South Africa Katherine Fritz MHS at the School of Public Health; Department of International Health; Social and Behavioral Interventions concentration Project Accept is an NIMH-sponsored HIV-prevention trial to test the efficacy of a community-based model of HIV voluntary testing and counseling (CBVCT). The study is being conducted in Thailand, Tanzania, Zimbabwe and South Africa. At each study site, eight communities have been randomized to receive either the novel community-based VCT intervention or standard-of-care VCT, which is clinic or center-based. The community-based VCT intervention has three components:
(1) free VCT service provided from mobile vans
(2) promotion of VCT through community outreach activities, led by popular opinion leaders from the community
(3) post-test support services offered to those who take part in CBVCT
The CBVCT approach is rooted in “Diffusion of Innovation” theory, which has been used as the rationale for a number of HIV/AIDS interventions (De Zoysa, Phillips, Kamenga, et al., 1995) (Rogers, 1994). This model, which explains how an “innovation” (a new idea, technology, or behavior) spreads, asserts that in each community there is a small number of “early adopters” who embrace the innovation (in this case, the behavior of seeking an HIV test). These early adopters influence others in a social network, who subsequently adopt the behavior as well, until the new behavior becomes a social norm. CBVCT is rooted in the idea that a community mobilization approach that promotes HIV testing among early adopters (particularly if these individuals are influential and central to the larger social network) can begin a process of changing community norms to both increase discussions about HIV in communities and decrease HIV-related stigma.
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Lauren Kleutsch
