Community Mobilisation Special Issue - Obstacles to local-level AIDS competence in rural Zimbabwe: Putting HIV prevention in context

Mercy Nhamo (1) , Catherine Campbell (2) , Simon Gregson (3)

1 Institute of Social Psychology
2 Institute of Social Psychology
3 DIDE - Department of Infectious Disease Epidemiology [London]

We explore the wider social context of an HIV-prevention programme in rural Zimbabwe. We make no comment on the intervention itself, rather seeking to examine the wider community dynamics into which it was inserted, to highlight how pre-existing social dynamics may have influenced community 'readiness' to derive optimal benefit from the intervention. Using the concept of 'the AIDS competent community', we analysed of 44 interviews and 11 focus groups with local people. Despite high levels of HIV/AIDS-related knowledge, there were several ways gender, poverty and low literacy may have undermined its perceived relevance to peoples' lives. Lack of opportunities for dialogue in the social milieu beyond the intervention may have limited opportunities for translating factual AIDS knowledge into action plans, or sharing hidden individual experiences of HIV/AIDS-affected family members or friends, given stigma and denial. The initiative of women and young people to respond effectively to AIDS was limited in a context dominated by adult males. People spoke of HIV/AIDS in a passive and fatalistic way, expecting outsiders to solve the problem. This tendency was exacerbated given the community's previous experiences of HIV/AIDS-related NGOs, which had often regarded local people as unpaid volunteer labour rather than building their capacity to make significant decisions and play leadership roles in health programmes. Despite obstacles, however, there were many potential community strengths and resources. There were high levels of HIV/AIDS-related knowledge. Public denial of HIV/AIDS masked huge reservoirs of support and kindness to AIDS-affected family and friends. There were many strong community organisations and clubs, potentially forming the springboard for more empowered community responses to HIV/AIDS. HIV/AIDS programmers should pay greater attention to community readiness for interventions, especially around (i) identifying and anticipating pre-existing obstacles to programme success; and (ii) mobilising the social assets that exist, even in contexts of poverty and gender inequality.

Mots clés: Life Sciences

Mercy Nhamo, Catherine Campbell, Simon Gregson. Community Mobilisation Special Issue - Obstacles to local-level AIDS competence in rural Zimbabwe: Putting HIV prevention in context. AIDS Care, 2010, 22 (S2), pp.1662-1669. ⟨10.1080/09540121.2010.521544⟩. ⟨hal-00651152⟩