Community-led interventions for HIV and AIDS prevention, treatment, and care in Southern Africa : a scoping review

Abstract

BACKGROUND : Over the past few decades, significant progress has been made in containing the HIV epidemic worldwide. A few countries, primarily in Southern Africa, have met the UNAIDS 95-95-95 goals. However, this does not warrant complacency. The contribution of communities to these gains is immeasurable. Therefore, there is a need to sustain and expand the involvement of communities in the testing, prevention, and treatment of HIV. AIM : This study aims to assess the scope and outcomes of community-led HIV interventions conducted in Southern Africa. STUDY DESIGN : This study followed a scoping review design. DATA SOURCES : PubMed, ScienceDirect, SCOPUS, Google Scholar, and Africa Journals Online (AJOL) databases were searched for peer-reviewed articles published in English between 2013 and 2023. METHODOLOGY : The scoping review was guided by the Joanna Briggs Institute methodology for scoping reviews. The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist. Primary studies using mixed-methods, quantitative, and qualitative approaches that detailed HIV and AIDS community-led interventions carried out in Southern Africa were considered for this review. Two reviewers separately extracted the data from the included studies using a data extraction tool in Microsoft Excel. We used NVivo to develop codes and categories for the scope and outcomes of community-led interventions. RESULTS : Thirteen articles were included in this scoping review. Eleven of the studies were quantitative studies, one was a mixed-methods study, and another one was a qualitative study. Peer-based programs, adherence clubs, community conversations, support groups, community-based HIV testing, and antiretroviral therapy (ART) linkage are some of the community-led interventions found in this scoping review. The outcomes of these interventions include increased awareness of HIV and AIDS, decreased risky behaviours and stigma related to HIV, increased disclosure of partners' HIV status, increased testing for HIV, linkage to care, adherence to ART, retention in care, and viral suppression. CONCLUSION : Based on the promise demonstrated in this review, further investment in and support for community-led HIV interventions in Southern Africa is justified. Scaling up these interventions, alongside robust evaluation efforts, holds significant potential to contribute to a more comprehensive and effective response to the HIV epidemic in the region.