Evaluating CAB

Evaluating the implementation of Common Ambition Bristol to reduce HIV inequities in African and Caribbean heritage communities 

Summary

HIV inequities persist among UK African and Caribbean heritage communities (ACHC), leading to disproportionately high rates of HIV, late diagnosis and limited access to HIV testing and pre-exposure prophylaxis (PrEP) a pill taken to prevent you contracting HIV. The government set a goal of ending new HIV transmissions by 2030. Their 2021 HIV Action Plan emphases addressing ACHC HIV inequities and recommends i) culturally sensitive education programs, ii) reducing HIV stigma, iii) culturally sensitive community testing and iv) supporting community led initiatives. Bristol has a high HIV prevalence (2.5 per 1,000 population) and ACHC are disproportionately affected. In 2019 Bristol became an HIV Fast Track City, a global partnership between high-burden HIV cities where local authorities, NHS, community groups and academics collaborate to eradicate HIV inequity. From this collaboration, a Health Foundation grant was awarded to fund Common Ambition Bristol (CAB), a community powered project driven by the Project Delivery Group (PDG) (6 members of ACHC and four sexual health staff) working in equal partnership. The PDG co-produced and piloted interventions to tackle HIV stigma, increase ACHC HIV testing and PrEP access. The 4 CAB interventions are: multimedia resources; targeted health promotion; community outreach; and accessible testing. The COM-B behaviour change model informed intervention design and content. Bristol City Council secured extra funding for a further 14 months of intervention delivery after the Health Foundation funding ends (Jan 2024). This mixed methods study aims to comprehensively evaluate the impact of the co-production process, the longer-term intervention implementation, effectiveness, and cost of the interventions. There are 4 work packages (WP). WP1 investigates the co-production process via the views of PDG and PAG (Project Advisory Group consisting of all co-apps) members. WP2 examines CAB interventions implementation by exploring the experiences of those who are delivering and receiving CAB interventions and wider stakeholders. WP3 evaluates the impact of CAB interventions on HIV stigma, HIV testing and PrEP uptake among ACHC, by conducting a pre/post intervention ACHC stigma survey and examining patient record data and comparing this with control site Croydon. WP4 estimates how much the co-production process and interventions cost to develop and deliver, and if they may provide value for money. PPI is embedded throughout the project and informed the proposal which includes 6 ACHC PPI co-apps. CAB is community led co-production, which will continue throughout this proposal with the PDG co-optimising and co-implementing interventions. Our existing team of 6 PPI community researchers will examine intervention implementation via observation and interviews. Our 2 African Voices Forum (AVF) PPI co-apps will help with community engagement and dissemination. This is a 20-month study, with parallel data collection in the first 14 months and analyses and dissemination in the last 6 months. Academic impact will be conference presentations and peer-reviewed publications. We will inform ACHC members of the public of findings via communications developed with our partners and a public seminar. We will use our extensive links with stakeholders and policymakers to disseminate findings to inform development of the co-production approach in shaping initiatives in other locations nationally and internationally.

Further Information

https://www.fundingawards.nihr.ac.uk/award/NIHR159088