Community mobilization to modify harmful gender norms and reduce HIV risk: results from a community cluster randomized trial in South Africa.
Outcomes: Gender‑Based Violence, Human Immunodeficiency Virus
View SourceKey Social Norms Take-aways This study demonstrates that community mobilization (CM) can shift harmful gender norms among men, creating more supportive social environments for HIV prevention. However, changing norms did not immediately translate into reductions in risk behaviors, highlighting the complexity of transforming norms into action. The findings suggest that norm change may precede behavioral change and that longer intervention timelines or more direct focus on behavior change may be necessary. Engaging men directly proved more effective than attempting to shift women’s norms via the same strategy.
Objectives To evaluate the impact of a theory-driven community mobilization intervention aimed at modifying harmful gender norms to reduce HIV risk and intimate partner violence in rural South Africa.
Methods A cluster randomized controlled trial was conducted across 22 villages (11 intervention, 11 control) in Mpumalanga, South Africa. Serial cross-sectional household surveys were administered in 2012 (baseline) and 2014 (endline) among adults aged 18–35. The primary outcome was gender norms measured using the Gender Equitable Men’s Scale (GEMS). Secondary outcomes included intimate partner violence (IPV), condom use, number of sexual partners, and hazardous alcohol use. Data were analyzed using intent-to-treat and adjusted regression models accounting for clustering.
Intervention Details The intervention, adapted from Sonke Gender Justice’s One Man Can campaign, engaged community members—particularly men—through workshops, community events, leadership engagement, and community action teams. Activities covered gender equity, violence, alcohol abuse, HIV, relationships, human rights, and activism. The intervention was designed around six core domains of community mobilization, including raising shared concern, critical consciousness, leadership engagement, and building social cohesion. It aimed to reach 40% of the target population (men aged 18–35) over two years.
Results Among men, GEMS scores significantly improved in intervention communities compared to controls (2.7-point increase; p=0.01), indicating more equitable gender norms. No significant GEMS changes were observed among women. Behaviorally, women in intervention communities reported fewer sexual partners (AOR 0.29), and trends toward lower IPV victimization were noted (though not statistically significant). No significant behavior changes were found among men.
Conclusions Community mobilization can effectively shift men’s attitudes toward gender norms, a critical first step toward reducing HIV risk and gender-based violence. However, without corresponding behavioral shifts, the study underscores the need for longer-term interventions and more targeted strategies that bridge attitudinal change and behavior modification, especially among men. Future efforts should deepen focus on action-oriented components and ensure greater engagement of women.
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