Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India

Am J Community Psychol. 2009 Jun;43(3-4):277-91. doi: 10.1007/s10464-009-9241-0.


This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Catchment Area, Health
  • Community Health Services / organization & administration*
  • Extramarital Relations
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control*
  • Humans
  • India / epidemiology
  • International Cooperation*
  • Male
  • Marriage / statistics & numerical data
  • Preventive Health Services / organization & administration*
  • Risk Factors
  • Risk-Taking
  • Sexually Transmitted Diseases / epidemiology
  • United States / epidemiology
  • Young Adult