A cluster randomized-controlled trial of a community mobilization intervention to change gender norms and reduce HIV risk in rural South Africa: study design and intervention

Audrey Pettifor, Sheri A Lippman, Amanda M Selin, Dean Peacock, Ann Gottert, Suzanne Maman, Dumisani Rebombo, Chirayath M Suchindran, Rhian Twine, Kathryn Lancaster, Tamu Daniel, F Xavier Gómez-Olivé, Kathleen Kahn, Catherine MacPhail, Audrey Pettifor, Sheri A Lippman, Amanda M Selin, Dean Peacock, Ann Gottert, Suzanne Maman, Dumisani Rebombo, Chirayath M Suchindran, Rhian Twine, Kathryn Lancaster, Tamu Daniel, F Xavier Gómez-Olivé, Kathleen Kahn, Catherine MacPhail

Abstract

Background: Community mobilization (CM) interventions show promise in changing gender norms and preventing HIV, but few have been based on a defined mobilization model or rigorously evaluated. The purpose of this paper is to describe the intervention design and implementation and present baseline findings of a Cluster Randomized Controlled Trial (RCT) of a two-year, theory-based CM intervention that aimed to change gender norms and reduce HIV risk in rural Mpumalanga province, South Africa.

Methods: Community Mobilizers and volunteer Community Action Teams (CATs) implemented two-day workshops, a range of outreach activities, and leadership engagement meetings. All activities were mapped onto six theorized mobilization domains. The intervention is being evaluated by a randomized design in 22 communities (11 receive intervention). Cross-sectional, population-based surveys were conducted with approximately 1,200 adults ages 18-35 years at baseline and endline about two years later.

Conclusions: This is among the first community RCTs to evaluate a gender transformative intervention to change norms and HIV risk using a theory-based, defined mobilization model, which should increase the potential for impact on desired outcomes and be useful for future scale-up if proven effective.

Trial registration: ClinicalTrials.gov NCT02129530.

Figures

Fig. 1
Fig. 1
Conceptual framework of the intervention, community mobilization domains, and outcomes

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