Investing in Communities: Evaluating the Added Value of Community Mobilization on HIV Prevention Outcomes Among FSWs in India

Community mobilization often requires greater time and resource investments than typical interventions, yet few evaluations exist to justify these investments. We evaluated the added benefit of community mobilization on HIV prevention outcomes among female sex workers (FSWs) using a composite measure of volunteer participation in program committees by FSWs. After adjusting for treatment propensity, we used multilevel structural equation modeling (MSEM) to test our program theory. We hypothesized that stronger community mobilization would be associated with increased levels of consistent condom use and with increased levels of perceived fairness, mediated by psychosocial processes. Community mobilization had an indirect effect on consistent condom use mediated through social cohesion and an indirect effect on perceived fairness mediated by collective efficacy. Our results suggest higher levels of community mobilization help improve condom use and reduce perceived discrimination beyond the effects of the core HIV intervention program. We recommend further testing of this model.