Influence of Participatory Negotiation on Performance of HIV/AIDS Community Health Projects in Kisumu County, Kenya

The United Nations has noted with concern that around 38.5 million across the globe live with HIV/AIDS. Globally, HIV/AIDS community health projects have been implemented and has influenced significantly the health sector with government and NGOs working together to shape agendas related to health. Therefore, there are efforts to combat HIV/AIDS internationally through Sustainable Development Goal and intensification of efforts to reinvigorate the global community. Based on the foregoing, the study examined how Participatory negotiation influences performance of HIV/AIDS community health projects implemented by Non-Governmental Organizations in Kisumu County, Kenya. This study was grounded on stakeholder’s theory as well as theory of change because the HIV/AIDS community health projects in Kenya is a results-oriented. The research design was descriptive cross-sectional survey which allows the use of both qualitative and quantitative methodologies of gathering data. The target population for this study will be a total of 30,118 comprising 59 monitoring and evaluation officers, 59 project managers and 30,000 beneficiaries of the HIV/AIDS community projects in Kisumu County. The study will purposively select 59 HIV/AIDS project managers and 59 Monitoring and evaluation officers. Using Krejcie and Morgan (1970) formula, the study used a sample size of 379 beneficiaries selected through simple random sampling technique. The study used structured questionnaire to collect quantitative data. Quantitative data was analyzed by using descriptive statistics of frequencies, percentages, mean score and standard deviation with results tabulated and presented on tables and graphs, as well as inferential statistics of Pearson correlation analysis and regression analysis. The simple linear regression coefficients as well as the Pearson correlation results indicated that there was significant effect of Participatory negotiations on Performance of HIV/AIDs Community Health Projects. The small p-values; implied that there was a significant effect of Participatory negotiations on Performance of HIV/AIDs Community Health Projects. The project managers and M&E officers should design appropriate implementation strategies for the health projects that will enable Participatory negotiation practices to be properly implemented in order to enhance performance of community HIV/AIDS health projects.

Introduction

Participatory negotiation refers to the thought process based on the understanding that a ‘negotiated process’ relates to the repackaging of a technological design within the local parameters by local stakeholders. Studies expounding on this view have resulted in literary discourse with a stimulating effect on the principle that development interventions should be considered part of the social change process and not the whole (Chennevilleet al., 2019). Efforts are still required in the United States to lower the HIV burden among African American youth. The negotiation process requires players to be willing to interact and make significant offers and counteroffers. According to Safari and Kisimbii (2020), the involvement of stakeholders in any intervention programs, involvement of the stakeholders in M&E processes similarly influences the performance trajectory of these projects. As part of development-oriented bargaining, local negotiators implement a package based on local needs and requirements (Parker & Becker-Benton, 2016). Parker and Becker-Benton (2016) study addressed how participatory communication has been used in HIV prevention studies around the world and using qualitative methodology studied in Asia, the Caribbean, and Africa. The study aided in developing knowledge-sharing channels to address health issues. It included identifying crucial areas, conceptualizing potential obstacles, promoting change, understanding the present knowledge mobilization process, and selecting appropriate communication techniques. The findings of Parker and Becker-Benton (2016) revealed that participatory negotiations in HIV-related projects enhance project ownership, constructive criticism, and knowledge-based change. However, this study considered the use of resolved points of difference and concessions to attain agreements as markers of performance in HIV/AIDS community health project implemented by NGOs in Kisumu County, Kenya.

Statement of the Problem

Participatory negotiation allows the involvement of implementers of the PM&E Process of HIV/AIDS community health projects through the level of resolved points of difference, level of making concessions to achieve agreements, degree of negotiations, implementation of negotiated solutions, and level of professional negotiators (Parker & Becker-Benton, 2016). In Kisumu and Homabay Counties, HIV/ AIDS prevalence is at 17.5% and 26.0%, respectively, compared to the national level of 4.9% despite HIV/AIDS program interventions (NACC, 2021). The National Aids and STIs Control Programme (NASCOP, 2021) report exposed Kisumu County with the highest number of new infection cases at 4,661 compared to Homabay, which recorded 4434, Siaya County at 3689, Kakamega at 2681 and Vihiga at 3152. These new infections in Kisumu County of age 15 and 24 years accounted for 30% of the new cases. A study by Onyangoet al. (2021) on HIV predominance among the deceased in the two busy mortuaries in Kisumu found that 28.5% of decedents were HIV positive (19% adults and 11% children) as the main reason for death. Deekset al. (2021) explain that the success of ART for PLHIV is a long-life treatment and currently complete cure medication not established, given HIV assimilates in the host and continues for a life span. This has elicited major concern among partners in the healthcare sector, given that various multi-sectoral agencies are working to reduce the HIV/AIDs scourge in Kisumu County. There is an effort to increase the effectiveness and performance of HIV/AIDS intervention projects, and the Kenya AIDs Control Council proposed Participatory negotiation when designing and implementing HIV community health projects. However, there is scanty evidence on how Participatory negotiation influences the performance and progress of HIV/AIDS community health projects hosted by NGOs in Kisumu County. The present study sought to answer the question of the effects of participatory negotiation and the performance of HIV/AIDS community health projects implemented by NGOs in Kisumu County.

Theoretical Background

The Stakeholder Theory

Stakeholder theory, established by Hein Kroos and Klaus Schwab in 1971, serves as a management tool to identify project stakeholders and assign responsibilities, legitimacy, and power (Hwang & Ng, 2013). It provides a framework for understanding stakeholder impact on projects, emphasizing the importance of community support and active participation for success (Harrison & Freeman, 1999). Harvey and Reed (2007) highlight that beneficiary involvement enhances project ownership, ensuring continuation beyond implementation. This theory is crucial for HIV/AIDS projects in Kisumu County, emphasizing participatory negotiation for better outcomes. Critics like Barney and Harrison (2020) argue that balancing diverse stakeholder needs is challenging, often leading to conflicts due to incompatible objectives.

Theory of Change

Theory of Change (ToC), proposed by Carol Weiss (1995), explains the success mechanisms of interventions, emphasizing strategies over mere information gathering about project effectiveness (Cox, 2009). ToC provides a blueprint for project execution, detailing procedures to achieve desired outcomes and evaluating a project’s unique contributions (Msila & Setlhako, 2013). It links intended impacts, quantifiable cumulative benefits, and overall goals, explaining how and why activities lead to improvements. The theory’s core tenet is that by clearly outlining a project’s objectives, execution, and rationale, staff and assessors can measure and compare outcomes to the original ToC (Alcock, 2009). For HIV/AIDS community health initiatives, ToC ensures performance by understanding success factors and avoiding mere replication of interventions (Mackay, 2007). In this study, ToC is applied through project managers deliberate efforts to use stakeholder feedback from participatory negotiations to refine actions and processes for optimal outcomes. This theory clarifies evaluation metrics and processes, aiding in developing best practice models by tracking project modifications and participatory M&E impacts on effectiveness. Critics argue that ToC benefits organizations only if they are open to learning and adapting their methods and thinking (Wunderet al., 2020). Without this openness, ToC becomes a “box-ticking exercise” rather than a meaningful strategy, and while some may believe ToC simplifies monitoring and evaluation, it values information collection as much as any other approach.

Performance of HIV/AIDS Community Health Projects

Project performance is measured by meeting cost, time, and quality expectations. This study explores Participatory Monitoring and Evaluation processes—participatory decision-making, negotiations, and action research—as factors influencing the performance of HIV/AIDS community development projects (Perry & Zulliger, 2012). Key performance indicators include relevance, effectiveness, efficiency, timeliness, impact, and sustainability, helping stakeholders achieve project goals and positive outcomes. Research by Obudho Simon and Mwenda (2021) highlighted the importance of planning, community involvement, sufficient funding, and committed leadership in enhancing health project performance. Engaging communities empower them through training and resource provision, improving HIV counseling and screening services (UNAIDS, 2020). In Sub-Saharan Africa, collaboration between the state and NGOs on health projects has significantly impacted regional policy development, addressing HIV/AIDS challenges (WHO, 2020). Project failure often receives more attention than success in project management, but many studies focus on elements influencing performance. Researchers like Naomi (2018) have explored indicators of NGO success and their impact on HIV program achievements. Factors such as project design, budget accuracy, timelines, funding security, communication efficiency, institutional strength, and risk management are key determinants of project performance. This study examines how participatory negotiation affects the performance of HIV/AIDS community health projects by NGOs in Kisumu County.

Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

The study on the HIV/AIDS Prevention Project for Youth (Project HAPPY) by Hollidayet al. (2020) utilized a community-based participatory research (CBPR) approach. Challenges such as recruitment, partner commitment, and retention arose during implementation. The study explored conducting HIV prevention with urban teens and offered solutions like conducting periodic community inventories to prevent service saturation, preparing for substitute partner engagement, consulting with the Institutional Review Board to avoid delays, selecting relevant incentives, and maintaining communication with community partners. However, it did not address the moderating effects of regulatory frameworks, mixed methods, and stakeholders’ theory, which this study will examine. Additionally, this research will focus on participatory negotiations and indicators for reaching agreements on the performance of HIV/AIDS community health projects by NGOs in Kisumu County, Kenya. Safaei (2018) examined deliberative democracy in healthcare, using Canada as a case study, to identify obstacles and opportunities for advanced countries through a qualitative literature review of 56 studies.

The study identified several challenges in healthcare, including inadequate financial motivation, healthcare costs, differing decision-making views, practical feasibility, professional interests, informational imbalances, and contextual factors. Safaei (2018) highlighted opportunities such as clear policy engagement, authority commitment, evidence documentation, patient decision-making modules, professional training on shared decision-making, and flexible leadership engagement. However, it did not consider participatory negotiation indicators affecting HIV project performance. This study will examine resolving differences, making concessions, mixed methods, program theory, and the moderating influence of bylaws on community HIV/AIDS projects by NGOs in Kisumu County, Kenya.

Diaset al. (2018) explored participatory HIV research with sex workers and gays in Botswana, analyzing the project’s socio-behavioral impacts. Using qualitative focus group discussions, they evaluated the project’s processes, highlighting the advantages and disadvantages of participatory methods, which led to transformative collaborations among community organizations, health professionals, and policymakers. The study demonstrated participatory research’s effectiveness in co-producing community health initiatives but lacked theoretical frameworks. This study will assess how professional involvement in participatory negotiations influences the performance of community HIV/AIDS projects by NGOs in Kisumu County, Kenya.

Bhattacharjeeet al. (2019) examined HIV prevention projects among female sex workers in Kenya, using qualitative data from annual surveys of 4,393 participants in 2017 and monitoring data from 92 organizations. The study highlighted that project success depends on effective implementation and early identification of program loopholes, aided by robust monitoring and evaluation. However, it focused solely on prevention frameworks and did not explore how participatory negotiation indicators influence community HIV/AIDS projects by NGOs in Kisumu County. This study employs both qualitative and quantitative methods to comprehensively assess the influence of participatory negotiation on project performance, considering the moderating effects of regulatory frameworks.

The conceptual framework adopted in this study is shown in Fig. 1.

Fig. 1. The conceptual framework on participatory negotiation on the performance of HIV/AIDS community health projects implemented by NGOs in Kisumu, County, Kenya.

Research Hypothesis

The study sought to test the following hypothesis: Participatory negotiation does not significantly influence performances of HIV/AIDS Community Health projects in Kisumu County, Kenya.

Data and Method

This research was anchored on the pragmatist paradigm as the philosophical thought underpinning the current study, given that it emphasizes the research problem of how HIV/AIDS projects executed by NGOs in Kisumu County, Kenya, perform. Given that it permits the application of both qualitative and quantitative research approaches, the pragmatism paradigm is favoured above the others. Investigating complicated phenomena in social and natural environments is a good use for this method. The researcher adopted both a descriptive cross-sectional survey and a correlation research design. A descriptive cross-sectional survey facilitates the carrying out of research at a particular time and helps characterize the prevalence of a health outcome in a specified population. At the same time, the correlation design reflects the strength and direction of the association between two or more variables, which, in the present study, were the HIV/AIDS community health project beneficiaries.

The study Unit of analysis was the HIV/AIDS Community Health Projects, from which data were collected from the beneficiaries of these projects in Kisumu County. The study was conducted in Kisumu County, which has 59 community health NGO projects implementing the HIV/AIDS program for the last two years. The target population was 30,000 beneficiaries aged 18 years and above because they are adults and would easily consent to information during data collection. The study used a simple random sampling method to sample the beneficiaries, given that this method eliminates biases. The 379 respondents were computed using Krejcie and Morgan's (1970) formula:

where s = the required sample size,

(1) $$\begin{array}{r}\mathit{s}=\frac{{\mathit{x}}^{\mathbf{\text{2}}}\mathit{N}\mathit{P}(\mathbf{\text{1}}-\mathit{P})}{{\mathit{e}}^{\mathbf{\text{2}}}(\mathit{N}-\mathbf{\text{1}})+{\mathit{x}}^{\mathbf{\text{2}}}\mathit{P}(\mathbf{\text{1}}-\mathit{P})}\end{array}$$

${\mathit{x}}^{\mathbf{\text{2}}}$= the table value of the chi-square for 1 degree of freedom at the desired confidence level (3.841),

N = The population size,

P = the population proportion (assumed to be 0.50 given that this would provide the maximum sample size),

e² = the degree of accuracy expressed as a proportion (0.05).

As a result of the formula, the study collected quantitative data using structured questionnaires that were administered to the 379 beneficiaries of the community HIV/AIDS projects. The data was analyzed through descriptive statistics (frequency distributions, percentages, weighted means, standard deviations, and percentages, as well as Person’s correlation and multiple regressions analysis).

Results

Demographic Profile Results

Distribution of the Respondents by Age

To ascertain if the sample was evenly distributed among age groups, participants were asked to disclose their age. This made sure that all age groups’ opinions were represented in the outcomes. Table I displays the distribution of respondents by age group, including frequency and percentage, based on the analysis of the data.

Table I. Distribution of Respondents by Age Group

Age group	Frequency	Percentage
18–27 years	143	41.3
28–37 years	143	41.3
38–47 years	44	12.7
48–57 years	13	3.8
58 years and above	3	0.9
Total	346	100

Table I reveals that 82.6% of participants were between the ages of 18 and 37, while 17.4% were 38 years of age or older. According to this distribution, the majority of respondents were in the sexually active age range, which may have made them more vulnerable to HIV/AIDS because of social behaviors. This suggests that most of them were old enough to know how to properly address inquiries about how the regulatory framework and participatory monitoring and evaluation processes affected the effectiveness of HIV/AIDS community health initiatives carried out by non-governmental organizations in Kisumu County, Kenya.

Distribution of Respondents by Gender

To ensure gender parity in HIV/AIDS community health projects, it was essential to investigate respondents’ gender. This information is significant for organizational management and policy decision-making. Respondents were asked to state their gender, and the results are presented in Table II.

Table II. Distribution of Respondents by Gender

Gender	Frequency	Percentage
Females	217	62.7
Males	129	37.3
Total	346	100

Table II shows that whereas men made up 37.3% of the respondents, women made up almost 60% of the sample. This suggests a gender difference in the number of women obtaining services from HIV/AIDS community health initiatives compared to males. This research suggests that women are more likely than men to actively seek out services relevant to their HIV/AIDS status, underscoring the need to motivate men to do the same.

Distribution of Respondents by Level of Education

In order to comprehend the impact of regulatory frameworks and participatory monitoring and evaluation procedures on the implementation of HIV/AIDS community health programs by non-governmental organizations in Kisumu County, Kenya, it is important to know the degree of education attained by the respondents. The distribution of respondents by degree of education is seen in Table III.

Table III. Distribution of Respondents by Level of Education

Level of education	Frequency	Percentage
None	31	9
Secondary	36	10.4
College	59	17.1
University	220	63.6
Total	346	100

According to the study’s findings, the majority of respondents (80.7%) had completed college or more schooling, while 19.3% had only completed secondary school. This indicates that the majority of participants have sufficient knowledge to offer trustworthy information on the impact of the regulatory framework and participatory monitoring and evaluation methods on the effectiveness of HIV/AIDS community health initiatives carried out by non-governmental organizations in Kisumu County, Kenya.

Distribution of the Respondents by Number of Years in the HIV/AIDS Community Health Projects

The duration of their involvement in HIV/AIDS community health programs was a question that the participants had to answer. This data was collected to see if they have the requisite experience to support the regulatory framework influencing the success of these initiatives carried out by NGOs in Kisumu County, Kenya, as well as the participatory monitoring and evaluation procedures. After the data analysis, Table IV presents the frequency and percentage distribution of respondents based on years of experience in the company.

Table IV. Distribution of Respondents by Number of Years in the HIV/AIDS Community Health Projects

Length of time in profession	Frequency	Percentage
1–5 years	104	30.1
6–10 years	176	50.9
11–15 years	54	15.6
16–20 years	9	2.6
21–25 years	1	0.3
26–30 years	2	0.5
Over 30 years	0	0.0
Total	346	100

Table IV demonstrates that while 19% of respondents had been active for 11 years or more, many respondents (81%) had been participating in HIV/AIDS community health initiatives run by NGOs in Kisumu County for 1–10 years. This shows that the majority of responders have enough expertise to offer insightful commentary on how participatory monitoring and assessment procedures and the legal environment impact these projects’ outcomes.

Performance of HIV/AIDs Community Health Projects

In this study, the performance of HIV/AIDS community health projects was the dependent variable. Key indicators for evaluating performance included reported HIV incidences, retention rates in treatment programs, project target achievements, viral load suppression rates, reductions in new infections, community outreach, treatment beneficiaries, awareness-driven increases in treatment uptake, and funding levels. The results were analyzed using frequencies, percentages, means, and standard deviations for each response. Additionally, line item means and standard deviations, as well as composite mean and composite standard deviation, were calculated and presented in Table V.

Table V. Performance of HIV/AIDS Community Health Projects

Statements	SA (5)	A (4)	N (3)	D (2)	SD (1)	Mean	Std. dev
The performance of HIV/AIDS projects is evaluated by the number of incidences reported and the achievement of set targets.	188 (54.3%)	143 (41.3%)	10 (2.9%)	1 (0.3%)	4 (1.2%)	4.47	0.682
There has been a significant increase in the number of project beneficiaries retained in treatment and care, with notable viral load suppression achieved through NGO interventions.	166 (48%)	161 (46.5%)	8 (2.3%)	3 (0.9%)	8 (2.3%)	4.37	0.781
HIV projects have contributed to a significant reduction in infection rates and positively influence project performance.	143 (41.4%)	152 (43.9%)	27 (7.8%)	6 (1.7%)	18 (5.2%)	4.14	1.01
NGOs have successfully reached various communities with preventive programs, increasing awareness and the number of people on treatment.	134 (38.8%)	165 (47.7%)	27 (7.8%)	14 (4.0%)	6 (1.7%)	4.18	0.869
The level of funding plays a crucial role in enhancing the performance of HIV projects.	109 (31.5%)	179 (51.7%)	26 (7.5%)	21 (6.1%)	11 (3.2%)	4.02	0.960
Composite element						4.24	0.86

The statement that HIV/AIDS project performance is evaluated by the number of incidences reported and target achievement was strongly supported, with 188 respondents (54.3%) strongly agreeing and 143 (41.3%) agreeing (M = 4.47, SD = 0.682). Only a small fraction disagreed, highlighting the importance placed on these metrics by stakeholders. The statement regarding the evaluation of HIV/AIDS project performance through the number of incidences reported and target achievement had a strong agreement among respondents (M = 4.47, SD = 0.682). The higher mean score (4.47) compared to the composite mean (4.15) indicates that reported incidences are viewed as a strong indicator of project success. The reduced standard deviation (0.682) reflects a greater consensus among participants than the composite standard deviation, supporting Sharmaet al.’s (2018) findings that stakeholder engagement enhances performance evaluation.

The increase in project beneficiaries retained in treatment, along with notable viral load suppression, was acknowledged by 166 respondents (48%) who strongly agreed, 161 (46.5%) agreed, 8 (2.3%) were neutral, 3 (0.9%) disagreed, and 8 (2.3%) strongly disagreed. This indicates widespread recognition of the effectiveness of NGO interventions, with only a minor percentage expressing dissent. The mean score of 4.37, higher than the composite mean of 4.15, suggests that increased beneficiary retention positively impacts project performance. The lower standard deviation (0.781) reflects greater agreement among participants compared to the composite standard deviation, indicating a strong consensus on the importance of retention in performance assessment.

Regarding the reduction in infection rates due to HIV projects, 143 (41.4%) strongly agreed, 152 (43.9%) agreed, 27 (7.8%) were neutral, 6 (1.7%) disagreed, and 18 (5.2%) strongly disagreed. The mean score of 4.14 suggests that most respondents agreed that HIV projects have led to a significant reduction in the number of infected individuals, thereby moderately influencing the performance of these projects. The higher standard deviation of 1.01 compared to the composite standard deviation of 0.915 indicates a wider range of opinions among the participants.

NGOs’ success in reaching communities with preventive programs was supported by 134 respondents (38.8%) who strongly agreed, 165 respondents (47.7%) who agreed, 27 respondents (7.8%) who were indifferent, and 14 respondents (4.0%) who disagreed. The NGOs’ preventative programs have significantly impacted the performance of HIV initiatives, as evidenced by the mean score of 4.18, which is higher than the composite mean of 4.15. There is general agreement among participants, as seen by the lower standard deviation of 0.869 compared to the composite standard deviation of 0.915. This demonstrates the effectiveness of these programs, with a minority expressing disagreement.

The crucial role of funding in enhancing project performance was recognized by 109 (31.5%) highly agreed, 179 (51.7%) agreed, 26 (7.5%) were neutral, 21 (6.1%) disagreed, and 11 (3.2%) severely disagreed out of the 346 responders reflecting some differences in experiences or perceptions regarding funding adequacy. The average score of 4.02 denotes agreement that higher funding levels improve HIV project success. On the other hand, the fact that the standard deviation of 0.960 is larger than the composite standard deviation of 0.915 indicates that participants had differing perspectives. These results corroborate those of Obudho Simon and Mwenda (2021), who highlighted that to enhance the overall success of community health programs, including HIV/AIDS efforts, it is critical to ensure planning, including the community, have sufficient funds and have committed leadership.

Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

Participatory negotiation in this study involves the engagement of implementers in the PM&E process of HIV/AIDS community health projects, focusing on resolving differences, making concessions, negotiating, implementing solutions, and involving professional negotiators. The results were analyzed to show frequency, percentage, mean scores, and standard deviations for each statement, with details presented in Table VI.

Table VI. Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

Statements	SA (5)	A (4)	N (3)	D (2)	SD (1)	Mean	Std. dev
Resolving differences and implementing negotiated solutions improve participatory negotiations.	199 (57.5%)	126 (36.4%)	11 (3.2%)	1 (0.3%)	9 (2.6%)	4.46	0.802
Making concessions to achieve agreements enhances participatory negotiations.	122 (35.2%)	202 (58.4%)	12 (3.5%)	1 (0.3%)	9 (2.6%)	4.23	0.761
Trust between negotiating parties influences the effectiveness of participatory negotiations.	161 (46.5%)	154 (44.5%)	22 (6.4%)	1 (0.3%)	8 (2.3%)	4.33	0.802
Involvement of professional negotiators by stakeholders enhances participatory negotiations.	161 (46.5%)	144 (41.7%)	14 (4.0%)	6 (1.7%)	21 (6.1%)	4.21	1.04
Active stakeholder engagement and resolution strategies improve participatory negotiations.	141 (40.8%)	161 (46.5%)	25 (7.2%)	15 (4.3%)	4 (1.2%)	4.21	0.845
Composite element						4.29	0.85

The factor of resolving differences and implementing solutions was recognized by the highest mean score (M = 4.46, SD = 0.802), attributed to resolving differences and implementing solutions, indicating a strong consensus among stakeholders that these actions significantly improved participatory negotiations. These results indicate that out of 346 study participants, 199 (57.5%) strongly agreed, 126 (36.4%) agreed, 11 (3.2%) were neutral, 1 (0.3%) disagreed, and 9 (2.6%) strongly disagreed that resolving points of difference by stakeholders influence participatory negotiations., underscoring its critical role in successful negotiations. The relatively low standard deviation suggests considerable agreement among stakeholders on this point. Compared to the composite mean of 4.29, this item is perceived as slightly more important, suggesting that stakeholders prioritize clear resolution and implementation of solutions as key to effective negotiations.

Making concessions to have a mean of 4.23 and a standard deviation of 0.761. These results indicate that out of 346 study participants, 122 (35.2%) strongly agreed, 202 (58.4%) agreed, 12 (3.5%) were neutral, 1 (0.3%) disagreed, and 9 (2.6%) strongly disagreed that stakeholders making concessions to achieve agreements influence participatory negotiations. This result shows that the line statement mean score of 4.23 was greater than the composite mean of 4.15. This finding highlights the importance of flexibility and compromise in reaching mutual agreements. The standard deviation here is slightly lower than the composite standard deviation, indicating a strong agreement among stakeholders regarding the necessity of making concessions. The mean score for this item is very close to the composite mean, suggesting that stakeholders view making concessions as generally important for successful participatory negotiations.

The influence of trust on negotiations was supported with a mean score of 4.33 (SD = 0.802). These results indicate that out of 346 study participants, 161 (46.5%) strongly agreed, 154 (44.5%) agreed, 22 (6.4%) were neutral, 1 (0.3%) disagreed, and 8 (2.3%) strongly disagreed that the degree of negotiating parties trusts to each other influence participatory negotiations. This result shows that the line statement mean score of 4.33 was greater than the composite mean of 4.15. indicating that trust is essential for effective negotiation processes. The standard deviation is identical to resolving differences and implementing solutions, highlighting consistent perceptions about the importance of trust. The mean score is slightly above the composite mean, suggesting that trust is seen as a crucial factor in participatory negotiations, potentially even more so than the average importance of all factors considered.

The involvement of professional negotiators showed a mean score of 4.21 (SD = 1.04), with 161 (46.5%) strongly agreeing, 144 (41.7%) agreeing, 14 (4%) neutral, 6 (1.7%) disagreeing, and 21 (6.1%) strongly disagreed that negotiating parties trust each other in the participatory negotiations process. This result shows that the line statement mean score of 4.21 was greater than the composite mean of 4.15. This suggests that expertise can enhance the quality and outcomes of negotiations. However, the higher standard deviation indicates varying opinions among stakeholders about the extent to which professional negotiators contribute to successful negotiations. The mean score is just below the composite mean, implying that while professional negotiators are valued, there is more variability in how stakeholders perceive their impact compared to other factors.

Active stakeholder engagement was rated with a mean score of 4.21 (SD = 0.845), where of the 346 participants, 141 (40.8%) strongly agreed, 161 (46.5%) agreed, 25 (7.2%) were neutral, 15 (4.3%) disagreed, and 4 (1.2%) strongly disagreed. The mean score of 4.21 exceeds the composite mean of 4.15, indicating that respondents believe professional negotiators’ involvement positively enhances participatory negotiations. This reinforces the idea that stakeholder participation is crucial in negotiation processes. The standard deviation is slightly lower than the composite standard deviation, indicating a relatively strong consensus on the importance of stakeholder engagement. The mean score matches that of professional negotiators, slightly below the composite mean. This suggests that while stakeholder engagement is important, it is perceived with somewhat less unanimity compared to the resolution of differences and trust among parties. These findings support Parker and Becker-Benton (2016), who noted that participatory negotiations foster knowledge sharing, address health issues, identify obstacles, promote change, and enhance communication techniques.

Correlation between Negotiation on Performance of HIV/AIDS Community Health Projects

The study examined the relationship between participatory negotiation and the performance of HIV/AIDS community health projects using Pearson correlation coefficients. Scores were analyzed at a 5% significance level, with correlations categorized according to Cohen (1988): very high (+0.90 to +1.0/−0.90 to −1.00), high (+0.70 to +0.90/−0.70 to −0.90), moderate (+0.50 to +0.70/−0.50 to −0.70), low (+0.30 to +0.50/−0.30 to −0.50), and very low (0.00 to +0.30/0.00 to −0.30).

In this study, the relationship between participatory negotiation and the performance of HIV/AIDS community health projects was tested using the hypothesis, “There is no significant relationship between participatory negotiation and project performance.” The mathematical model used was Performance = f (Participatory Negotiation). The study found a low positive significant correlation (r = 0.475, p < 0.001), indicating a significant relationship and leading to the rejection of the null hypothesis. This supports the findings by Parker and Becker-Benton (2016), who noted that participatory negotiations enhance knowledge sharing and address health issues by identifying key areas, conceptualizing obstacles, promoting change, and selecting effective communication techniques.

Regression Analysis of Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

To find out how participatory negotiation affected the execution of HIV/AIDS community health programs, simple linear regression was used. It was important to hear what the participants had to say about how participatory bargaining and the implementation of HIV/AIDS community health programs affected them. To determine if participatory negotiation was a major or negligible predictor of the success of HIV/AIDS community health programs, the simple regression model was employed. The next sub-thematic sections go into additional detail about them.

Model Summary of Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

The model summary sought to determine whether participatory negotiation as a predictor significantly or insignificantly predicted the performance of HIV/AIDs community health projects. The regression model summary results are presented in Table VII.

Table VII. Regression Model Summary Table of Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

R	R-squared	Adjusted R-squared	Std. error of the estimate
0.475	0.226	0.224	0.292

The model summary in Table VII suggests that there is a low positive correlation (R = 0.475) between participatory negotiation and the performance of HIV/AIDs community health projects and those predicted by the regression model. In addition, 22.6% of the variation in the performance of HIV/AIDs community health projects is explained by participatory negotiation.

ANOVA of Participatory Negotiation on Performance of HIV/AIDS Community Health Projects

The study sought to establish if the regression model is the best fit for predicting the performance of HIV/AIDS community health projects after the use of participatory negotiation. The ANOVA results are presented in Table VIII.

Table VIII. ANOVA Table of the Regression of Participatory Negotiation on the Performance of HIV/AIDS Community Health Projects

	Sum of squares	Df	Mean square	F	Sig.
Regression	8.547	1	8.547	100.348	<0.001
Residual	29.300	344	0.085
Total	37.847	345

The ANOVA results from Table IV. 18 indicated that the F-statistic (1,344) = 100.348 is significant, with a p-value of 0.000, which is less than 0.05. This implies that the predictor coefficient is not equal to zero, indicating that the regression model significantly improves the prediction of performance in HIV/AIDS community health projects.

Coefficients for Regression of Participatory Negotiation on Performance of HIV/AIDS Community Health projects

The study sought to establish whether there was an effect of participatory negotiation on the performance of HIV/AIDS community health projects. The regression coefficient results are presented in Table IX.

Table IX. Coefficients for the Regression of Participatory Negotiation on the Performance of HIV/AIDS Community Health projects

	Unstandardized coefficients		Standardized coefficients	t	Sig.
	B	Std. error	Beta
(Constant)	2.335	0.188		12.408	<0.001
Participatory negotiation	0.444	0.044	0.475	10.017	<0.001

The study aimed to determine the effect of participatory negotiation on the performance of HIV/AIDS community health projects. Simple linear regression analysis revealed a significant effect of participatory negotiation on project performance. The coefficient for the constant term (β₀ = 2.335; p < 0.001 < 0.05) and for participatory negotiation (β₂ = 0.444; p < 0.001 < 0.05) were both statistically significant. The regression model, y = 2.335 + 0.444X₂, indicates that for each unit increase in participatory negotiation, the performance of HIV/AIDS community health projects increases by 0.444 units, with other factors held constant. This finding demonstrates a linear relationship between participatory negotiation and project performance and aligns with Parker and Becker-Benton (2016), who highlighted that participatory negotiations facilitate knowledge sharing, address health issues, identify critical areas, conceptualize obstacles, and improve communication techniques.

Conclusion

The goal of the study was to determine how much participatory bargaining affects HIV/AIDS community health project performance. Both the Pearson correlation findings and the simple linear regression coefficients showed that participatory bargaining had a substantial impact on the performance of HIV/AIDS community health projects. The lower p-values suggested that the performance of HIV/AIDS community health projects was significantly impacted by participatory discussions. To improve the effectiveness of community HIV/AIDS health initiatives, project managers and M&E officers should create suitable implementation methods for the health projects that will allow participatory negotiating procedures to be correctly implemented.