The most effective woman-initiated method to prevent HIV/sexually transmitted infections is the female condom (FC). Yet, FCs are often difficult to find and denigrated or ignored by community health and service providers. Evidence increasingly supports the need to develop and test theoretically driven, multilevel interventions using a community-empowerment framework to promote FCs in a sustained way. We conducted a study in a midsized northeastern US city (2009-2013) designed to create, mobilize and build capacity of a community group to develop and implement multilevel interventions to increase availability, accessibility and support for FCs in their city. The Community Action and Advocacy Board (CAAB) designed and piloted interventions concurrently targeting community, organizational and individual levels. Ethnographic observation of the CAAB training and intervention planning and pilot implementation sessions documented the process, preliminary successes, challenges and limitations of this model. The CAAB demonstrated ability to conceptualize, plan and initiate multilevel community change. However, challenges in group decision-making and limitations in members' availability or personal capacity constrained CAAB processes and intervention implementation. Lessons from this experience could inform similar efforts to mobilize, engage and build capacity of community coalitions to increase access to and support for FCs and other novel effective prevention options for at-risk women.

译文

由妇女发起的预防艾滋病毒/性传播感染的最有效方法是女用避孕套 (FC)。然而,社区卫生和服务提供商通常很难找到、诋毁或忽视社区卫生和服务提供商。越来越多的证据支持需要使用社区赋权框架来开发和测试理论驱动的多层次干预措施,以持续的方式促进FCs。我们在美国东北部中型城市 (2009-2013) 进行了一项研究,旨在创建,动员和建设社区团体的能力,以开发和实施多层次干预措施,以增加其城市中FCs的可用性,可及性和支持。社区行动和倡导委员会 (CAAB) 同时针对社区,组织和个人级别设计并试行了干预措施。对CAAB培训和干预计划以及试点实施会议的人种学观察记录了该模型的过程,初步成功,挑战和局限性。CAAB表现出了概念化,计划和发起多层次社区变革的能力。但是,小组决策中的挑战以及成员可用性或个人能力的限制限制了CAAB流程和干预实施。从这一经验中吸取的教训可以为动员、参与和建设社区联盟能力的类似努力提供信息,以增加对FCs和其他针对高危妇女的新型有效预防选择的机会和支持。

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