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Community mobilization for HIV prevention is a process that engages individuals, groups, organizations and sectors of the population to increase awareness and reduce HIV infection in the community. Community mobilization for HIV prevention facilitates change through collective actions that address issues that promote HIV infection. It is important for agencies implementing this intervention to have the capacity to develop, plan, conduct, and evaluate community mobilization activities.
The Department of State Health Services (DSHS) encourages agencies implementing this intervention to work with multiple sectors in their community to effectively launch community mobilization (e.g., non-profit, for-profit, healthcare, education, housing, local government, and economic development).
6.1 Community Mobilization Intervention Goals
The goal of this intervention is to develop and support community-level HIV prevention efforts.
Goals of community mobilization for HIV prevention include:
- Strengthening community involvement in HIV prevention efforts by increasing community dialogue, a sense of community ownership, participation, and collaboration in HIV prevention activities;
- Increasing local coordination and collaboration among community members, groups, organizations, and sectors (e.g., private business, public business, and public institutions);
- Increasing advocacy and education;
- Increasing sustainability of HIV prevention efforts;
- Broadening the reach of HIV prevention interventions;
- Reaching the most vulnerable populations;
- Creating an environment in which individuals are empowered to reduce their own risk of acquiring HIV infection;
- Increasing access to HIV prevention; and
- Addressing the social determinants of health.
Successful community mobilization projects will build capacity necessary to empower community members and stakeholders to become advocates and agents for change in a comprehensive HIV prevention effort. Funded agencies will be required to:
- Establish networks and collaborations necessary to mount a community-wide response to the HIV epidemic in their local area; and
- Conduct an assessment of community needs and resources.
Innovation and creativity are encouraged in the development of community mobilization strategies.
Funded agencies are encouraged to demonstrate their ability to access priority populations through a variety of methodologies. One example is the use of technology, such as internet dating sites, social network media (e.g., Twitter), and other internet-based methods.
6.2 Target Priority Populations
Funded agencies are required to target community mobilization activities to appropriate priority populations. Agencies should refer to specific demographic and risk data by county to determine what the appropriate priority population is for any particular area of the state. Through the analysis of state epidemiological data, DSHS has identified the following priority populations for the state of Texas:
- HIV-positive persons;
- Black Men who have Sex with Men (MSM);
- All MSM (other than Black MSM);
- High-risk heterosexual Black females;
- High-risk heterosexual Black males;
- Injection Drug Users (IDU); and
- Transgender persons.
With DSHS approval, funded agencies may target community mobilization activities to identified emergent populations.
Funded agencies are encouraged to use methods that have the potential for the greatest impact and reach. The selection of priority populations must be supported by local epidemiological and needs assessment data. Health Service Delivery Area (HSDA) specific data are available in Appendix D of the
Competitive Request for Proposal (RFP) for HIV Prevention Projects, Agency Requisition Number: HIVPREV-0519.1.
The most current epidemiological and surveillance reports can be found at the following DSHS website:
dshs.texas.gov/hivstd/reports/
DSHS recognizes the need to support activities targeting factors that cut across populations, including but not limited to:
- Partners of HIV-positive persons;
- Homeless persons;
- Incarcerated and recently released persons;
- Young adults;
- Sex workers;
- Persons with STI and Hepatitis C diagnoses; and
- Persons with substance use and mental health disorders.
More detailed information regarding priority populations and risk behaviors can be found in the
Texas HIV/STD Prevention Plan.
6.3 Required Program Components
Community mobilization activities will be conducted according to client and community needs and resources. Community needs and resources will be identified through a systematic community assessment and will serve as the basis for the development of a community mobilization plan.
6.3.1 Community Assessment
Agencies funded by DSHS for community mobilization activities are required to conduct a community assessment. The initial assessment must:
- Identify priority needs of the targeted community as it relates to HIV prevention and community risk reduction;
- Identify existing resources that can be incorporated into coordinated prevention actions;
- Prioritize target populations based on local epidemiology; and
- Include input from clients and consumers, local and regional leadership, local planning bodies, AIDS service organizations, health departments and other community stakeholders.
It is the responsibility of the funded agency to develop one or more community assessment tools, or use established tools, to identify and prioritize HIV prevention concerns for the target community and specific populations of interest.
6.3.2 Community Mobilization Plan
Agencies must have a plan for mobilizing community resources to address the specific needs of the target population as indicated by the needs assessment. Agencies must have an established process for reassessing community needs and resources on a periodic basis. Agencies may use process and outcome monitoring to serve this purpose. See Section 24.7 Process and Outcome Monitoring in this document for more information. Funded agencies may adapt their community mobilization plan with DSHS approval and as guided by new information about community needs and resources.
The DSHS website contains information on
Community Assessment Tools and External Resources for Prevention Contractors.
Community Mobilization plans can include a variety of activities. Agencies are expected to create community mobilization plans for HIV prevention and submit them to DSHS for approval.
6.3.2.1 Examples of Community Mobilization Activities
Activities should draw on community resources and address community needs. The activities in a plan should complement each other as part of a coordinated effort to gain community support for changes that will reduce HIV incidence and increase access to care for People Living With HIV and AIDS (PLWHA).
Community Conversations
Community Conversations is a component of the Community Capacity Enhancement program (developed by the United Nations) and addresses the underlying causes of HIV/AIDS, including gender issues, stigma, and discrimination. The goal of Community Conversations is to empower communities and stakeholders and to build capacity within communities to address their HIV prevention needs. Community Conversations integrates individual and collective concerns and addresses attitudes and behaviors embedded in social systems and structures. This strategy relies on facilitation and strength identification rather than expert intervention. The steps of Community Conversations include relationship building, concern and problem identification, concern exploration, decision making, action, review and reflection.
Community Mobilization Campaigns
Community mobilization campaigns can include media campaigns, advocacy, coordination of community HIV prevention resources and other activities that bring together traditional and non-traditional partners to reduce new HIV infections. Homegrown approaches or community mobilization adaptations must incorporate the basic elements of the required program activities and address the goals noted above. All approaches to community mobilization must be approved by DSHS.
Large Scale Events
Large scale events should engage the target population while serving as an opportunity to gather information and start a dialogue about relevant HIV prevention issues and needs. The event may also provide social support for participants by allowing community members to gather around common issues. Community mobilization events are also intended to catalyze volunteer advocacy networks or action groups. The funded agency is responsible for assessing the impact of the event and post-event community activities.
6.4 Client and Community Engagement
By definition, community mobilization demands community participation beyond a single encounter. Clients, community members, and organizations are integral to community mobilization planning, implementation, and assessment. Funded agencies are required to solicit and maintain the involvement of community members throughout the lifecycle of community mobilization activities. Extended engagement may include ongoing involvement of a community advisory board or coalition, continuous training of volunteers to implement core community mobilization activities, and sustained efforts to enlist community advocates to promote HIV prevention and disseminate HIV awareness messages.
6.5 Multiple Levels of HIV Prevention and Behavior Change
Community mobilization for HIV prevention must address change at multiple socio-ecological levels, including individual (knowledge, attitudes, beliefs, and intentions), interpersonal contexts (social networks), organizational settings, and public policy.
Increasing the scale of HIV prevention intervention and mobilizing communities are mutually supportive activities that can be achieved through a variety of approaches. Funded agencies may adopt or create an effective model that matches their organizational resources, existing programming, and the local prevention landscape.
6.6 Coordinated Approach to HIV Prevention
As a component of community mobilization, funded agencies are to have a plan to create, enhance, or draw upon formal partnerships, coalitions, networks of individuals, and organizations to respond to the HIV prevention needs of their area. Agencies are to provide opportunities for these partners, networks, and coalitions to actively participate in the development and implementation of the community mobilization efforts for HIV prevention. These collaborations are intended to foster local change that supports HIV prevention priorities.
6.7 Process and Outcome Monitoring
Agencies are required to create and implement process and outcome monitoring plans designed to ensure adherence to their approved community mobilization program design and to effect appropriate adjustments in response to changes in the prevention landscape (following discussion and approval by DSHS). The design should include measures, data collection protocols, data analysis, and a process for program modification based on monitoring results. Information regarding tools on Outcome Monitoring can be found at the following DSHS website:
dshs.texas.gov/hivstd/fieldops/outcome.shtm
6.8 List of Helpful Websites and Websites Referenced in Chapter 6
Information regarding Health Service Delivery Area (HSDA) specific data can be found at the following website:
esbd.cpa.state.tx.us/bid_show.cfm?bidid=100382
Information regarding the most current epidemiological and surveillance reports can be found at the following DSHS website:
dshs.texas.gov/hivstd/reports/
Information regarding priority populations and risk behaviors and the Texas HIV/STD Prevention Plan can be found at the following DSHS website:
dshs.texas.gov/hivstd/planning/
Information regarding Community Assessment Tools and External Resources for Prevention Contractors can be found at the following DSHS website:
dshs.texas.gov/hivstd/fieldops/CommAssess.shtm
Information regarding Tools on Outcome Monitoring can be found at the following DSHS website:
dshs.texas.gov/hivstd/fieldops/outcome.shtm
Centers for Disease Control and Prevention:
cdc.gov
Health and Safety Code:
statutes.legis.state.tx.us/?link=HS
Texas Constitution and Statutes:
statutes.legis.state.tx.us/?link=HS
Texas Family Code:
statutes.legis.state.tx.us/?link=HS
U.S. Code:
law.cornell.edu/uscode/text
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