Applying the Diffusion of Innovation Model to HIV Testing in Two African Cities Pubblico
Reid, Jennifer Allison (2012)
Published
Abstract
Abstract
Applying the Diffusion of Innovation Model to HIV Testing in Two
African
Cities
Objectives: The purpose of this study was to determine the
effectiveness of the INA promotional
strategy in promoting couples' voluntary counseling and testing in
Lusaka, Zambia and Kigali,
Rwanda. The INA model was based in the diffusions of innovation
model. Secondary objectives
were to determine the spread of CVCT through the cities, explore
the difference in decision to
test between couples with invites and those without, and the effect
of other promotional
strategies.
Design: INAs were recruited from faith‐based, health,
private, and community‐based
organizations. INAs were given training in CVCT methodology and
given invitations to give to
potential clients.
Methods: All couples attending CVCT clinics were given in taken
surveys. A subset of couples
were also given more detailed surveys. Descriptive statistics and
chi‐squared tests were
calculated based on these data.
Results: In Kigali, 43% of couples attending CVCT clinics had INA
invitations. Among couples with
invites, 91% decided to test compared to 84% among couples without
testing (p‐value <0.001).
Previous individual HIV testing increased between 2003‐2008,
from 37 to 53% in men and from
45 to 71% in women. Additionally, prior joint testing also
increased from 6% in 2005 to 28% in
2008.
In Lusaka, 68% of couples attending CVCT clinics had INA
invitations. Among couples with
invites, 79% decided to test compared to 88% among couples without
testing (p‐value <0.001).
Prior individual HIV testing increased between 2005 and 2009, from
24 to 33% in men and from
38 to 63% in women but joint HIV testing remained the same at
around 4%.
Conclusions: The INA promotional strategy was important for
attracting couples to attend CVCT
clinics in both cities. In Kigali, those with INA invites were more
likely to test than those without
invites while in Lusaka the reverse was true. The increase in joint
testing over the years in Kigali
demonstrates the diffusion of the CVCT model through the city. The
low numbers in Lusaka
demonstrate the lack of diffusion. A possible explanation is that
Lusaka is a much larger and
more heterogeneous city than Kigali which makes it harder for a new
idea to spread.
Table of Contents
Table of Contents
Chapter 1: Introduction . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .1
Chapter 2: Comprehensive Literature Review . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .4
Table A: Recent Articles using the Diffusion of Innovations Model .
. . . . . . . . . . . . . . . . 9
Chapter 3: Manuscript . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . 13
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 15
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .16
Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 18
Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 20
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 22
References . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .27
Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .28
Chapter 4: Discussion, Conclusion, and Recommendations . . . . . .
. . . . . . . . . . . . . . . . .33
References . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .36
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