Social Network Influence on HIV Testing Among Urban Men in Tanzania

Yamanis, Thespina J.; Dervisevic, Ervin; Mulawa, Marta; Conserve, Donaldson F.; Barrington, Clare; Kajula, Lusajo; Maman, Suzanne

doi:10.1007/s10461-016-1513-8

Cited by 53 publications

(61 citation statements)

References 61 publications

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“…Since the 1990s, researchers have used social network data (e.g., partner notification and contact tracing) to understand sexual behavior (58) and epidemic change for both HIV (59,60) and other sexually transmitted infections (61). More recently, two approaches have been used to capture sexual networks de novo: (i) focusing on quasi-closed communities, such as those confined to islands (62) or those with well-defined social networks where boundary specification is relatively straightforward (63,64); and (ii) attempting to gain saturated coverage of behaviorally or geographically defined groups (65-68). One powerful emerging use of social networks for understanding HIV transmission is its combination with phylogenetic data, thereby attempting to minimize the limitations of both data types (69)(70)(71), although there remain important ethical issues to consider in such detailed inference (72).…”

Section: Using Social Network To Understand Hiv Treatment and Prevenmentioning

confidence: 99%

Using social networks to understand and overcome implementation barriers in the global HIV response

Harling¹,

Tsai²

2019

Preprint

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Despite the development of several efficacious HIV prevention and treatment methods in the past decades, HIV continues to spread globally. Uptake of interventions is non-randomly distributed across populations, and such inequality is socially patterned both statically (due to homophily) and dynamically (due to social selection and influence). Social network analysis (SNA) methods, including egocentric, sociocentric, and respondent-driven sampling, provide tools to measure mostat-risk populations, to understand how epidemics spread, and to evaluate intervention take-up. SNAinformed designs can improve intervention effectiveness by reaching otherwise inaccessible populations and improve efficiency by maximizing spillovers to at-risk but susceptible individuals through social ties; they thus have the potential to be both more effective and less unequal in their effects than SNA-naïve approaches. While SNA-informed designs are often resource-intensive, they are uniquely able to help reach those most in need of HIV prevention and treatment interventions.Increased collection of social network data during both research and implementation work would provide important information to improve the roll-out of existing studies in the present and to inform the design of more data-efficient, SNA-informed interventions in the future.

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Section: Using Social Network To Understand Hiv Treatment and Prevenmentioning

confidence: 99%

Using social networks to understand and overcome implementation barriers in the global HIV response

Harling¹,

Tsai²

2019

Preprint

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“…The main findings from this analysis vividly demonstrated that peer pressure (19) and opportunity cost of attending ANC instead of being at work (20) exerted significant influences on male partners and played major role in their decision to engage or attend antenatal care along with their pregnant partners. It was found that men as peers perceived themselves as a strong group hence did not see the need of listening to their partner.…”

Section: Discussionmentioning

confidence: 90%

Socio-cultural and economic barriers, and facilitators influencing men’s involvement in antenatal care including HIV testing: A qualitative study from urban Blantyre, Malawi

Sakala

Kumwenda

Conserve

et al. 2020

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BackgroundMale partner involvement in antenatal care (ANC) is associated with positive maternal and neonatal outcomes. However, only a handful of men attend ANC with their partners. This study aimed to understand the underlying barriers and facilitators influencing men’s ANC attendance including HIV testing in Blantyre, Malawi.MethodsData were collected during a formative qualitative study of a cluster-randomised trial. Six focus group discussions (FGDs) with 42 men and women and 20 in-depth interviews (IDIs) were conducted at three primary health centres in urban Blantyre, Malawi. FGD participants were purposively sampled with IDI participants subsequently sampled after FGD participation. Thematic analysis was used to analyse the data.ResultsThe economic requirement to provide for their families exerted pressure on men and often negatively affected their decision to attend ANC together with their pregnant partners despite obvious benefits. Peer pressure and the fear to be seen by peers queueing for services at ANC, an environment traditionally viewed as a space for women and children made men feel treated as trespassers and with some level of hostility rendering them feeling emasculated when they attend ANC. Health system problems associated with overall organization of the ANC services, which favours women created resistance among men to be involved. An association between ANC and HIV testing services discouraged men from attending ANC because of their fear of testing HIV-positive in the presence of their partners. The availability of a male friendly clinic offering a private, quick, supportive/sensitive and flexible service was considered to be an important incentive that would facilitate male men’s ANC attendance. Men described compensation to cover transport and opportunity cost for attending the clinic as a motivator to attending ANC services and accepting an HIV test. ConclusionPeer and economic influences were the most influential barriers of men attending ANC and testing for HIV with their pregnant partners. Addressing these socio-economic barriers and having a male friendly clinic are promising interventions to promote male ANC attendance in this setting.

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“…We used a cluster design because we were interested in evaluating an intervention delivered within social networks [22]. Camp-based social networks serve as important socialization environments for men, propagating norms that are associated with men's sexual partner concurrency [23], IPV perpetration [24,25], as well as HIV testing [26,27].…”

Section: Methodsmentioning

confidence: 99%

“…The fact that men in camps engaged in the intervention and we were able to follow up with them over time suggests that camp-based networks are viable targets for interventions. The data we collected on these social networks provided us with important insight on how young men's social networks influence their HIV risk behaviors [25][26][27] and IPV [17].…”

Section: Plos Onementioning

confidence: 99%

Results from a cluster-randomized trial to evaluate a microfinance and peer health leadership intervention to prevent HIV and intimate partner violence among social networks of Tanzanian men

et al. 2020

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Despite calls to engage men in HIV and intimate partner violence (IPV) prevention efforts, effective approaches to reach and engage men in low-resource, high-HIV prevalence settings are limited. We identified and engaged social networks of mostly young men in a study designed to evaluate the efficacy of a combined microfinance and peer health leadership intervention to prevent HIV and IPV. We conducted a cluster-randomized trial among 60 social networks locally referred to as "camps" within Dar es Salaam, Tanzania. Camps were randomly assigned (1:1) to a microfinance and peer health leadership intervention or a control condition that received a brief delayed intervention after the study's conclusion. Allocation was not masked to participants or researchers. Behavioral assessments were conducted at baseline and 30-months post-intervention launch, with biological samples drawn at 30-months to test for sexually-transmitted infections (STIs). Primary outcomes included prevalence of STIs and past-year IPV perpetration. Secondary outcomes included STI sexual risk behaviors and past-year HIV testing. Proximal intervention targets included inequitable gender norm attitudes and hope. A modified Poisson regression approach was used to estimate intention-to-treat intervention effects on outcomes assessed at the 30month follow-up. We enrolled 1,258 men within 60 camps. Of these men, 1,029 (81.8%) completed the 30-month follow-up. There were no differences by condition in STI prevalence, IPV perpetration, or sexual risk behaviors at the 30-month follow-up. Intervention participants reported greater levels of past-year HIV testing, controlling for baseline testing (aRR 1.13 95% CI 1.005-1.28). They also reported significantly lower levels of inequitable gender norm attitudes (adjusted effect-0.11, 95% CI-0.21-0.003). We successfully engaged and retained social networks of men in this multilevel intervention study. While we

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Social Network Influence on HIV Testing Among Urban Men in Tanzania

Cited by 53 publications

References 61 publications

Using social networks to understand and overcome implementation barriers in the global HIV response

Using social networks to understand and overcome implementation barriers in the global HIV response

Socio-cultural and economic barriers, and facilitators influencing men’s involvement in antenatal care including HIV testing: A qualitative study from urban Blantyre, Malawi

Results from a cluster-randomized trial to evaluate a microfinance and peer health leadership intervention to prevent HIV and intimate partner violence among social networks of Tanzanian men

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