CVCT – Couples Voluntary Counseling and Testing. Spouses receive pre and post test counseling together. Results are disclosed to one another with a counselor present. INL – Influential Network Leader. Recognized leader in the community, trained in CVCT sensitization methods. INA – Influential Network Agent. Nominated by INLs, responsible for CVCT recruitment.
2004-2005 INA Study: success of this model is evidenced by the increase in couples testing at CVCT 2006-2007: the INA study ends and as a result CVCT uptake markedly diminishes 2008: new funding mandates a target of 10,000 couples tested per year. Through a major scale-up in the INA/INL program we are already beginning to see a major increase in couples testing at our sites
Web of influence as a tool in combating stigma towards hiv aids zambia emory hiv research project
Web of Influence as a Tool in
Combating Stigma Towards
Zambia-Emory HIV Research Project
Zambia Emory* HIV Research Project
Postnet 412,P/B E891,
Emmasdale, Lusaka, Zambia
*Emory University, Atlanta, Georgia, USA
• CVCT – Couples Voluntary Counseling
• CLO – Community Liaison Officer
• INL – Influential Network Leader
• INA – Influential Network Agent
• In 2004 ZEHRP adopted an innovative
promotional strategy of inviting couples for
voluntary counseling and testing (CVCT).
• This model uses community Influential Network
Leaders (INLs) from four sectors
• These influential persons are responsible for
selecting Influential Network Agents (INAs) who
are responsible for CVCT recruitment.
• Health Related
– Clinics, Home-based Care, Community Health
– Pastors, Church Elders, Christians/Muslims
– Schools, Clubs
– Markets, Trading Centers
• INLs provide feedback to ZEHRP on concerns
arising in their communities.
• INLs receive intensive training on community
sensitization methods for the endorsement of
• INLs are responsible for identifying Influential
Network Agents (INAs) from their sectors.
• One-on-one within the community
• Door to Door
• Public Endorsements
– Market Places
– Sporting Events
– Women’s Groups
– Work Places
• Attend an intensive 4 day training on
CVCT and recruitment methods.
• Responsible for CVCT recruitment through
use of an anonymous invitation system.
• Reimbursed per couple that chooses to
attend CVCT (whether or not they decide
• Given a 4 month contract.
– Exhaust their “Web of Influence”
One INA’s Web of Influence, , , .
Stigma in Zambia
• HIV is a stigmatized disease world wide and has
proven to be a challenge in Zambia.
• High levels of stigma discourage people from
testing, disclosing status, and accessing and
adhering to interventions such as ARVs and
• ZEHRP faces the additional challenge of
convincing couples of the benefits of testing and
being counseled together.
Couples Tested 2003-2007
* 2008 projection based on first quarter uptake and targets
2003 2004 2005 2006 2007 2008*
• In 2007 a total of 429 INAs and INLs were
• In 2007 over 9,280 invitations were distributed
by the INA/INLs. Out of these invitations 1,407
couples attended CVCT and 67% of couples
tested at ZEHRP.
• In 2008 INAs have already delivered 10,515
invitations with the target of testing 10,000
• In 2008, over 2,800 couples have attended
CVCT with over 2,300 choosing to test.
Key Findings cont.
• Through the utilization social networks and
community leaders, ZEHRP has built trust
and helped to change attitudes on
HIV/AIDS in the communities.
• The increase in CVCT uptake when the
INA/INL model was introduced, indicates
that this model is successful and that the
community based model is combating
Promotional strategies where community
leaders are the predominate
spokespersons of HIV/AIDS prevention
and treatment messages are most likely to
be successful and sustainable.
If stigma towards HIV/AIDS is to be
eliminated, a community-based, multi-
sectoral approach should be adopted that
draws influential leaders of the
communities to spearhead the
sensitizations on HIV/AIDS and the
promotion of VCT.