The role of the community conversation approach in facilitating HIV/AIDS competence and utilisation of testing services in Africa: the case of Ethiopia

Abstract

Background: HIV/AIDS is a global epidemic. Although unpublished studies showed that the number of AIDS related deaths has fallen by 39% between 2005 and 2013 in sub-Saharan Africa, the region still accounted for 74% of all the people dying from AIDS-related causes. While the community conversation approach (CCA) is increasingly advocated for HIV prevention in developing countries, its impact on measurable outcomes regarding HIV/AIDS competence and HIV testing practices has not been well established. The aim of this study was to examine the role of CCA on HIV/AIDS competence and recent HIV testing practice in Ethiopia.

Methods: Cross-sectional data were collected on N = 29 639 participants in the Ethiopian Demographic and Health Survey in 2010 using a structured face-to-face interview. Multiple logistic regression analyses were used adjusting for potential confounders (age, sex, marital status, educational status, religion, residence, wealth index and age at first sex).

Results: A significant association between CCA exposure and comprehensive knowledge about HIV/AIDS was found in women and men (odds ratios, OR = 0.52, 95% CI: 0.47; 0.57) and (OR = 0.77 95% CI: 0.70; 0.85) respectively. Both men and women exposed to CCA were more likely to test for HIV than their non-exposed counterparts were (OR = 2.54, 95% CI: 2.29; 2.82) and (OR = 1.70, 95% CI: 1.57; 1.85) respectively. Higher education, wealth status, urban residence and delaying sexual initiation to at least 16 years of age were independently associated with recent HIV testing.

Conclusions: CCA was found promising in facilitating HIV/AIDS prevention by improving respondents’ knowledge and uptake of HIV testing services. Hence, CCA should be expanded to reach more people and follow up of participants may be warranted, focusing on vulnerable groups.

Keywords: HIV/AIDS, behaviour, attitude, knowledge, community conversation programme