Conceptualizing Community Mobilization for HIV Prevention: Implications for HIV Prevention Programming in the African Context

Introduction: Community Mobilization for HIV Prevention

 Community mobilizing strategies, designed to engage and galvanize community members to take action towards achieving a common goal [1], are increasingly recognized as essential components of HIV prevention programs. In the area of HIV prevention, community mobilizing interventions have demonstrated successes in increasing condom use [2-7], improving service access and quality [7,8], increasing social capital or social cohesion [7,9] and most recently in promoting uptake of HIV counseling and testing [10]. Beyond these demonstrated successes, community mobilization (CM) will play a key role in effective implementation of key bio-medical interventions in the future. For example, landmark trials have demonstrated the efficacy of early antiretroviral treatment (ART) for HIV positive individuals to prevent transmission to uninfected partners [11] and providing ARTs to high risk HIV negative individuals to prevent acquisition of the virus [12]. The success of treatment-as-prevention approaches hinges on developing CM strategies to inspire broad support for care and treatment for those living with or at elevated risk for HIV/AIDS, their providers, and their family and community networks. Unleashing the potential of community mobilization for HIV prevention is particularly critical in sub-Saharan Africa, which shoulders 70% of the global HIV epidemic [13].

Community mobilization interventions to prevent HIV have varied widely in tactics and focus. A number of CM efforts have included components that address the larger social and structural context surrounding HIV, including efforts to reduce discrimination against groups most vulnerable to HIV; to create social cohesion and extend social networks for disenfranchised communities; and to ensure community participation in prevention and care programming [14-17]. The best known HIV prevention mobilizing effort was undertaken by sex workers in Sonagachi (Kolkata), India. Over 15 years of evolving participatory prevention and organizing, condom use increased and remained high and HIV prevalence declined and remained low among sex workers in Kolkata as compared to sex workers in other Indian cities [3].

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