XIX International AIDS Conference


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LBPE35 - Poster Exhibition

Evaluation of Zimbabwe's National Behaviour Change Programme implemented between 2007 and 2011

B. Tambashe1, R. Buzdugan2, C. Watadzaushe3, J. Dirawo3, O. Mundida4, A. Copas2, G. Woelk3, L. Langhaug2, C. Benedikt1, F. Cowan2,3

1UNFPA Zimbabwe, Harare, Zimbabwe, 2University College London, Centre for Sexual Health & HIV Research, London, United Kingdom, 3ZAPP-UZ, University of Zimbabwe, Harare, Zimbabwe, 4National AIDS Council of ZImbabwe, Harare, Zimbabwe

Background: The National Behaviour Change Programme (NBCP) has been implemented in Zimbabwe since 2007; initially in 26 districts (phase I) expanded nationally to all districts in 2010 (phase II).
Methods: Representative household bio-behavioral surveys of all 18-24 year olds and a proportion of 25-44 year olds were conducted in 16 districts (8 phase I, 8 phase II districts) in 2007 and 2011. We compared knowledge, attitudes and reported behavior between phase I and phase II districts and between 2007 and 2011, using multivariate logistic or multinomial regression analyses.
Results: There were 4,776 participants at baseline and 10,059 at endline (response rate 79% and 72% respectively). In 2011, 74% of participants reported exposure to programme activities.

Figure 1
[Figure 1]

While programme exposure was higher in phase I than phase II communities, the difference was too small to explore changes as a result of programme exposure. HIV prevalence in 18-24 year old women (proxy for cumulative incidence) had declined equally in both phase I (10.9% declining to 9.1%) and phase II (12.4% declining to 10.6%) communities [AOR 1.02 p=0.983] between 2007-11.

 BaselineEndlineAORp value
Entire samplen=2033n=4075  
[HIV prevalence by survey round and gender]

There were significant changes reported between 2007 and 2011 irrespective of programme phase;

 Baseline (n=4796)Endline (n=10065)AORp value
HIV Knowledge Low (0-2 questions)<0.001
Medium (3-4 questions)59.856.12.09 
High (5-6 questions) 
Attitudes to HIV index (mean) 0-<0.001
Men only >=2 Sex partners last 12 months29.124.40.48<0.001
Women only >=2 Sex partners last 12 months7.45.10.44<0.001
Condom use at last sex with all non-regular partners, last 12 months23.539.92.36<0.001
[Changes over time]

HIV knowledge increased, attitudes to HIV and gender were more positive. In addition, reported age at first intercourse among 18-24 year olds had declined, reported number of sexual partners in previous 12 months had declined and the proportion who currently had >2 partners had decreased.

Figure 2
[Figure 2]

Condom use at last sex and with non regular partners had increased.

Figure 3
[Figure 3]

HIV testing had increased as had disclosure of HIV status.
Conclusions: Three quarters of Zimbabweans have been exposed to the NBCP since 2007; coverage is now uniform across the country. Over this period there have been significant increases in knowledge, positive attitudes and norms and reported safer sexual behaviour coupled with a well documented decline in HIV incidence.

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