A model for community representation and participation in HIV prevention trials among women who engage in transactional sex in Africa
A model for community representation and participation in HIV prevention trials among women who engage in transactional sex in Africa
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DOI：
10.1080/09540120701842803
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发表时间：
2008-10-01
影响因子：
1.7
通讯作者：
Ross, David
中科院分区：
文献类型：
--
作者：
Shagi, Charles;Vallely, Andrew;Ross, David
积极让社区参与设计和实施艾滋病毒预防研究的有效伙伴关系对于在发展中国家成功开展符合道德规范、适合当地的临床试验至关重要。对于脆弱的高危人群尤其如此，因为这些人群的定义或“社区”、“参与”和“代表”可能很难应用。本研究旨在调查坦桑尼亚西北部姆万扎市艾滋病毒和性传播感染高危职业妇女群体中社区联络参与模式的可行性，为第三阶段阴道杀菌剂试验做准备。这种方法植根于参与式行动导向研究，并使用改编自参与式学习和行动技术的工具。在可行性研究期间，在 10 个城市行政区为从事非正式食品摊贩或在传统和现代酒吧、餐馆、酒店和宾馆工作的妇女建立了流动社区性健康和生殖健康服务。参与式绘图是由项目现场工作人员和病区在与社区成员和研究参与者协商后分为 78 个地理设施集群进行的。集群和区级别的代表是在现场社区联络官和成立的现场社区咨询委员会的推动下选举产生的。在更广泛的可行性研究中，使用逻辑框架来指导社区联络系统（CLS）的实施、监测和评估。 CLS 对于可行性研究的成功进行至关重要，现已作为姆万扎正在进行的 MDP301 III 期杀菌剂试验的一部分得到巩固和扩展。本文提出的参与模型很可能适用于资源有限环境中的其他弱势、受污名化、高危研究人群。
Actively engaging communities in effective partnerships for the design and implementation of HIV prevention research is vital to the successful conduct of ethically robust, locally-appropriate clinical trials in developing countries. This is especially true in vulnerable at-risk sub-populations, where definitions or "community", "participation" and "representation" can be difficult to apply. This study was conducted to investigate the feasibility of a participatory model of community liaison among an Occupational cohort of women at high-risk of HIV and sexually-transmitted infections in Mwanza City, northwest Tanzania in preparation for a Phase III vaginal microbicide trial. This approach was rooted in participatory action-orientated research and used tools adapted from participatory learning and action techniques. During the feasibility study, a mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern bars, restaurants, hotels and guesthouses was established in 10 city wards. Participatory mapping was carried out by project fieldworkers and wards divided into 78 geographical Clusters of facilities in consultation with community members and study participants. Representatives at cluster and ward level were elected in a process facilitated by the site Community Liaison Officer and a site-level Community Advisory Committee established. A logical framework was used to guide the implementation, monitoring and evaluation of the community liaison system (CLS) within the broader feasibility study. The CLS was essential to the successful conduct of the feasibility study and has now been consolidated and expanded as part of the on-going MDP301 Phase III microbicide trial in Mwanza. The participatory model presented in this paper is likely to be generalisable to other vulnerable, stigmatised, at-risk Study populations in resource-limited settings.