Community-based research: Improving access to PrEP

Lukas Buri, Nurse, Checkpoint Vaud

The prominence given to community-based approaches at IAS 2024 demonstrates the vitality of the various communities in the defence of sexual rights for all. The plenary session on HIV prevention strategies also highlighted their importance, with a presentation by Dulce Ferraz (Fundação Oswaldo Cruz, Fiocruz, Brazil and Institut de psychologie, Université Lumière Lyon 2, France). Her talk presented the community-based research method and its use to understand the factors that facilitate or limit access to PrEP for key populations.

The basic principle of community-based research is that communities are experts! All the knowledge and skills built up by the communities must be recognised as basic entities for producing new scientific knowledge. The different types of knowledge mobilised (experiential, technical, theoretical, methodological) in community-based research are treated horizontally. The aim is also to achieve a continuous balance of power between academic experts and community experts. Another important principle of this methodology is that it is based on an understanding of the needs of the communities, involving a participatory approach at all stages of the research (in terms of developing the research questions, methodology, data collection, use of the results and their communication).

Although this research methodology had already been used in the 1940s, it was in the 1980s, in response to the urgency inherent in the HIV/AIDS crisis, that community-based research progressed and was systematised as a methodological tool in the field of public health.

This innovation is linked to the community leadership that enabled responses to HIV (such as condom use and safer sex rules) to be developed before they were recognised as effective by scientific collectives. An even more important element inherent in community involvement is the development of the notion of a human rights-based response to HIV. Community struggles have highlighted the fact that lack of access to information, prevention and treatment is not the result of technical limitations but of political decisions that can only be overcome by integrating the notion of human rights and solidarity into the development of health policies.

It is therefore important to include, now and in the future, the voice of communities, their skills and their knowledge in scientific research processes whose scope will enable political and social changes to be made to give full access to human rights for all.

Ducle Ferraz is currently conducting a literature review (in progress) on the facilitating factors and obstacles to making PrEP accessible to key populations. One of her previous publications can be consulted at the following address:

https://pubmed.ncbi.nlm.nih.gov/35876978/

To find out more about community-based research, an article outlining the key principles is available at the following address:

https://doi.org/10.1146/annurev.publhealth.19.1.173