In this HIV prevention trial sponsored by the National Institute of Mental Health (NIMH), 34 communities in Africa (in South Africa, Tanzania, and Zimbabwe) and 14 communities in Thailand will be randomized to receive either a community-based voluntary counseling and testing (CBVCT) intervention in addition to standard clinic-based VCT (SVCT) services, or SVCT services alone. These strategies are designed to change community norms and reduce risk for HIV infection among all community members, irrespective of whether they participated directly in the intervention.
- The primary objective of this study is to test the hypothesis that communities receiving three years of CBVCT, relative to communities receiving three years of SVCT, will have significantly lower prevalence of recent HIV-1 infection.
- The secondary objective of this study is to test the hypotheses that CBVCT communities, relative to SVCT communities, will at the end of the intervention period report significantly less HIV risk behavior, higher rates of HIV testing, more favorable social norms regarding HIV testing, more frequent discussions about HIV, more frequent disclosure of HIV status, less HIV-related stigma, and fewer HIV-related negative life events.
- To make VCT more available in community settings
- To engage the community through outreach
- To provide post-test support
- In the first year of the study, a four-fold increase in testing was observed in the intervention versus comparison communities.
- There was an overall 95% adherence to intervention components.
- The provision of mobile services, combined with appropriate support activities, may have significant effects on utilization of voluntary counseling and testing.
- These findings also provide early support for community mobilization as a strategy for increasing testing rates.