This model, from the International HIV/AIDS Alliance, suggests bringing people with HIV, community stakeholders, and health providers together to develop partnerships, address gaps and difficulties, and support families and individuals.

Each member of the community has different roles to play in the community engagement process, which builds on their experience and strengths and coordinates activities in order to:

1. Mitigate the impact of stigma and discrimination on prevention, treatment, care, and support;
2. Increase community awareness and understanding of available HIV services;
3. Increase access to and use of services through referral systems and support;
4. Increase community understanding of the connections between prevention, care, and treatment;
5. Support individuals in successful use of treatment and preventive behaviours; and
6. Support health care workers in delivering services and ensuring that their own health needs are met.

Who should be involved in community engagement?

Key stakeholders should be chosen with gender balance in mind, and will typically include:

• Local health centre and HIV clinic staff;
• Networks of HIV-positive people including children and young people affected by HIV;
• Networks of marginalised groups (such as sex workers);
• Local decision-makers (such as councils and health committees);
• Home-based care providers;
• Youth leaders and young people themselves;
• School teachers and parents' representatives;
• Traditional leaders, educators, and healers;
• Pastors and others with moral and spiritual influence in the community; and
• Local employers and businesses such as pharmacies.

How does community engagement work in practice?

In Zambia the Antiretroviral Treatment, Community Education, and Referral (ACER) project has pioneered the Alliance approach since 2004. A referral system operates between home-based care providers, positive people's networks, traditional healers, youth groups, and antiretroviral (ARV) and health clinics. Treatment supporters, openly living with HIV, work in ARV clinics and coordinate partner activities in the community. This has encouraged high levels of treatment adherence, low drop-out rates, and reduced stigma.

In Uganda, the Alliance Networks Support Project has scaled up the approach, with over 80 openly HIV-positive support agents providing adherence support in clinics and communities. They operate a referral system with stakeholders to identify those in need of care and support, linking them to appropriate services and providing ongoing support. Local networks of people with HIV also link with other services for care, food, and economic strengthening.

In the Caribbean, the Alliance supports peer groups of people with HIV to use community engagement tools to develop a dialogue with health providers, leading to reduction in stigma and significant improvements in the quality of health care. This in turn has helped to mitigate the effects of stigma and improve community perceptions of people with HIV.

[Text for this summary courtesy of the International HIV/AIDS Alliance.]