CSO: civil society organization, *Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials [1]. **GPP Blueprint for Stakeholder Engagement (AVAC) [7].
Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted
This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror Good Participatory Practice (GPP) goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.
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