Connecting-Africa | Find publications

Advanced search

Find:


Title Community mobilization to modify harmful gender norms and reduce HIV risk: results from a community cluster randomized trial in South Africa
Full text https://escholarship.org/uc/item/08h3c14r
Date 2018
Author(s) Pettifor, Audrey; Lippman, Sheri A; Gottert, Ann; Suchindran, Chirayath M; Selin, Amanda; Peacock, Dean; Maman, Suzanne; Rebombo, Dumisani; Twine, Rhian; Gómez-Olivé, Francesc Xavier; Tollman, Stephen; Kahn, Kathleen; MacPhail, Catherine
Abstract IntroductionCommunity mobilization (CM) is increasingly recognized as critical to generating changes in social norms and behaviours needed to achieve reductions in HIV. We conducted a CM intervention to modify negative gender norms, particularly among men, in order to reduce associated HIV risk.MethodsTwenty two villages in the Agincourt Health and Socio-Demographic Surveillance Site in rural Mpumalanga, South Africa were randomized to either a theory-based, gender transformative, CM intervention or no intervention. Two cross-sectional, population-based surveys were conducted in 2012 (pre-intervention, n = 600 women; n = 581 men) and 2014 (post-intervention, n = 600 women; n = 575 men) among adults ages 18 to 35 years. We used an intent-to-treat (ITT) approach using survey regression cluster-adjusted standard errors to determine the intervention effect by trial arm on gender norms, measured using the Gender Equitable Mens Scale (GEMS), and secondary behavioural outcomes.ResultsAmong men, there was a significant 2.7 point increase (Beta Coefficient 95% CI: 0.62, 4.78, p = 0.01) in GEMS between those in intervention compared to control communities. We did not observe a significant difference in GEMS scores for women by trial arm. Among men and women in intervention communities, we did not observe significant differences in perpetration of intimate partner violence (IPV), condom use at last sex or hazardous drinking compared to control communities. The number of sex partners in the past 12 months (AOR 0.29, 95% CI 0.11 to 0.77) were significantly lower in women in intervention communities compared to control communities and IPV victimization was lower among women in intervention communities, but the reduction was not statistically significant (AOR 0.53, 95% CI 0.24 to 1.16).ConclusionCommunity mobilization can reduce negative gender norms among men and has the potential to create environments that are more supportive of preventing IPV and reducing HIV risk behaviour. Nevertheless, we did not observe that changes in attitudes towards gender norms resulted in desired changes in risk behaviours suggesting that more time may be necessary to change behaviour or that the intervention may need to address behaviours more directly.Clinical trials numberClinicalTrials.gov NCT02129530.
Subject(s) Public Health; Biomedical and Clinical Sciences; Clinical Sciences; Health Sciences; Mental Health; Pediatric; Clinical Trials and Supportive Activities; Infectious Diseases; Clinical Research; HIV/AIDS; Pediatric AIDS; Violence Against Women; Prevention; Violence Research; Aetiology; Prevention of disease and conditions; and promotion of well-being; 2.3 Psychological; social and economic factors; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; Infection; Gender Equality; Adolescent; Adult; Community Health Services; Cross-Sectional Studies; Female; Gender Identity; HIV Infections; Humans; Intimate Partner Violence; Male; Rural Population; Sexual Partners; South Africa; Surveys and Questionnaires; Young Adult; HIV; community mobilization; gender norms; gender-based violence; HIV; Public Health and Health Services; Other Medical and Health Sciences; Clinical sciences; Epidemiology; Public health
Coverage e25134
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source Journal of the International AIDS Society, vol 21, iss 7
Rights public
Identifier qt08h3c14r
Repository Berkeley - University of California
Added to C-A: 2023-11-13;08:53:03