A community participation intervention to reduce HIV/AIDS stigma, Nakhon Ratchasima province, northeast Thailand

Abstract

This paper explores HIV/AIDS stigma in the socio-cultural context of Nakhon Ratchasima Province in the northeastern region of Thailand. Action research was used to develop a community participation intervention. The intervention was implemented in one village over a period of eight months. We describe the intervention and then test its effect on HIV/AIDS knowledge and HIV/AIDS stigma using a non-equivalent pre-test-post-test control group design. Analysis of co-variance confirms that, controlling for initial levels of HIV/AIDS knowledge and stigma, the intervention had a significant effect on HIV/AIDS knowledge score (p<0.01) and HIV/AIDS stigma score (p<0.01). Participatory observations by the researchers on villagers’ perceptions and behaviour were consistent with the quantitative results. These results suggest that community interventions which empower the community, combined with a financial contribution to reduce resource constraints, are a useful and effective means of increasing interaction between people living with HIV/AIDS (PLWHA) and other community members, increasing tolerance and reducing HIV/AIDS stigma.

Acknowledgements

The authors acknowledge the Thai Health Promotion Foundation for funding this research. The authors are indebted to the people living with HIV/AIDS and villagers who willingly agreed to be interviewed and participate during the project. The paper has also benefited greatly from the comments of three anonymous referees. All errors and omissions are the responsibility of the authors.

Notes

1. The ANCOVA tests whether individuals with the same pre-test value of the variable will have the same post-test value of the variable, using treatment as a design factor. This is the most appropriate test to use given that individuals were not randomly drawn into the control or implementation groups (their selection into one group or the other depended on which village they lived in).

2. Community leaders included formal leaders such as the village headman and local government organisation members and informal leaders such as members of women's groups, youth groups, village health volunteer groups, temple health volunteer groups, elderly groups, village fund groups, healthcare providers, monks and teachers.

3. At the time of the study, the exchange rate was approximately US$1 = B40. The total grant was therefore approximately US$250.