16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

EXPOSURE TO A COMMUNITY-MOBILIZATION INTERVENTION AND HIV-RELATED KNOWLEDGE, ATTITUDES, AND PRACTICES - BOTSWANA, 2003

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAc0202

Koppenhaver T.¹, Fleming D.², Meyerson B.³, Robbins A.³, Kebonang G.S.⁴, Roels T.H.¹, Kilmarx P.H.^5
1BOTUSA Project, Global AIDS Program, Gaborone, Botswana, ²BOTUSA Project, Gaborone, Botswana, ³National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, United States, ⁴Humana People to People / Total Community Mobilization, Gaborone, Botswana, ⁵Centers for Disease Control and Prevention (CDC), Atlanta, United States

BACKGROUND The Total Community Mobilization (TCM) program is a door-to-door intervention which delivers HIV prevention and treatment-related information to households in Botswana. We examine the association of exposure to TCM with selected indicators of HIV/AIDS-related knowledge, attitudes, and practices (KAP).

METHODS: Our data come from a cross-sectional household survey, which interviewed 807 15-to 49-year-old Batswana in seven of Botswana’s 22 health districts in 2003. At this time, TCM was operating in five of these seven health districts. We used bivariate and multivariate analyses to compare KAP outcomes among those individuals with reported TCM exposure (defined as having ever spoken with someone from TCM, either in a group or individually) to those without.

RESULTS: In the five TCM-active health districts, 23% of respondents reported exposure to TCM. Controlling for demographics and regularly listening to an HIV/AIDS education-entertainment radio drama, TCM exposure was significantly (p<.05) associated with spontaneously mentioning abstinence (adjusted odds ratio (AOR) 1.99) and condom use (AOR 2.96) as HIV prevention methods. TCM exposure was similarly associated with knowing that it’s possible to prevent mother-to-child transmission (MTCT) and that AZT is a means of preventing MTCT, but not with spontaneously mentioning the three modes of transmission (pregnancy, delivery, and breastfeeding). On four of six separate questions about stigma, TCM exposure was significantly associated with non-stigmatizing responses (AORs from 1.44 to 9.12). Further, TCM-exposed individuals were twice as likely as the unexposed to report having been tested for HIV (AOR 1.96, p<.01). However, TCM-exposed individuals were no more likely to report abstaining, not having concurrent sex partners, or using condoms with non-cohabiting partners.

CONCLUSIONS: These findings suggest that TCM has helped to improve HIV-prevention knowledge, reduce stigma, and encourage testing in Botswana. The lack of association between TCM exposure and targeted sexual behaviors indicates that important behavior-change challenges remain.

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2006-08-13
MoAc0202

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