Kuhlmann, A.S., Galavotti, C., Hastings, P., et al. AIDS and Behavior (October 2013), E-publication ahead of print.
To address the limited documentation of the impact of community mobilization on HIV prevention outcomes, the authors conducted a theory-based evaluation of the Avahan-India AIDS Initiative, describing the impact of community mobilization on HIV prevention outcomes among female sex workers (FSWs) in the state of Andhra Pradesh. They presented findings on community mobilization, measured by geographical clusters (104 clusters sampled; 1,986 FSWs) and used psychosocial scales to measure mobilization within the population. The authors’ model hypothesized that stronger community mobilization would act on psychosocial factors, which in turn would support positive HIV prevention outcomes. The findings demonstrated that Avahan’s community mobilization added value in key HIV prevention outcomes, e.g., positive indirect effects on consistent condom use and perceived discrimination. Although each cluster received the same intervention activities, the level of community mobilization varied; clusters with greater community mobilization showed more positive outcomes. Greater social cohesion and increased collective efficacy were associated with improved consistency of condom use and higher reported levels of equitable treatment in public places, respectively. The average rate of volunteering for program committees (a measurement of the strength of community mobilization) was 45 percent among FSWs. Future interventions should incorporate evaluation of community mobilization processes and outcomes. More robust measures of community mobilization are needed.