Impact and process evaluation of integrated community and clinic-based HIV-1 control: A cluster-randomised trial in eastern Zimbabwe
2007

HIV Prevention Strategies in Eastern Zimbabwe

Sample size: 800 publication 10 minutes Evidence: moderate

Author Information

Author(s): Gregson Simon, Adamson Saina, Papaya Spiwe, Mundondo Jephias, Nyamukapa Constance A, Mason Peter R, Garnett Geoffrey P, Chandiwana Stephen K, Foster Geoff, Anderson Roy M

Primary Institution: Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London

Hypothesis

Can integrated community and clinic-based strategies for HIV prevention reduce the proportion of people infected with HIV in Eastern Zimbabwe?

Conclusion

The intervention did not reduce population-level HIV-1 incidence, although it did reduce incidence among men who attended program meetings.

Supporting Evidence

  • Despite greater program activity, the incidence rate ratio of HIV-1 was 1.27 compared to control communities.
  • Males attending program meetings had lower HIV-1 incidence.
  • More male STI patients in intervention communities reported cessation of symptoms.

Takeaway

The study tried to help people in Zimbabwe avoid getting HIV by teaching them about safe sex and giving out condoms, but it didn't work for everyone.

Methodology

A cluster-randomized controlled trial comparing intervention and control communities over three years.

Potential Biases

Possible contamination of intervention effects between communities and reliance on self-reported data.

Limitations

The income-generating projects were not implemented due to economic conditions, and the intervention did not have a significant impact at the community level.

Participant Demographics

Participants included males and females aged 15-54 from various socio-economic backgrounds in Eastern Zimbabwe.

Statistical Information

P-Value

0.012

Confidence Interval

95% CI 0.92–1.75

Statistical Significance

p = 0.012

Digital Object Identifier (DOI)

10.1371/journal.pmed.0040102

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