Culturally-Embedded Extraordinary Positive Deviant Stories Inspire HIV/AIDS Dialogue, Behavioral and Normative Change

Objective:Program aims to promote gender equity, HIV/AIDS prevention and treatment adherence, participatory development and collective action through behavior change.

Methods:HIV/AIDS Prevention Gender Tool: Tchova-Tchova Histórias da Vida (TTHV) is used to facilitate social and behavioral change through community dialogue in which risk factors are discussed and explored, and participants critically examine how social/gender norms operate in their own lives, their families and communities. The tool consists of video profiles depicting “positive deviant” men, women and couples telling how they overcame gender, cultural and social barriers to make positive changes in their lives with a specific focus on HIV prevention and treatment. Community facilitators lead interactive sessions to accompany the profiles that explore how gender norms have impacted HIV and health and how to overcome them and adopt positive behavior.

Results:In post-only survey with non-equivalent control group, participation in TTHV sessions showed significant positive effect on sharing household tasks between genders. Participants also had higher rates of communicating with their partner about HIV and/or sexual behavior and of correctly identifying prevention methods. Participants were significantly less likely to report multiple sexual partners.

Qualitative evaluation through focus groups showed very positive reception of the program and its messages. Participants appreciated opportunities to raise questions and express opinions, felt discussions increased social cohesion and trust among community members, and felt program messages had improved the quality of couples' interpersonal relationships. .

Conclusions:Culturally embedded social modeling and community dialogue contributed to deeper understanding of HIV risk and provided credible and actionable catalysts for change.