PLoS ONE (Jan 2014)

NIMH Project Accept (HPTN 043): results from in-depth interviews with a longitudinal cohort of community members.

  • Suzanne Maman,
  • Heidi van Rooyen,
  • Petra Stankard,
  • Alfred Chingono,
  • Tshifhiwa Muravha,
  • Jacob Ntogwisangu,
  • Zipho Phakathi,
  • Namtip Srirak,
  • Stephen F Morin,
  • NIMH Project Accept (HPTN 043) study team

DOI
https://doi.org/10.1371/journal.pone.0087091
Journal volume & issue
Vol. 9, no. 1
p. e87091

Abstract

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IntroductionNIMH Project Accept (HPTN 043) is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evaluation design included a longitudinal study with community members to assess attitudinal and behavioral changes in study outcomes including HIV testing norms, HIV-related discussions, and HIV-related stigma.MethodsA cohort of 657 individuals across all sites was selected to participate in a qualitative study that involved 4 interviews during the study period. Baseline and 30-month data were summarized according to each outcome, and a qualitative assessment of changes was made at the community level over time.ResultsMembers from intervention communities described fewer barriers and greater motivation for testing than those from comparison communities. HIV-related discussions in intervention communities were more grounded in personal testing experiences. A change in HIV-related stigma over time was most pronounced in Tanzania and Zimbabwe. Participants in the intervention communities from these two sites attributed community-level changes in attitudes to project specific activities.DiscussionThe Project Accept intervention was associated with more favorable social norms regarding HIV testing, more personal content in HIV discussions in all study sites, and qualitative changes in HIV-related stigma in two of five sites.