Psychosocial Aspects of ART Counseling: A Comparison of HIV Beliefs and Knowledge in PMTCT and ART-Naïve Women

Abstract

Antiretroviral therapy (ART)-readiness counseling has been deemed critical to adherence, instilling knowledge, and promoting positive beliefs and attitudes. In the landscape of changing policy in South Africa, some ART initiators have had prior ART-readiness counseling (e.g., for prevention-of-mother-to-child-transmission [PMTCT] programs). The extent to which previous counseling resulted in retained knowledge and belief is unknown, which may be important to the promotion of women’s ART adherence. We compared 320 women living with HIV and initiating ART, with and without prior PMTCT on HIV knowledge, treatment, beliefs, and attitudes. The PMTCT group held more accurate beliefs and more positive attitudes about ART. Both groups lacked understanding of basic HIV biology. Non-disclosure of HIV status was high. Thus, in individuals re-initiating therapy, some knowledge about HIV and its treatment was not well retained. Tailored education and counseling may be critical to adherence, with a focus on biological concepts that impact ART resistance.

A Mobile App to Screen for Neurocognitive Impairment: Preliminary Validation of NeuroScreen Among HIV-Infected South African Adults

“…A total of 102 HIV-positive black South African adults, aged 18 to 56 years, were recruited following their participation in a larger randomized controlled trial (RCT) of a multimedia, laptop-based, lay health worker-delivered ART-readiness intervention for ART initiators (known as Masivukeni or “Let’s Wake Up”) conducted in Cape Town, South Africa (see [ 36 - 38 ]). Inclusion criteria were (1) HIV-positive, (2) age 18 years or older, (3) willing to be contacted by study staff for participation in other research studies, (4) isiXhosa or English speaking, (5) capable of consent, (6) willing to complete 2 to 3 hours of neuropsychological testing, and (7) willing to allow access to medical records by study staff.…”

A culturally fair test of processing speed: Construct validity, preliminary normative data, and effects of HIV infection on performance in South African adults.

“…The HIV-infected participants were all part of a cohort recruited into a randomized controlled trial, Masivukeni (Gouse et al, 2017; Robbins et al, 2014), that evaluated the efficacy of a multimedia-based adherence intervention for adults initiating antiretroviral therapy (i.e., participants initiated ART upon enrollment in the trial). These participants were recruited from the same two clinics described in Study 1.…”

18-24-month HIV-free survival as measurement of the effectiveness of prevention of mother-to-child transmission in the context of lifelong antiretroviral therapy: Results of a community-based survey

“…Factors associated with HIV-free survival in Lesotho included HIV-positive mothers disclosing their HIV status and HIV-exposed infants taking cotrimoxazole prophylaxis. It can be hypothesized that women who disclosed their HIV status got more support to be adherent to their treatment [ 26 , 27 ]. HIV-exposed infants who had growth difficulties were more likely to be HIV-infected and/or to die.…”