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Robson I, Mphande M, Lee J, Hubbard JA, Daniels J, Phiri K, Chikuse E, Coates TJ, Cornell M, Dovel K. Implementing a male-specific ART counselling curriculum: a quality assessment with healthcare workers in Malawi. J Int AIDS Soc 2024; 27:e26270. [PMID: 39039724 PMCID: PMC11263468 DOI: 10.1002/jia2.26270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/29/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION There is little HIV counselling that directly meets the needs of men in Eastern and Southern Africa, limiting men's knowledge about the benefits of HIV treatment and how to overcome barriers to engagement, contributing to poorer HIV-related outcomes than women. Male-specific approaches are needed to improve men's outcomes but may be difficult for healthcare workers (HCWs) to implement with fidelity and quality in low-resource settings. We developed a male-specific counselling curriculum which was implemented by male HCWs and then conducted a mixed-methods quality assessment. METHODS We audio-recorded counselling sessions to assess the quality of implementation (n = 50) by male HCWs from two cadres (nurse, n = 10 and lay cadre, n = 10) and conducted focus group discussions (FGDs) with HCWs at 6 and 9 months after rollout to understand barriers and facilitators to implementation. Counselling sessions and FGDs were translated, transcribed and analysed using thematic analysis adapted from WHO Quality Counselling Guidelines. We assessed if sessions were respectful, informative, interactive, motivating and included tailored action plans for overcoming barriers to care. All data were collected September 2021-June 2022. RESULTS All sessions used respectful, non-judgemental language. Sessions were highly interactive with most HCWs frequently asking open-ended questions (n = 46, 92%) and often incorporating motivational explanations of how antiretroviral therapy contributes to life goals (n = 42, 84%). Few sessions included individually tailored action plans for clients to overcome barriers to care (n = 9, 18%). New counselling themes were well covered; however, occasionally themes of self-compassion and safe sex were not covered during sessions (n = 16 and n = 11). HCWs believed that having male HCWs conduct counselling, ongoing professional development and keeping detailed counselling notes facilitated quality implementation. Perceived barriers included curriculum length and client hesitancy to participate in action plan development. Findings were similar across cadres. CONCLUSIONS Implementing high-quality male-specific counselling using male nurses and/or lay cadre is feasible. Efforts to utilize lay cadres should be prioritized, particularly in low-resource settings. Programmes should provide comprehensive job aids to support HCWs. Ongoing training and professional development are needed to (1) improve HCWs' skills in tailored action plans, and (2) sensitize HCWs to the need for self-compassion within male clients to promote holistic sexual health.
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Affiliation(s)
- Isabella Robson
- Division of Infectious DiseasesDavid Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
- Implementation Science DepartmentPartners in HopeLilongweMalawi
| | - Misheck Mphande
- Implementation Science DepartmentPartners in HopeLilongweMalawi
| | - Jiyoung Lee
- David Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Julie Anne Hubbard
- Division of Infectious DiseasesDavid Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Joseph Daniels
- Edson College of Nursing and Health InnovationArizona State UniversityPhoenixArizonaUSA
| | - Khumbo Phiri
- Implementation Science DepartmentPartners in HopeLilongweMalawi
| | - Elijah Chikuse
- Implementation Science DepartmentPartners in HopeLilongweMalawi
| | - Thomas J. Coates
- Division of Infectious DiseasesDavid Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
- University of California Global Health InstituteSan FranciscoCaliforniaUSA
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & ResearchSchool of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Kathryn Dovel
- Division of Infectious DiseasesDavid Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
- Implementation Science DepartmentPartners in HopeLilongweMalawi
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Palis H, Young P, Korchinski M, Wood S, Xavier J, Luk N, Mahil S, Bartlett S, Brown H, Salmon A, Nicholls T, Slaunwhite A. "Shared experience makes this all possible": documenting the guiding principles of peer-led services for people released from prison. BMC Public Health 2024; 24:84. [PMID: 38172781 PMCID: PMC10765918 DOI: 10.1186/s12889-023-17524-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is a growing body of evidence demonstrating the effectiveness of peer-led services in supporting community reintegration for people released from prison. This study aims to document the guiding principle of a peer-led service for people released from prison, from the perspective of peer mentors. METHODS Data were collected using focus groups (N = 10; 2 groups with 5 participants each) and one-on-one interviews (N = 5) including a total of 13 people, representing all UTGSS staff at the time of the study. An inductive thematic analysis was used to identify patterns in the data. Initial coding was done by using "in-vivo" codes (i.e. applying codes to terms used by participants). This informed the direction of the next stage of analysis, which focused on identifying categories that synthesized the codes and data across transcripts. In this stage, broad themes and sub-themes were developed. FINDINGS Six themes were constructed to reflect the guiding principles of UTGSS staff. This includes four central themes: 1) Offering hope; 2) Building respectful relationships; 3) Providing consistent support; 4) Meeting people where they are at. Two connected themes are also reported: 1) Relying on shared experience, which participants reported serves as the foundation for practicing these guiding principles and 2) Bridging connections to services, which reflects the outcome of practicing these guiding principles. CONCLUSION The principles identified in this study can be used by UTGSS staff as a guide for checking-in on progress with clients and may be considered as a model for reflection on practice by staff providing similar peer-led services. These principles should not be applied in a prescriptive way, as relationship building is at the centre of peer support, and different applications will be required depending on clients' goals and the range of supports available within their community.
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Affiliation(s)
- Heather Palis
- Department of Psychiatry, University of British Columbia, 255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.
- Department of Psychiatry, University of British Columbia, BC Centre for Disease Control, 655 W 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.
| | - Pam Young
- Unlocking the Gates Services Society, 22838 Lougheed Hwy. Unit 104, Maple Ridge, BC, V2X 2V6, Canada
| | - Mo Korchinski
- Unlocking the Gates Services Society, 22838 Lougheed Hwy. Unit 104, Maple Ridge, BC, V2X 2V6, Canada
| | - Shawn Wood
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Jessica Xavier
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Nelson Luk
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Simrat Mahil
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Sofia Bartlett
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Helen Brown
- School of Nursing, University of British Columbia, 2211 Wesbrook Mall T201, Vancouver, BC, V6T 2B5, Canada
| | - Amy Salmon
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, 70-1081 Burrard Street, Vancouver, BC, V6Z IY6, Canada
| | - Tonia Nicholls
- Department of Psychiatry, University of British Columbia, 255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
- BC Mental Health and Substance Use Services, 4949 Heather St, Vancouver, BC, V5Z 3L7, Canada
| | - Amanda Slaunwhite
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
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Hariprasad S, Phiri K, Thorp M, Holland K, Nyirenda R, Gupta S, Phiri S, Sabin L, Dovel K. Stakeholder Priorities for ART Initiation and Early Retention Interventions in Malawi: A Qualitative Study Comparing International and National Perspectives. RESEARCH SQUARE 2023:rs.3.rs-3725505. [PMID: 38196656 PMCID: PMC10775367 DOI: 10.21203/rs.3.rs-3725505/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background New or returning ART clients are often ineligible for differentiated service delivery (DSD) models, though they are at increased risk of treatment interruption and may benefit greatly from flexible care models. Stakeholder support may limit progress on development and scale-up of interventions for this population. We qualitatively explored stakeholder perceptions of and decision-making criteria regarding DSD models for new or returning ART clients in Malawi. Methods We conducted in-depth interviews with internationally based stakeholders (from foundations, multilateral organizations, and NGOs) and Malawi-based stakeholders (from the Malawi Ministry of Health and PEPFAR implementing partners). The interviews included two think-aloud scenarios in which participants rated and described their perceptions of 1) the relative importance of five criteria (cost, effectiveness, acceptability, feasibility, and equity) in determining which interventions to implement for new or returning ART clients and 2) their relative interest in seven potential interventions (monetary incentives, nonmonetary incentives, community-based care, ongoing peer/mentor support and counseling, eHealth, facility-based interventions, and multimonth dispensing) for the same population. The interviews were completed in English via video conference and were audio-recorded. Transcriptions were coded using ATLAS.ti version 9. We examined the data using thematic content analysis and explored differences between international and national stakeholders. Results We interviewed twenty-two stakeholders between October 2021 and March 2022. Thirteen were based internationally, and nine were based in Malawi. Both groups prioritized client acceptability but diverged on other criteria: international stakeholders prioritized effectiveness, and Malawi-based stakeholders prioritized cost, feasibility, and sustainability. Both stakeholder groups were most interested in facility-based DSD models, such as multimonth dispensing and extended facility hours. Nearly all the stakeholders described person-centered care as a critical focus for any DSD model implemented. Conclusions National and international stakeholders support DSD models for new or returning ART clients. Client acceptability and long-term sustainability should be prioritized to address the concerns of nationally based stakeholders. Future studies should explore the reasons for differences in national and international stakeholders' priorities and how to ensure that local perspectives are incorporated into funding and programmatic decisions.
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Dovel KL, Hariprasad S, Hubbard J, Cornell M, Phiri K, Choko A, Abbott R, Hoffman R, Nichols B, Gupta S, Long L. Strategies to improve antiretroviral therapy (ART) initiation and early engagement among men in sub-Saharan Africa: A scoping review of interventions in the era of universal treatment. Trop Med Int Health 2023; 28:454-465. [PMID: 37132119 PMCID: PMC10354296 DOI: 10.1111/tmi.13880] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Men in sub-Saharan Africa (SSA) have lower rates of antiretroviral therapy (ART) initiation and higher rates of early default than women. Little is known about effective interventions to improve men's outcomes. We conducted a scoping review of interventions aimed to increase ART initiation and/or early retention among men in SSA since universal treatment policies were implemented. METHODS Three databases, HIV conference databases and grey literature were searched for studies published between January 2016 to May 2021 that reported on initiation and/or early retention among men. Eligibility criteria included: participants in SSA, data collected after universal treatment policies were implemented (2016-2021), quantitative data on ART initiation and/or early retention for males, general male population (not exclusively focused on key populations), intervention study (report outcomes for at least one non-standard service delivery strategy), and written in English. RESULTS Of the 4351 sources retrieved, 15 (reporting on 16 interventions) met inclusion criteria. Of the 16 interventions, only two (2/16, 13%) exclusively focused on men. Five (5/16, 31%) were randomised control trials (RCT), one (1/16, 6%) was a retrospective cohort study, and 10 (10/16, 63%) did not have comparison groups. Thirteen (13/16, 81%) interventions measured ART initiation and six (6/16, 37%) measured early retention. Outcome definitions and time frames varied greatly, with seven (7/16, 44%) not specifying time frames at all. Five types of interventions were represented: optimising ART services at health facilities, community-based ART services, outreach support (such as reminders and facility escort), counselling and/or peer support, and conditional incentives. Across all intervention types, ART initiation rates ranged from 27% to 97% and early retention from 47% to 95%. CONCLUSIONS Despite years of data of men's suboptimal ART outcomes, there is little high-quality evidence on interventions to increase men's ART initiation or early retention in SSA. Additional randomised or quasi-experimental studies are urgently needed.
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Affiliation(s)
- Kathryn L Dovel
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
- Partners in Hope Medical Center, Lilongwe, Malawi
| | - Santhi Hariprasad
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Julie Hubbard
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
- Partners in Hope Medical Center, Lilongwe, Malawi
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Khumbo Phiri
- Partners in Hope Medical Center, Lilongwe, Malawi
| | | | - Rachel Abbott
- Division of HIV, Infections Diseases & Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Risa Hoffman
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Brooke Nichols
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Sundeep Gupta
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Lawrence Long
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA
- Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Lippman SA, de Kadt J, Ratlhagana MJ, Agnew E, Gilmore H, Sumitani J, Grignon J, Gutin SA, Shade SB, Gilvydis JM, Tumbo J, Barnhart S, Steward WT. Impact of short message service and peer navigation on linkage to care and antiretroviral therapy initiation in South Africa. AIDS 2023; 37:647-657. [PMID: 36468499 PMCID: PMC9994809 DOI: 10.1097/qad.0000000000003453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 12/07/2022]
Abstract
OBJECTIVE We examine the efficacy of short message service (SMS) and SMS with peer navigation (SMS + PN) in improving linkage to HIV care and initiation of antiretroviral therapy (ART). DESIGN I-Care was a cluster randomized trial conducted in primary care facilities in North West Province, South Africa. The primary study outcome was retention in HIV care; this analysis includes secondary outcomes: linkage to care and ART initiation. METHODS Eighteen primary care clinics were randomized to automated SMS ( n = 7), automated and tailored SMS + PN ( n = 7), or standard of care (SOC; n = 4). Recently HIV diagnosed adults ( n = 752) were recruited from October 2014 to April 2015. Those not previously linked to care ( n = 352) contributed data to this analysis. Data extracted from clinical records were used to assess the days that elapsed between diagnosis and linkage to care and ART initiation. Cox proportional hazards models and generalized estimating equations were employed to compare outcomes between trial arms, overall and stratified by sex and pregnancy status. RESULTS Overall, SMS ( n = 132) and SMS + PN ( n = 133) participants linked at 1.28 [95% confidence interval (CI): 1.01-1.61] and 1.60 (95% CI: 1.29-1.99) times the rate of SOC participants ( n = 87), respectively. SMS + PN significantly improved time to ART initiation among non-pregnant women (hazards ratio: 1.68; 95% CI: 1.25-2.25) and men (hazards ratio: 1.83; 95% CI: 1.03-3.26) as compared with SOC. CONCLUSION Results suggest SMS and peer navigation services significantly reduce time to linkage to HIV care in sub-Saharan Africa and that SMS + PN reduced time to ART initiation among men and non-pregnant women. Both should be considered candidates for integration into national programs. TRIAL REGISTRATION NCT02417233, registered 12 December 2014; closed to accrual 17 April 2015.
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Affiliation(s)
- Sheri A. Lippman
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Julia de Kadt
- International Training and Education Center for Health (I-TECH), Pretoria, Republic of South Africa
| | - Mary J. Ratlhagana
- International Training and Education Center for Health (I-TECH), Pretoria, Republic of South Africa
| | - Emily Agnew
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Hailey Gilmore
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jeri Sumitani
- International Training and Education Center for Health (I-TECH), Pretoria, Republic of South Africa
| | - Jessica Grignon
- International Training and Education Center for Health (I-TECH), Pretoria, Republic of South Africa
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Sarah A. Gutin
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Starley B. Shade
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer M. Gilvydis
- International Training and Education Center for Health (I-TECH), Pretoria, Republic of South Africa
| | - John Tumbo
- Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, Republic of South Africa
| | - Scott Barnhart
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Wayne T. Steward
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Heidari O, Tobin KE, Pollock S, Li FY, Webel AR, Duncan DT, Latkin C. Social Network Influence on Syphilis Testing for Black Sexual Minority Men in Baltimore, Maryland: A Cross-sectional Social Network Analysis. J Assoc Nurses AIDS Care 2023; 34:5-14. [PMID: 36656090 DOI: 10.1097/jnc.0000000000000380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Black sexual minority men (BSMM), including those with HIV, have disproportionate rates of syphilis infection. This study examines the associations of social network characteristics on syphilis testing, given that social network approaches are well established as effective methods to establish health-promoting social norms. We analyzed baseline data from a sexual health behavioral intervention. Using multivariable logistic regression, we modeled individual and social network characteristics on syphilis testing. Of the 256 participants, 37% tested for syphilis in the past year. In the adjusted model controlling for individual factors, odds of syphilis testing increased 89% for each increase in network member participants being encouraged to get a syphilis test (95% confidence interval [1.19-3.00]). Feeling comfortable accompanying a friend for HIV/sexually transmitted infection testing was associated with 2.47 increased odds of syphilis testing. Encouraging and training individuals to discuss sexual health topics with their network members may lead to the establishment of testing in social networks of Black sexual minority men.
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Affiliation(s)
- Omeid Heidari
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Karin E Tobin
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Sarah Pollock
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Fang-Ying Li
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Allison R Webel
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Dustin T Duncan
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
| | - Carl Latkin
- Omeid Heidari * , PhD, MPH, ANP-C, is an Assistant Professor, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Karin E. Tobin, PhD, is an Associate Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Sarah Pollock, MSPH, is a PhD student, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
- Fang-Ying Li, PhD, is a Research Associate and Director of Health Education, Aurora Healthcare US Corporation, Danvers, Massachusetts, USA
- Allison R. Webel, PhD, RN, FAAN, is a Professor and Associate Dean of Research, University of Washington, School of Nursing, Department of Child, Family, and Population Health Nursing, Seattle, Washington, USA
- Dustin T. Duncan is an Associate Professor, Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
- Carl Latkin is a Professor, Johns Hopkins University, Bloomberg School of Public Health, Department of Health Behavior and Society, Baltimore, Maryland, USA
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7
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Tobin KE, Heidari O, Winiker A, Pollock S, Rothwell MD, Alexander K, Owczarzak J, Latkin C. Peer Approaches to Improve HIV Care Cascade Outcomes: a Scoping Review Focused on Peer Behavioral Mechanisms. Curr HIV/AIDS Rep 2022; 19:251-264. [PMID: 35798989 DOI: 10.1007/s11904-022-00611-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW There are three main components of peer-based approaches regardless of type: education, social support, and social norms. The purpose of this scoping review was to examine evidence in the literature among peer-based interventions and programs of components and behavioral mechanisms utilized to improve HIV care cascade outcomes. RECENT FINDINGS Of 522 articles found, 40 studies were included for data abstraction. The study outcomes represented the entire HIV care cascade from HIV testing to viral suppression. Most were patient navigator models and 8 of the studies included all three components. Social support was the most prevalent component. Role modeling of behaviors was less commonly described. This review highlighted the peer behavioral mechanisms that operate in various types of peer approaches to improve HIV care and outcomes in numerous settings and among diverse populations. The peer-based approach is flexible and commonly used, particularly in resource-poor settings.
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Affiliation(s)
- Karin E Tobin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Omeid Heidari
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Abigail Winiker
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah Pollock
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Melissa Davey Rothwell
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jill Owczarzak
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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8
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Nardell MF, Hedt-Gauthier B, Earnshaw VA, Bogart LM, Dietrich JJ, Courtney I, Tshabalala G, Bor J, Orrell C, Gray G, Bangsberg DR, Katz IT. Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines. AIDS Behav 2022; 26:1366-1376. [PMID: 34705150 PMCID: PMC9007825 DOI: 10.1007/s10461-021-03493-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 01/06/2023]
Abstract
Some people with HIV (PWH) test positive multiple times without initiating antiretroviral therapy (ART). We surveyed 496 ART-eligible PWH following routine HIV testing at three clinics in Soweto and Gugulethu, South Africa in 2014-2015. Among repeat positive testers (RPTs) in this cohort, we compared rates of treatment initiation by prior treatment eligibility and assessed psychosocial predictors of treatment initiation in logistic regression models. RPTs represented 33.8% of PWH in this cohort. Less than half of those who reported eligibility for ART on prior testing started treatment upon retesting, in contrast to two thirds of RPTs who were previously ineligible for treatment who started treatment once they learned of their eligibility. Those who reported coping through substance use were more likely to decline treatment versus those not using substances. PWH who test repeatedly represent a vulnerable population at risk for ART non-initiation who may benefit from interventions addressing individualized coping strategies.
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Affiliation(s)
- Maria F Nardell
- Division of Global Health Equity, Brigham and Women's Hospital, Thorn Building 14th Floor, Boston, MA, 02120, USA.
- Harvard Medical School, Boston, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, USA.
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, USA
| | | | - Janan J Dietrich
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Western Cape, South Africa
| | - Ingrid Courtney
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Gugulethu Tshabalala
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Jacob Bor
- Department of Global Health, Boston University School of Public Health, Boston, USA
| | - Catherine Orrell
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Office of the President, South African Medical Research Council, Western Cape, South Africa
| | - David R Bangsberg
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
| | - Ingrid T Katz
- Harvard Medical School, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
- Harvard Global Health Institute, Cambridge, USA
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9
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Simbayi LC, Moyo S, van Heerden A, Zuma K, Zungu N, Marinda E, Jooste SE, Cloete A, Mabaso M, van Rooyen H. Global HIV efforts need to focus on key populations in LMICs. Lancet 2021; 398:2213-2215. [PMID: 34856188 PMCID: PMC8629491 DOI: 10.1016/s0140-6736(21)02692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/21/2022]
Affiliation(s)
| | - Sizulu Moyo
- Human Sciences Research Council, Cape Town 8000, South Africa
| | | | | | | | | | | | - Allanise Cloete
- Human Sciences Research Council, Cape Town 8000, South Africa
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10
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Dardier G, Jabot F, Pouliquen F. Can Air Quality Citizen-Sensors Turn into Clean Air Ambassadors? Insights from a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10046. [PMID: 34639347 PMCID: PMC8508063 DOI: 10.3390/ijerph181910046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
While the figure of ambassador is being increasingly called upon in the field of environmental health, its scope remains fuzzy and its success factors have been little studied. This article presents the results of a qualitative study performed over three years on a French citizen-sensor scheme for air quality. The scheme draws on volunteer citizens to measure fine particles by means of micro-sensors. Volunteers are also tasked with raising awareness in their entourage about environmental issues with the aim of changing people's behaviour. We investigated this strategy and sought to identify the conditions that enable citizens to become effective clean air ambassadors. The scheme's intervention logic was first reconstructed and a literature review of similar projects was conducted. Then, three surveys were carried out with the scheme's volunteers. Each survey consisted of an observation of the volunteers' practices and individual interviews (70 in all) in order to understand these citizen-sensors motivations and experiences, and characterize how they fulfilled their role. We concluded that, for citizen sensing, the scope and role of ambassador should be reconsidered insofar as these citizens serve as peer leaders and mediators. In this respect, we try to define the success factors for citizen-sensing-based ambassadors programmes.
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Affiliation(s)
- Guilhem Dardier
- EHESP, F-35000 Rennes, France; (F.J.); (F.P.)
- Univ Rennes, EHESP, CNRS, ARENES—UMR 6051, F-35000 Rennes, France
| | - Françoise Jabot
- EHESP, F-35000 Rennes, France; (F.J.); (F.P.)
- Univ Rennes, EHESP, CNRS, ARENES—UMR 6051, F-35000 Rennes, France
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