title: The role of community conversations in facilitating local HIV competence: case study from rural Zimbabwe.
abstract: BACKGROUND
  This paper examines the potential for community conversations to strengthen positive responses to HIV in resource-poor environments. Community conversations are an intervention method through which local people work with a facilitator to collectively identify local strengths and challenges and brainstorm potential strategies for solving local problems.
  
  
  METHODS
  We conducted 18 community conversations (with six groups at three points in time) with a total of 77 participants in rural Zimbabwe (20% HIV positive). Participants were invited to reflect on how they were responding to the challenges of HIV, both as individuals and in community groups, and to think of ways to better support openness about HIV, kindness towards people living with HIV and greater community uptake of HIV prevention and treatment.
  
  
  RESULTS
  Community conversations contributed to local HIV competence through (1) enabling participants to brainstorm concrete action plans for responding to HIV, (2) providing a forum to develop a sense of common purpose in relation to implementing these, (3) encouraging and challenging participants to overcome fear, denial and passivity, (4) providing an opportunity for participants to move from seeing themselves as passive recipients of information to active problem solvers, and (5) reducing silence and stigma surrounding HIV.
  
  
  CONCLUSIONS
  Our discussion cautions that community conversations, while holding great potential to help communities recognize their potential strengths and capacities for responding more effectively to HIV, are not a magic bullet. Poverty, poor harvests and political instability frustrated and limited many participants' efforts to put their plans into action. On the other hand, support from outside the community, in this case the increasing availability of antiretroviral treatment, played a vital role in enabling communities to challenge stigma and envision new, more positive, ways of responding to the epidemic.
authors.affiliation: Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE London, UK. c.campbell@lse.ac.uk
authors.forename: Catherine
authors.initials: C
authors.lastname: Campbell
authors.forename: Mercy
authors.initials: M
authors.lastname: Nhamo
authors.forename: Kerry
authors.initials: K
authors.lastname: Scott
authors.forename: Claudius
authors.initials: C
authors.lastname: Madanhire
authors.forename: Constance
authors.initials: C
authors.lastname: Nyamukapa
authors.forename: Morten
authors.initials: M
authors.lastname: Skovdal
authors.forename: Simon
authors.initials: S
authors.lastname: Gregson
mesh_terms: D057191:Capacity Building; D003142:Communication; D018672:Community Health Planning / Q000379:methods*; D019058:Community Networks; D055812:Community-Based Participatory Research; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D019982:Organizational Case Studies; D011204:Poverty Areas; D012424:Rural Population; D012932:Social Facilitation; D057545:Social Stigma; D012944:Social Support; D015030:Zimbabwe