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

The impact of community mobilisation on HIV prevention in middle and low income countries: a systematic review and critique.
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DOI:
10.1007/s10461-014-0748-5
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发表时间:
2014-11
期刊:
影响因子:
4.4
通讯作者:
McLean, Susie
McLean, Susie
中科院分区:
医学2区
文献类型:
--
作者:
Cornish, Flora;Priego-Hernandez, Jacqueline;Campbell, Catherine;Mburu, Gitau;McLean, Susie

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虽然社区动员(CM)越来越多地倡导艾滋病毒预防,但其对可衡量成果的影响尚未确定。我们进行了一项系统的审查CM内的艾滋病毒预防干预措施(N = 20),生物医学,行为和社会结果的影响。在风险最大的群体(特别是性工作者)中,证据多少有些一致,表明有产生积极影响的趋势,在行为和社会结果方面的结果比在生物医学方面的结果更强。在青年和一般社区中,证据仍然不确定。通过让具有强烈集体认同感的群体参与,并同时处理社会政治背景问题,成功似乎会得到加强。我们认为,调查结果的不确定性反映了证据的问题,而不是表明CM是无效的。我们讨论CM的可操作性的弱点,忽视社会背景,上下文特定的CM过程和审查方法的愿望,以提供简单的,超越上下文的答案之间的不兼容。本文的在线版本(doi:10.1007/s10461-014-0748-5)包含补充材料,可供授权用户使用。
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. The online version of this article (doi:10.1007/s10461-014-0748-5) contains supplementary material, which is available to authorized users.
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