Population Council Research that makes a difference

In Zambia, 14.3 percent of adults are infected with HIV, with an estimated 1.6 percent of the population newly infected each year. The National AIDS Council’s Strategy for the Prevention of HIV and AIDS in Zambia aims to reduce new HIV infections by 50 percent by the end of 2014. To contribute to that goal, the Population Council and its partner, Project Concern International, with financial support from the United States Agency for International Development (USAID), are implementing a three-year HIV prevention project called "Community Mobilization for Preventive Action (COMPACT)." The project will develop and determine the feasibility of "community compacts" as an innovative approach to prevent HIV in Zambian communities.

Broadly, community compacts are agreements between service providers and recipient communities that are intended to increase the effectiveness of services by promoting community ownership. COMPACT will work directly with four communities to design and implement some of the first compacts in Zambia. A cornerstone of the compact approach is to work with existing community structures to form a community compact development committee (CCDC), which will comprise community leaders and other stakeholders and will manage the compact. The aim is to mobilize the communities in their efforts to prevent HIV through a capacity-building process that enables communities to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. COMPACT will continuously build the capacity of the CCDC and community-based organizations through structured training, ongoing mentoring support, and community-to-community skills transfer. We are complementing the community compacts with a system of incentives designed to reward communities for reaching their targets. The rewards are not given to individuals; they are community goods that are intended to further the goals of each intervention and motivate the community. They will be bestowed at public events to celebrate achievements and reinforce community ownership of and participation in the compact.

COMPACT will measure changes in behavior in the four project communities using a knowledge, attitudes, and practices survey that examines topics such as gender norms, gender-based violence, alcohol abuse, sexual behavior and condom use, HIV counseling and testing, uptake of male circumcision, and disclosure of HIV status. The evaluation will carry out HIV testing in the community to provide a basis for measuring progress. In addition, the project will generate ongoing documentation highlighting outcomes of community participatory assessments, lessons, and challenges in developing and implementing community compacts. The feedback will be disseminated to district and national HIV program managers and policymakers, as well as globally, to share lessons learned about this innovative approach.