Imperial College London
Portrait Picture

Professor Sarah Fidler BSc. MBBS. FRCP. PhD

Faculty of Medicine, Department of Infectious Disease

Professor of HIV and Communicable Diseases
 
 
 
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Contact

 

+44 (0)20 7594 6230s.fidler

 
 
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Location

 

clinical trial centre Winston Churchill wingMedical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bond:2016:10.1080/09540121.2016.1178958,
author = {Bond, V and Chiti, B and Hoddinott, G and Reynolds, L and Schaap, A and Simuyaba, M and Ndubani, R and Viljoen, L and Simwinga, M and Fidler, S and Hayes, R and Ayles, H and Seeley, J and HPTN, 071 PopART study team},
doi = {10.1080/09540121.2016.1178958},
journal = {AIDS Care},
pages = {99--107},
title = {"The difference that makes a difference": highlighting the role of variable contexts within an HIV Prevention Community Randomised Trial (HPTN 071/PopART) in 21 study communities in Zambia and South Africa.},
url = {http://dx.doi.org/10.1080/09540121.2016.1178958},
volume = {28},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - This paper explores contextual heterogeneity within a community randomised trial HPTN 071 (Population Effects of Antiretroviral Treatment to Reduce HIV Transmission) carried out in 21 study communities (12 Zambian, 9 South African). The trial evaluates the impact of a combination HIV prevention package (including household-based HIV counselling and testing and anti-retroviral treatment (ART) eligibility regardless of CD4-count) on HIV incidence. The selection, matching and randomisation of study communities relied on key epidemiological and demographic variables and community and stakeholder support. In 2013, following the selection of study communities, a "Broad Brush Survey" (BBS) approach was used to rapidly gather qualitative data on each study community, prior to the implementation of the trial intervention. First-year process indicator intervention data (2014-2015) were collected during the household-based intervention by community lay workers. Using an open/closed typology of urban communities (indicating more or less heterogeneity), this qualitative inquiry presents key features of 12 Zambian communities using a list of four meta-indicators (physical features, social organisation, networks and community narratives). These indicators are then compared with four intervention process indicators in a smaller set of four study communities. The process indicators selected for this analysis indicate response to the intervention (uptake) amongst adults. The BBS qualitative data are used to interpret patterns of similarity and variability in the process indicators across four communities. We found that meta-indicators of local context helped to interpret patterns of similarity and variability emerging across and within the four communities. Features especially significant for influencing heterogeneity in process indicators include proportion of middle-class residents, proximity to neighbouring communities and town centre, the scale of the informal economy
AU  - Bond,V
AU  - Chiti,B
AU  - Hoddinott,G
AU  - Reynolds,L
AU  - Schaap,A
AU  - Simuyaba,M
AU  - Ndubani,R
AU  - Viljoen,L
AU  - Simwinga,M
AU  - Fidler,S
AU  - Hayes,R
AU  - Ayles,H
AU  - Seeley,J
AU  - HPTN,071 PopART study team
DO  - 10.1080/09540121.2016.1178958
EP  - 107
PY  - 2016///
SN  - 0954-0121
SP  - 99
TI  - "The difference that makes a difference": highlighting the role of variable contexts within an HIV Prevention Community Randomised Trial (HPTN 071/PopART) in 21 study communities in Zambia and South Africa.
T2  - AIDS Care
UR  - http://dx.doi.org/10.1080/09540121.2016.1178958
UR  - http://hdl.handle.net/10044/1/39285
VL  - 28
ER  -
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