Abstract
BackgroundThere is increased focus on HIV prevention with African men who report experiencing childhood sexual (CSA) or physical abuse (CPA).ObjectiveTo better understand the effects of a community-based intervention (Project Accept HPTN 043) on HIV prevention behaviors among men who report CSA or CPA experiences.MethodsProject Accept compared a community-based voluntary mobile counseling and testing (CBVCT) intervention with standard VCT. The intervention employed individual HIV risk reduction planning with motivational interviewing in 34 African communities (16 communities at 2 sites in South Africa, 10 in Tanzania, and 8 in Zimbabwe). Communities were randomized unblinded in matched pairs to CBVCT or SVCT, delivered over 36 months. The post-intervention assessment was conducted using a single, cross-sectional random survey of 18-32 year-old community members (total N = 43,292). We analyzed the effect of the intervention on men with reported CSA or CPA across the African sites. Men were identified with a survey question asking about having experienced CSA or CPA across the lifespan. The effect of intervention on considered outcomes of the preventive behavior was statistically evaluated using the logistic regression models.ResultsAcross the sites, the rates of CSA or CPA among men indicated that African men reflected the global prevalence (20%) with a range of 13–24%. The statistically significant effect of the intervention among these men was seen in their increased effort to receive their HIV test results (OR 2.71; CI: (1.08, 6.82); P: 0.034). The intervention effect on the other designated HIV prevention behaviors was less pronounced.ConclusionThe effect of the intervention on these men showed increased motivation to receive their HIV test results. However, more research is needed to understand the effects of community-based interventions on this group, and such interventions need to integrate other keys predictors of HIV including trauma, coping strategies, and intimate partner violence.
Highlights
There is increased focus on HIV prevention with African men who report experiencing childhood sexual (CSA) or physical abuse (CPA)
More research is needed to understand the effects of community-based interventions on this group, and such interventions need to integrate other keys predictors of HIV including trauma, coping strategies, and intimate partner violence
More research is needed to understand community-based interventions in reducing HIV risk behaviors among men with a history of childhood sexual or physical abuse living in African settings
Summary
There is increased focus on HIV prevention with African men who report experiencing childhood sexual (CSA) or physical abuse (CPA). There is increased focus on understanding HIV prevention among African men who report having experienced sexual or physical abuse as children [1,2]. Predictors of HIV risk behaviors among those with a history of CSA or CPA include intersecting issues like trauma, shame, limited coping strategies and substance abuse [3,4,5]. More research is needed to understand community-based interventions in reducing HIV risk behaviors among men with a history of childhood sexual or physical abuse living in African settings
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