Abstract
Although a number of HIV prevention programs have been implemented, such as mass media campaigns, high rates of unprotected and concurrent sexual partnerships, as well as low uptake HIV testing and limited HIV knowledge, persist in Tanzania. We examined the effect and predicting factors of HIV prevention communication among people living with HIV (PLH) exposed to NAMWEZA intervention, and their at-risk social network members (NMs) Quantitative data were collected from 326 participants at baseline and 24 months of follow-up. In-depth interviews with 20 PLH were conducted at follow-up. Results indicated specific communication about condom use and HIV testing increased; (mean increase of 0.28 (SD = 0.14) scores, P = 0.012 and 0.42 (SD = 0.11) scores, p < 0.001 respectively while general discussion about protecting other people from HIV did not change significantly; mean increase was 0.01 scores (SD = 0.005), p = 0.890. Positive predictors of communication included being single; OR = 1.10, p = 0.01, female; OR = 1.15, p = 0.03, aged 30 years or older; OR = 1.23, p < 0.01, HIV knowledge, dose of NAMWEZA participation; OR = 1.01, p < 0.001, and high self-efficacy for condom use; OR = 1.4, p < 0.001. Stigma demonstrated a significant but negative association with communication for condom use; OR = 1.01, p < 0.01.Qualitative data reflected perceived possession of more individual skills and ability to address some personal/cultural obstacles to communicating about HIV prevention including those observed in the quantitative data. NAMWEZA improved communication about HIV prevention among PLH with their at-risk-NMs. The approach is a promising complement to media campaigns in similar populations. Future research and program evaluation efforts should explore how communities perceive and communicate about protecting others from HIV.
Highlights
HIV remains a significant public health concern in Tanzania—a country with 1.6 million people living with HIV, 74,000 new HIV infections, and 40,000 HIV/AIDS-related deaths occurring each year
We examined the effect and predicting factors of HIV prevention communication among people living with HIV (PLH) exposed to NAMWEZA intervention, and their at-risk social network members (NMs) Quantitative data were collected from 326 participants at baseline and 24 months of follow-up
We focus our research on improving HIV/AIDS care and treatment services in Tanzania
Summary
HIV remains a significant public health concern in Tanzania—a country with 1.6 million people living with HIV, 74,000 new HIV infections, and 40,000 HIV/AIDS-related deaths occurring each year. Advocating for HIV prevention and educating people on the benefits of seeking and remaining in HIV care are among such efforts implemented across the country, largely through mass media (MoH, 2013) Despite these efforts, a large proportion of the population has demonstrated a low uptake of HIV prevention approaches, including condom use and HIV testing services. Preliminary results of another survey known as the Tanzania HIV impact Survey (THIS) conducted in 2016/2017 showed that the proportions of people who had received an HIV test and had knowledge of their HIV status were still low and varied widely by risk group—among men who have sex with men who were HIV-positive only 14% knew their status before they took the test. This plan emphasized the need to adopt specific evidencebased social/behavior change communication models to advance safer sexual behaviors for HIV prevention (MoH 2013–2017)
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