Utilizing an HIV community advisory board as an agent of community action and health promotion in a low-resource setting: a case-study from Nova Iguaçu, Rio de Janeiro, Brazil

摘要

Introduction: Brazil’s HIV burden has greatly increased over the past decade, especially for socially marginalized and vulnerable groups such as adolescents, women, and men who have sex with men. The reasoning for worsening HIV outcomes is complex, but ongoing economic and political crises have placed extreme operational and financial burdens on both the public health system and HIV-related civil society, affecting both treatment and prevention efforts and delivery. Context: Community-based HIV-related health-promotion activities have continued in Nova Iguaçu, Rio de Janeiro, despite these setbacks. These efforts have been led by a semi-independent community advisory board and engagement group based at the Hospital Geral de Nova Iguaçu with support from researchers based at the Oswaldo Cruz Foundation. Methods: The research team supported, documented, and participated in various activities led by the community advisory board and engagement group from 2017–2018 including meetings, community workshops/lectures, production of health promotion materials, and the dissemination of research findings. Results: The research team utilized the concepts of vernacular knowledge and critical pedagogy to describe and document the ongoing, bottom-up approach, community-led efforts of the community advisory board and engagement group. In particular, we describe the process of stakeholder engagement, popularization of research results, and resource sharing spearheaded by the community advisory board in Nova Iguaçu. Conclusion: The community advisory board demonstrates how community-led efforts are essential to HIV and AIDS response efforts in light of worsening HIV burdens and global shifts towards biomedicalization. Their HIV-related activities rely on existing community networks and resources with secondary support from a research team. This illustrates a key intervention point between traditional research and an empowering community mobilization that can inform similar efforts in other low-resource settings.