Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa

Kemp, Christopher G.; Gerth‐Guyette, Emily; Dube, Lungile; Andrasik, Michele P.; Rao, Deepa

doi:10.1007/s10461-016-1386-x

Cited by 7 publications

(13 citation statements)

References 39 publications

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“…Of these, 175 manuscripts were excluded because they did not report on intervention (72), did not examine linkage to care (48), did not report qualitative finding (26), did not focus on PLHIV (5), or were reporting on literature reviews (2) (Table 1). We identified twenty-five manuscripts comprised of twenty-two peer-reviewed articles [18, 19, 21, 37–55], two theses/dissertations [56, 57] and one conference abstract [58] (Figure 1). Among these, seventeen studies were single component interventions [19, 21, 37–42, 45, 47, 49, 50, 53, 54, 56–58] and eight were multiple component interventions [18, 43, 44, 46, 48, 51, 52, 55].…”

Section: Resultsmentioning

confidence: 99%

“…We identified twenty-five manuscripts comprised of twenty-two peer-reviewed articles [18, 19, 21, 37–55], two theses/dissertations [56, 57] and one conference abstract [58] (Figure 1). Among these, seventeen studies were single component interventions [19, 21, 37–42, 45, 47, 49, 50, 53, 54, 56–58] and eight were multiple component interventions [18, 43, 44, 46, 48, 51, 52, 55]. We identified cross-sectional (16) [18, 19, 39, 41–46, 49–51, 53–55, 58], longitudinal (6) [21, 37, 47, 48, 52, 57], and longitudinal-quantitative parent studies (3) study designs [38, 40, 56].…”

Section: Resultsmentioning

confidence: 99%

“…Among these, seventeen studies were single component interventions [19, 21, 37–42, 45, 47, 49, 50, 53, 54, 56–58] and eight were multiple component interventions [18, 43, 44, 46, 48, 51, 52, 55]. We identified cross-sectional (16) [18, 19, 39, 41–46, 49–51, 53–55, 58], longitudinal (6) [21, 37, 47, 48, 52, 57], and longitudinal-quantitative parent studies (3) study designs [38, 40, 56]. Twelve studies [18, 37–41, 44, 47, 49–51, 53] were from high-income countries (HIC: USA, UK, Canada), eight [19, 43, 45, 46, 52, 54, 56, 58] from middle-income countries (MIC: South Africa, India, Botswana), and five [21, 42, 48, 55, 57] from low-income countries (LIC: Haiti, Tanzania, Cambodia, Malawi, Kenya).…”

Section: Resultsmentioning

confidence: 99%

“…We identified cross-sectional (16) [18, 19, 39, 41–46, 49–51, 53–55, 58], longitudinal (6) [21, 37, 47, 48, 52, 57], and longitudinal-quantitative parent studies (3) study designs [38, 40, 56]. Twelve studies [18, 37–41, 44, 47, 49–51, 53] were from high-income countries (HIC: USA, UK, Canada), eight [19, 43, 45, 46, 52, 54, 56, 58] from middle-income countries (MIC: South Africa, India, Botswana), and five [21, 42, 48, 55, 57] from low-income countries (LIC: Haiti, Tanzania, Cambodia, Malawi, Kenya). Overall, 24 studies focused on adults [18, 19, 21, 37–43, 45–58], eight included adolescents (defined as ages 10–19) [21, 37, 44–48, 57], and four included pregnant women [21, 43, 55, 57].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies assessed how healthcare providers and support workers living with HIV and advocating on behalf of PLHIV improved linkage interventions [21, 38, 41, 44, 46, 49, 51–53, 56–58]. These studies were from the United States, India, England, Kenya, South Africa and Malawi.…”

Section: Cross Cutting Themesmentioning

confidence: 99%

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Facilitators and barriers in HIV linkage to care interventions

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Beanland

et al. 2016

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Objective To synthesize qualitative evidence on linkage to care interventions for people living with HIV. Design Systematic literature review. Methods We searched nineteen databases for studies reporting qualitative evidence on linkage interventions. Data extraction and thematic analysis were used to synthesize findings. Quality was assessed using the CASP tool and certainty of evidence was evaluated using the CERQual approach. Results Twenty-five studies from eleven countries focused on adults (24 studies), adolescents (8 studies), and pregnant women (4 studies). Facilitators included community-level factors (i.e. task-shifting, mobile outreach, integrated HIV and primary services, supportive cessation programs for substance users, active referrals, and dedicated case management teams) and individual-level factors (encouragement of peers/family and positive interactions with healthcare providers in transitioning into care). One key barrier for people living with HIV was perceived inability of providers to ensure confidentiality as part of linkage to care interventions. Providers reported difficulties navigating procedures across disparate facilities and having limited resources for linkage to care interventions. Conclusions Our findings extend the literature by highlighting the importance of task-shifting, mobile outreach, and integrated HIV and primary services. Both community and individual level factors may increase the feasibility and acceptability of HIV linkage to care interventions. These findings may inform policies to increase the reach of HIV services available in communities .

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Cross Cutting Themesmentioning

confidence: 99%

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Facilitators and barriers in HIV linkage to care interventions

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Beanland

et al. 2016

Aids

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ART Denial: Results of a Home-Based Study to Validate Self-reported Antiretroviral Use in Rural South Africa

et al. 2018

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OBJECTIVE: There is increasing interest in home based testing and treatment of HIV to expand access to treatment in sub-Saharan Africa. Such programs rely on self-reported HIV history and use of antiretroviral therapy (ART). However, the accuracy of self-reported ART use in community settings is not well described. In this study, we compared self-reported ART (SR-ART) use in a home based survey against biological exposure to ART (BE-ART), in a population study of older adults in South Africa. METHODS: Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa (HAALSI) is a cohort of adults aged 40+. The baseline home-based interview included self-reported HIV status and ART use. All participants also underwent biological testing for HIV antibodies, viral load and exposure to emtricitabine (FTC) or lamivudine (3TC), which are included in all first-line and second-line ART regimens in the public-sector South African HIV program. We calculated the performance characteristics for SR-ART compared to BE-ART and fit multivariable logistic regression models to identify correlates of invalid SR-ART responses. RESULTS: Of 4,560 HAALSI participants with a valid HIV test result available, 1,048 (23%) were HIV-positive and 734 [70% of people living with HIV (PLWH)] were biologically validated ART users (BE-ART). The sensitivity of SR-ART use was 64% (95% CI: 61–68%) and the specificity was 94% (95% CI: 91–96%); the positive predictive value (PPV) was 96% (95% CI: 94–98%) and negative predictive value (NPV) was 52% (95% CI: 48–56%). We found no sociodemographic predictors of accurate SR-ART use. CONCLUSIONS: Over one in three individuals with detectable ART in their blood denied current ART use during a home-based interview. These results demonstrate ongoing stigma related to HIV and its treatment, and have important implications for community health worker programs, clinical programs, and research studies planning community-based ART initiation in the region.

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Integrated access to care and treatment (I ACT) support groups for adolescents living with HIV in public healthcare facilities in South Africa: feasibility and acceptability for scaling up

et al. 2018

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Integrated Access to Care and Treatment (I ACT) for adolescents is an educational support group initiative conducted monthly by trained healthcare providers (counsellors/health promoters). It follows a defined educational curriculum of six topics including, HIV/AIDS, disclosure, sexual and reproductive and mental health. Qualitative assessments, conducted midway of I ACT implementation at four primary healthcare facilities in North West province, South Africa, aimed to explore the perceptions of healthcare providers and the experiences of adolescents living with HIV (ALHIV). Face-to-face interviews were conducted with healthcare providers (n = 4), Facility Managers (n = 4) and ALHIV 15-19 years (n = 15). Interviews were recorded, transcribed, translated, verified and a content analysis performed. ALHIV reported the benefit and educational value of I ACT support groups. Healthcare providers shared their experience with initiating the groups and Facility Managers highlighted implementation challenges. In this study I ACT for adolescents supported ALHIV needs and promoted engagement with healthcare providers and peers. Sustaining I ACT for adolescents will require additional health system strengthening like provision of human and material resources.

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Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa

Cited by 7 publications

References 39 publications

Facilitators and barriers in HIV linkage to care interventions

Facilitators and barriers in HIV linkage to care interventions

ART Denial: Results of a Home-Based Study to Validate Self-reported Antiretroviral Use in Rural South Africa

Integrated access to care and treatment (I ACT) support groups for adolescents living with HIV in public healthcare facilities in South Africa: feasibility and acceptability for scaling up

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