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. 2014 Nov;18(11):2110-34.
doi: 10.1007/s10461-014-0748-5.

The impact of community mobilisation on HIV prevention in middle and low income countries: a systematic review and critique

Flora Cornish  1 , Jacqueline Priego-Hernandez, Catherine Campbell, Gitau Mburu, Susie McLean
Affiliations

The impact of community mobilisation on HIV prevention in middle and low income countries: a systematic review and critique

Flora Cornish et al. AIDS Behav. 2014 Nov.

Abstract
in English, Spanish

While community mobilisation (CM) is increasingly advocated for HIV prevention, its impact on measurable outcomes has not been established. We performed a systematic review of the impact of CM within HIV prevention interventions (N = 20), on biomedical, behavioural and social outcomes. Among most at risk groups (particularly sex workers), the evidence is somewhat consistent, indicating a tendency for positive impact, with stronger results for behavioural and social outcomes than for biomedical ones. Among youth and general communities, the evidence remains inconclusive. Success appears to be enhanced by engaging groups with a strong collective identity and by simultaneously addressing the socio-political context. We suggest that the inconclusiveness of the findings reflects problems with the evidence, rather than indicating that CM is ineffective. We discuss weaknesses in the operationalization of CM, neglect of social context, and incompatibility between context-specific CM processes and the aspiration of review methodologies to provide simple, context-transcending answers.

Mientras que la movilización de la comunidad (MC) es cada vez más recomendada para la prevención del VIH, su impacto en resultados mensurables no se ha establecido. Realizamos una revisión sistemática del impacto de la MC en intervenciones para la prevención del VIH (N = 20), en resultados biomédicos, conductuales y sociales. En grupos de riesgo (particularmente trabajadoras sexuales) la evidencia es más bien consistente, indicando una tendencia general de impacto positivo, siendo los resultados conductuales y sociales más robustos que los biomédicos. En los jóvenes y comunidades en general la evidencia no es concluyente. Resultados favorables parecen ser mejorados al involucrar grupos con una fuerte identidad colectiva y, simultáneamente, atender al contexto socio-político. Proponemos que la naturaleza poco concluyente de los hallazgos refleja problemas con la evidencia, en lugar de sugerir que la MC es inefectiva. Discutimos las debilidades en la operacionalización de la MC, la desatención al contexto social y la incompatibilidad entre procesos contextualmente específicos en la MC y la pretensión de las metodologías de revisión de proveer respuestas simples y que trasciendan el contexto.

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