Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

A Dose-Response Relationship Between Exposure to an HIV Prevention Intervention and Preventive Behaviors in Mozambique: Findings

Poster Number

65

Document Type

Poster

Publication Date

3-2016

Abstract

Background: Mozambique has seen improvements in condom use and in the uptake of voluntary HIV counseling and testing (VCT), yet the overall uptake of preventive behaviors (such as reduction of sexual partners) is limited. Continued investments have been made in HIV prevention programs, including community-based behavior change communications (BCC) efforts carried out by FHI360’s Capable Partners Program (CAP). However, evidence from Mozambique is limited regarding the minimum dosage of intervention programming necessary to encourage behavior change.

Methods: In 2014, we conducted a multi-phased household cluster survey in 12 districts in 4 provinces of Mozambique where CAP was implemented. We interviewed 923 individuals aged 15-64 (399 men, 524 women), 624 of whom were exposed to CAP BCC, and 299 who were not exposed to any HIV intervention. Participation was divided into three levels according to respondent involvement in eight CAP activities in the past 6-12 months: low (1-3 instances of participation), medium (4-6 instances) and high (more than 7 instances). Activities included one-on-one talks with a peer educator, participation in discussion groups, and watching theater performances or films about HIV/AIDS. The participation variable was regressed on five outcomes: intention to seek VCT in the next 6 months, ever sought counseling and testing for HIV/AIDS (individual VCT), ever gone for an HIV test with any of their sex partners (couples VCT), condom use at last sex, and current multiple concurrent partners.

Results: Our results suggest a significant dose-response relationship between CAP participation and three outcomes: intention to test for HIV at low (AOR=2.67;95%CI:1.49-4.78), medium (AOR=4.29;95%CI:2.14-8.58), and high (AOR=5.71;95%CI:3.32-9.81) participation, individual VCT at low (AOR=2.66;95%CI:1.52-4.67), medium (AOR=3.60;95%CI:2.14-8.58) and high (AOR=5.71;95%CI:3.32-9.81) participation and couples VCT at low (AOR=3.73;95%CI:1.52-4.67), medium (AOR=4.31;95%CI:1.79-10.38) and high (AOR=9.41;95%CI:4.48-19.79) participation. For condom use, only a medium level of participation was positively associated with reporting condom use at last sex (AOR: 2.81;95%CI:1.49-4.78), while no association was found for current multiple concurrent partners.

Conclusion: Initial findings suggest higher levels of participation in CAP activities are significantly associated with increased intention to seek VCT, and reporting individual and couples VCT. Investing in greater dosages of intervention programming may be worthwhile for behavior change.

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Presented at: GW Research Days 2016

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A Dose-Response Relationship Between Exposure to an HIV Prevention Intervention and Preventive Behaviors in Mozambique: Findings

Background: Mozambique has seen improvements in condom use and in the uptake of voluntary HIV counseling and testing (VCT), yet the overall uptake of preventive behaviors (such as reduction of sexual partners) is limited. Continued investments have been made in HIV prevention programs, including community-based behavior change communications (BCC) efforts carried out by FHI360’s Capable Partners Program (CAP). However, evidence from Mozambique is limited regarding the minimum dosage of intervention programming necessary to encourage behavior change.

Methods: In 2014, we conducted a multi-phased household cluster survey in 12 districts in 4 provinces of Mozambique where CAP was implemented. We interviewed 923 individuals aged 15-64 (399 men, 524 women), 624 of whom were exposed to CAP BCC, and 299 who were not exposed to any HIV intervention. Participation was divided into three levels according to respondent involvement in eight CAP activities in the past 6-12 months: low (1-3 instances of participation), medium (4-6 instances) and high (more than 7 instances). Activities included one-on-one talks with a peer educator, participation in discussion groups, and watching theater performances or films about HIV/AIDS. The participation variable was regressed on five outcomes: intention to seek VCT in the next 6 months, ever sought counseling and testing for HIV/AIDS (individual VCT), ever gone for an HIV test with any of their sex partners (couples VCT), condom use at last sex, and current multiple concurrent partners.

Results: Our results suggest a significant dose-response relationship between CAP participation and three outcomes: intention to test for HIV at low (AOR=2.67;95%CI:1.49-4.78), medium (AOR=4.29;95%CI:2.14-8.58), and high (AOR=5.71;95%CI:3.32-9.81) participation, individual VCT at low (AOR=2.66;95%CI:1.52-4.67), medium (AOR=3.60;95%CI:2.14-8.58) and high (AOR=5.71;95%CI:3.32-9.81) participation and couples VCT at low (AOR=3.73;95%CI:1.52-4.67), medium (AOR=4.31;95%CI:1.79-10.38) and high (AOR=9.41;95%CI:4.48-19.79) participation. For condom use, only a medium level of participation was positively associated with reporting condom use at last sex (AOR: 2.81;95%CI:1.49-4.78), while no association was found for current multiple concurrent partners.

Conclusion: Initial findings suggest higher levels of participation in CAP activities are significantly associated with increased intention to seek VCT, and reporting individual and couples VCT. Investing in greater dosages of intervention programming may be worthwhile for behavior change.