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Grassroots Community Organizations’ Contribution to the Scale-Up of HIV Testing and Counselling Services in Zimbabwe

Publication year: 
2013
Author (s): 
Gregson, Simon
Publication in: 
AIDS 2013, 27: pp. 1657-1666
Abstract:

Objective: To investigate whether community engagement (participation in grassroots organizations) contributed to increases in HIV testing in Zimbabwe.
Methods:Prospective data on membership of local community organizations (e.g.
women’s groups and burial societies) and uptake of HIV testing and counselling (HTC) and prevention-of-mother-to-child transmission (PMTCT) services were collected from 5260 adults interviewed in two consecutive rounds of a general-population cohort survey in eastern Zimbabwe between 2003 and 2008. The effects of community engagement on uptake of services during the follow-up period were measured using logistic regression to adjust for observed confounding factors.

Results: Sixteen percent of men and 47% of women were consistent members of
community organizations; 58 and 35% of these people discussed HIV in their meetingsand were members of externally sponsored organizations, respectively. Fewer men (10.1%) than women (32.4%) took up HTC during follow-up [adjusted odds ratio(aOR)¼ 4.08, 95% confidence interval (CI) 3.43–4.86, P < 0.001]. HTC uptake was higher for members of community organizations than for nonmembers: men, 15.0
versus 9.2% (1.67, 1.15–2.43, P ¼0.007); women, 35.6 versus 29.6% (1.26, 1.06–
1.49,P ¼ 0.008). Membership of community organizations showed a nonsignificant
association with PMTCT uptake amongst recently pregnant women (42.3 versus 34.2%;
1.30, 0.94–1.78, P ¼ 0.1). The most consistent positive associations between com-
munity participation and HTC and PMTCT uptake were found in organizations that
discussed HIV and when external sponsorship was absent.

Conclusion:
Grassroots organizations contributed to increased uptake of HTC services
in eastern Zimbabwe in the mid-2000s. Partnerships with these organizations could
harness community support for the further increases in HIV testing needed in sub-Saharan Africa.