Introducing the D4 Diagnostic Quadrant as a targeting tool: developing a framework for the effectiveness of HIV/AIDS interventions in Tanzania and beyond

Article

<< Previous

Next >>

Online Early

doi:10.1071/PY12034

The issues influencing community health services and primary health care

	Search




	Advanced Search



	Journal Home

	About the Journal

	Editorial Board

	Contacts



	Content

	Online Early

	Current Issue

	Just Accepted

	All Issues

	Special Issues

	Sample Issue



	For Authors

	General Information

	Instructions to Authors

	Submit Article



	For Referees

	Referee Guidelines

	Review Article

	Annual Referee Index



	For Subscribers

	Subscription Prices

	Customer Service

	Print Publication Dates

e-Alerts

Subscribe to our email Early Alert or

feeds for the latest journal papers.

Connect with us

Introducing the D4 Diagnostic Quadrant as a targeting tool: developing a framework for the effectiveness of HIV/AIDS interventions in Tanzania and beyond

Andre M. N. Renzaho ^A ^C ^D ^E and Matthew Clarke ^B

^A World Vision Australia, 1 Vision Drive, East Burwood, Vic. 3151, Australia.
^B School of Humanties and Social Sciences, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia.
^C Present address: Migration, Social Disadvantage, and Health Programs, Monash University, Level 3, Burnet Building, 89 Commercial Road, Melbourne, Vic. 3004, Australia.
^D Present address: Centre for International Health, Burnet Institute, Level 3, Burnet Building, 89 Commercial Road, Melbourne, Vic. 3004, Australia.
^E Corresponding author. Email: andre.renzaho@monash.edu

Australian Journal of Primary Health - http://dx.doi.org/10.1071/PY12034
Submitted: 27 March 2012 Accepted: 20 June 2012 Published online: 4 September 2012





	PDF (263 KB) $25



	Export Citation

Print

Abstract

The current study develops and evaluates a tool to distinguish four different categories of educators for the effective delivery of HIV/AIDS health education using data from 548 randomly selected participants aged 16 years. The D4 Diagnostic Quadrant is based on HIV knowledge and sexual practice behaviours and indicates four distinct typologies of educator. The discerning educator has high HIV/AIDS knowledge and healthy sexual practices. The dissolute educator has high HIV/AIDS knowledge but employs unhealthy or risky sexual practices. The decorous educator has low HIV/AIDS knowledge but practices healthy sexual practices. The disempowered educator has low HIV/AIDS knowledge and employs unhealthy or risky sexual practices. The study found that the two categories that will result in the most effective behaviour-change interventions are those that target ‘discerning’ and ‘decorous’ individuals as the educators. Both these categories have underlying healthy practices that minimise the risk of HIV transmission. The D4 Diagnostic Quadrant tool provides information as to existing knowledge and beliefs about HIV/AIDS that can inform decisions relating to the allocation of scarce resources. The tool will be very useful in the selection process of would-be educators particularly in health-promotion interventions.

Additional keywords: behaviour change, peer training.

References

Carey M, Morrison-Beedy D, Johnson B (1997) The HIV-Knowledge Questionnaire: development and evaluation of a reliable, valid, and practical self-administered questionnaire. AIDS and Behavior 1, 61–74.
| CrossRef |

Clarke M (2002) Achieving behaviour change: three generations of HIV/AIDS programming and jargon in Thailand. Development in Practice 12, 625–636.
| CrossRef |

Dixon S, McDonald S, Roberts J (2002) The impact of HIV and AIDS on Africa’s economic development. BMJ (Clinical Research Ed.) 324, 232–234.
| CrossRef |

Feldblum PJ, Kuyoh M, Omari M, Ryan KA, Bwayo JJ, Welsh M (2000) Baseline STD prevalence in a community intervention trial of the female condom in Kenya. Sexually Transmitted Infections 76, 454–456.
| CrossRef | CAS |

Feldblum PJ, Kuyoh MA, Bwayo JJ, Omari M, Wong E, Tweedy K, Welsh M (2001) Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya. AIDS 15, 1037–1044.
| CrossRef | CAS |

Fields SD (2005) Adaptation of an existing HIV knowledge questionnaire for use with young men of color who have sex with men. Journal of Multicultural Nursing and Health 11, 47–55.

Gonzalo T, Goñi MG, Muñoz-Fernández MA (2009) Socio-economic impact of antiretroviral treatment in HIV patients. An economic review of cost savings after introduction of HAART. AIDS Reviews 11, 79–90.

Ilinigumugabo A (1996) The economic consequences of AIDS in Africa. African Journal of Fertility, Sexuality, and Reproductive Health 1, 153–161.

Kinsman J, Nakiyingi J, Kamali A, Carpenter L, Quigley M, Pool R, Whitworth J (2001) Evaluation of a comprehensive school-based AIDS education programme in rural Masaka, Uganda. Health Education Research 16, 85–100.
| CrossRef | CAS |

Klepp KI, Ndeki SS, Leshabari MT, Hannan PJ, Lyimo BA (1997) AIDS education in Tanzania: promoting risk reduction among primary school children. American Journal of Public Health 87, 1931–1936.
| CrossRef | CAS |

MacCallum RC, Zhang S, Preacher KJ, Rucker DD (2002) On the practice of dichotomization of quantitative variables. Psychological Methods 7, 19–40.
| CrossRef |

Mfinanga GS, Ngadaya E, Kimaro G, Mtandu R, Lema LA, Basra D, Lwila F, Egwaga S, Kitua AY (2008) Capacity of healthcare facilities in the implementation of Direct Observed Treatment strategy for tuberculosis in Arumeru and Karatu districts, Tanzania. Tanzania Journal of Health Research 10, 95–98.
| CrossRef | CAS |

National AIDS Control Program (2004) HIV/AIDS: STDI Surveillance Report. Ministry of Health, Government of Tanzania.

Parnell B, Benton K (1999) ‘Facilitating sustainable behaviour change.’ (Macfarlane Burnet Centre for Medical Research: Melbourne)

Peltzer K, Promtussananon S (2005) HIV/AIDS knowledge and sexual behavior among junior secondary school students in South Africa. Journal of the Social Sciences 1, 1–8.
| CrossRef |

Renzaho AMN, Pallotta-Chiarolli M (2009) Commercial sex work, survival sex, sexual violence and HIV/AIDS prevention in Arumeru district, Arusha region of Tanzania. The Open Tropical Medicine Journal 2, 27–38.
| CrossRef |

Stigler MH, Kugler KC, Komro KA, Leshabari MT, Klepp KI (2006) AIDS education for Tanzanian youth: a mediation analysis. Health Education Research 21, 441–451.
| CrossRef |

Tanzania Commission for AIDS (2006) HIV/AIDS in Tanzania. Available at http://www.tanzania.go.tz/hiv_aids.html [Verified 12 August 2010]

Tanzania Commission for AIDS, Zanzibar AIDS Commission, National Bureau of Statistics, Office of Chief Government Statistician, Macro International (2008) Tanzania HIV/AIDS and Malaria Indicator Survey 2007–08. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc.

Tibaijuka AK (1997) AIDS and Economic Welfare in Peasant Agriculture: Case Studies from Kagabiro Village, Kagera Region, Tanzania. World Development 25, 963–975.
| CrossRef |

UNAIDS (2009) Joint United Nations Programme on HIV/AIDS and World Health Organization. AIDS epidemic update. UNAIDS/09.36E/JC1700E. UNAIDS, Geneva.

WHO, UNAIDS, UNICEF (2009) Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report 2009. World Health Organization, Geneva.

World Bank (1999) ‘Confronting AIDS: public priorities in a global epidemic.’ (Oxford University Press: Oxford)

World Health Organization (2005) United Republic of Tanzania: summary country profile for HIV/AIDS treatment scale-up: WHO Country Office for the United Republic of Tanzania and the WHO Regional Office for Africa. Available at http://www.who.int/hiv/HIVCP_TZA.pdf [Verified 20 January 2007]

Subscriber Login

	Username: Password:

Legal & Privacy | Contact Us | Help