Examining Mediators of the Relationship Between Community Mobilization and HIV Incidence Among Young South African Women Participating in the HPTN 068 Study Cohort

AIDS Behav. 2022 May;26(5):1347-1354. doi: 10.1007/s10461-021-03491-7. Epub 2021 Oct 19.


We previously demonstrated that village community mobilization (CM) was associated with reduced HIV incidence among adolescent girls and young women (AGYW) in South Africa. Little remains known about the mechanisms linking CM to HIV incidence. Using longitudinal data from 2292 AGYW in the HPTN 068 cohort (2011-2017), we examined whether school attendance, pro-social engagement, and hope for the future mediated the relationship between CM and HIV incidence. CM was measured at the village-level via two population-based surveys (2012 and 2014). Mediators and incident HIV infection were measured through HPTN 068 surveys and HIV testing. Mediation analyses were conducted using Mplus 8.5, adjusting for village-level clustering and covariates. Hope for the future mediated the relationship between CM and HIV incidence (indirect effect-RR 0.98, bias-corrected 95% CI 0.96, 0.99). Pro-social engagement and school attendance did not demonstrate indirect effects. CM reduces AGYW's HIV acquisition risk, in part, by engendering hope.

Keywords: Adolescent girls and young women; Community mobilization; HIV prevention; Hope for the future; South Africa.

MeSH terms

  • Adolescent
  • Black People
  • Cohort Studies
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Humans
  • Incidence
  • Sexual Behavior
  • South Africa / epidemiology