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. 2021 Aug;25(8):2400-2409.
doi: 10.1007/s10461-021-03202-2. Epub 2021 Mar 4.

Project ACCLAIM: Intervention Effect on Community Knowledge, Attitudes and Beliefs of Maternal and Child Health and HIV/AIDS in Eswatini, Uganda and Zimbabwe

N Bandopadhay  1 , G B Woelk  2 , M P Kieffer  3 , D Mpofu  3 ; Project ACCLAIM Study Group
Collaborators, Affiliations

Project ACCLAIM: Intervention Effect on Community Knowledge, Attitudes and Beliefs of Maternal and Child Health and HIV/AIDS in Eswatini, Uganda and Zimbabwe

N Bandopadhay et al. AIDS Behav. 2021 Aug.

Abstract

The ACCLAIM Study aimed to assess the effect of a package of community interventions on the demand for, uptake of, and retention of HIV-positive pregnant/postpartum women in maternal and child health (MCH) and prevention of mother-to-child HIV transmission (PMTCT) services. The study occurred from 2013 to 2015 in Eswatini, Uganda, and Zimbabwe. The three interventions were: (1) a social learning and action component for community leaders, (2) community days, and (3) peer discussion groups. Household cross-sectional surveys on community members' MCH and PMTCT knowledge, attitudes, and beliefs were analyzed pre- and post-intervention, using MCH, HIV stigma, and gender-equitable men (GEM) indicators. We used t-tests to measure the significance of mean pre- vs. post-intervention score changes stratified by gender within each intervention arm and generalized linear models to compare mean score changes of the cumulative intervention arms with the community leaders-only intervention. Response rates were over 85% for both surveys for men and women, with a total of 3337 pre-intervention and 3162 post-intervention responses. The combined package of three interventions demonstrated a significantly greater increase in MCH scores for both women (diff = 1.34, p ≤ 0.001) and men (diff = 2.03, p < 0.001). The arms that included interventions for both community leader engagement and community days (arms 2 and 3)led to a greater increase in mean GEM scores compared to the community leader engagement intervention alone (arm 1), for both women (diff = 1.32, p = 0.002) and men (diff = 1.37, p = 0.004). Our findings suggest that a package of community interventions may be most effective in increasing community MCH/HIV knowledge and improving gender-equitable norms.

Keywords: Community interventions; Gender; HIV stigma; HIV/AIDS; KAB; Maternal and child health; PMTCT.

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Conflict of interest statement

All authors affirm that they have no competing financial interests to declare.

Figures

Fig. 1
Fig. 1
Trial design. Reprinted from “Evaluating the effectiveness of selected community-level interventions on key maternal, child health, and prevention of mother-to-child transmission of HIV outcomes in three countries (the ACCLAIM project): a study protocol for a randomized controlled trial,” by Woelk, G.B., Kieffer, M.P., Walker, D., Mpofu, D., Machekano, R., and the Project ACCLAIM study group. Trials, 17(88) 2016, p.5
See this image and copyright information in PMC

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