Valuing community input

The theme of World AIDS Day on 1 December 2023 was ‘Let communities lead’. This was a very welcome theme because it acknowledged that programmes for HIV prevention and initiatives for HIV treatment and care have been driven by those communities that have been impacted the most. Health providers need to listen and engage with local and national communities to ensure that interventions are appropriately targeted. To allow communities to lead, it is essential that they are part of the discussions.

In its simplest form, ‘community’ has been defined as involving geographical nearness, similarities in characteristics and the sharing of attitudes and interests towards a particular topic. However, this can be seen as too simplistic in its approach because wider communities have micro-communities that exist within them.

Over two decades ago, MacQueen and colleagues explored what community was and how to define participation in public health with relation to HIV vaccine trials (MacQueen et al, 2001). Unsurprisingly, they found that community meant different things to different people, but core elements included joint action, locus, sharing, social ties and diversity as being important. Twenty-one years later, Harting and colleagues undertook a critical review, exploring participation in health promotion activities, finding that it can be transformative and empowering for marginalised communities and confirming that many of the core elements from 20 years prior still exist (Harting et al 2022).