (0000-0003-1676-7583, Imperial College London), Renée Hayes (0000-0002-1729-9892, London School of Hygiene & Tropical Medicine), Richard Hayes (0000-0002-3651-0892), Helen Ayles (0000-0003-4108-2842, University of London), Janet Seeley (0000-0002-0583-5272, London School of Hygiene & Tropical Medicine), on Behalf of the HPTN study team |
| Year | 2016 |
| Volume | 28 |
| Issue | sup3 |
| Pages | 99-107 |
| Publication date | 2016-06-02 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | AIDS Care (JOURNAL) |
| Journal identifiers | ISSN: 0954-0121 • E-ISSN: 1360-0451 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09540121.2016.1178958 |
| PMID | 27421057 |
| OpenAlex | W2467355390 |
| Language | EN |
| Citations received | 9 |
| References cited | 12 |
This paper explores contextual heterogeneity within a community randomised trial HPTN 071 (Population Effects of Antiretroviral Treatment to Reduce HIV Transmission) carried out in 21 study communities (12 Zambian, 9 South African). The trial evaluates the impact of a combination HIV prevention package (including household-based HIV counselling and testing and anti-retroviral treatment (ART) eligibility regardless of CD4-count) on HIV incidence. The selection, matching and randomisation of study communities relied on key epidemiological and demographic variables and community and stakeholder support. In 2013, following the selection of study communities, a "Broad Brush Survey" (BBS) approach was used to rapidly gather qualitative data on each study community, prior to the implementation of the trial intervention. First-year process indicator intervention data (2014-2015) were collected during the household-based intervention by community lay workers. Using an open/closed typology of urban communities (indicating more or less heterogeneity), this qualitative inquiry presents key features of 12 Zambian communities using a list of four meta-indicators (physical features, social organisation, networks and community narratives). These indicators are then compared with four intervention process indicators in a smaller set of four study communities. The process indicators selected for this analysis indicate response to the intervention (uptake) amongst adults. The BBS qualitative data are used to interpret patterns of similarity and variability in the process indicators across four communities. We found that meta-indicators of local context helped to interpret patterns of similarity and variability emerging across and within the four communities. Features especially significant for influencing heterogeneity in process indicators include proportion of middle-class residents, proximity to neighbouring communities and town centre, the scale of the informal economy, livelihood-linked mobility, presence of HIV stakeholders over time and commitment to community action. Future interdisciplinary analysis is needed to explore if these patterns of difference continue to hold up over the full intervention period and all intervention communities
Community engagement · Environmental health · Geography · Political science · Population · Psychological intervention · Public relations · Qualitative property · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology
Factors associated with use of community-based, peer-led sexual and reproductive health services by adolescent boys and young men aged 18–24 in Lusaka, Zambia
Who is a mobile man ‘at risk’? Masculinity, work-related mobility, and HIV-related risks in Uganda and South Africa
Accessing ART in Malawi while living in South Africa – a thematic analysis of qualitative data from undocumented Malawian migrants
Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy
Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa
Sexual risk and HIV prevention choices among men who are mobile for work
The Urban Environment and Disparities in Sexual and Reproductive Health Outcomes in the Global South
Value and Limitations of Broad Brush Surveys Used in Community-Randomized Trials in Southern Africa
A Failed Method? Reflections on Using Audio Diaries in Uganda With Young People Growing Up With HIV in the BREATHER Trial
| Citations per year | 1.13 |
|---|---|
| Citation span | 2018 - 2026 (9) |
| Highly cited | No |