A Framework for Health Communication Across the HIV Treatment Continuum

Babalola, Stella; Lith, Lynn M Van; Mallalieu, Elizabeth C.; Packman, Zoe R; Myers, Emily; Ahanda, Kim Seifert; Harris, Emily; Gurman, Tilly; Figueroa, Maria-Elena

doi:10.1097/qai.0000000000001206

Cited by 30 publications

(32 citation statements)

References 204 publications

(234 reference statements)

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“…Peer navigation is another element of our intervention whereby FSW leaders work to link and retain FSWs living with HIV into care and onto ART. These efforts promote peer-led health communication and social support which have been effective in facilitating treatment-seeking behaviors in other settings, 28 including among FSWs in the Abriendo Puertas (Opening Doors) project in the Dominican Republic. 11 …”

Section: Discussionmentioning

confidence: 99%

Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania

Kerrigan

Mbwambo

Likindikoki

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background:Community empowerment approaches have been found to be effective in responding to HIV among female sex workers (FSWs) in South Asia and Latin America. To date, limited rigorous evaluations of these approaches have been conducted in sub-Saharan Africa.Methods:A phase II community randomized controlled trial is being conducted in Iringa, Tanzania, to evaluate the effectiveness of a community empowerment–based combination HIV prevention model (Project Shikamana) among a stratified sample of HIV-infected and HIV-uninfected FSWs. Cohort members were recruited from entertainment venues across 2 communities in the region using time-location sampling. All study participants gave consent, and were surveyed and screened for HIV at baseline. Primary biological study outcomes are viral suppression among the HIV-infected and remaining free of HIV among HIV-uninfected women.Results:A cohort of 496 FSWs was established and is currently under follow-up. Baseline HIV prevalence was 40.9% (203/496). Among HIV-infected FSWs, 30.5% (62/203) were previously aware of their HIV status; among those who were aware, 69.4% were on antiretroviral therapy (43/62); and for those on antiretroviral therapy, 69.8% (30/43) were virally suppressed. Factors associated with both HIV infection and viral suppression at baseline included community, age, number of clients, and substance use. Amount of money charged per client and having tested for sexually transmitted infection in the past 6 months were protective for HIV infection. Social cohesion among FSWs was protective for viral suppression.Conclusions:Significant gaps exist in HIV service coverage and progress toward reaching the 90-90-90 goals among FSWs in Iringa, Tanzania. Community empowerment approaches hold promise given the high HIV prevalence, limited services and stigma, discrimination, and violence.

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Section: Discussionmentioning

confidence: 99%

Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania

Kerrigan

Mbwambo

Likindikoki

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…As illustrated by the framework for health communication across the HIV treatment cascade, a combination of communication approaches should be implemented to best impact behaviors in the HIV care continuum. 22 In this study, we hypothesize that stigma is acting as a barrier to the uptake of services, limiting coverage and effectiveness for key populations in Senegal. Moreover, the study posits that combination stigma interventions will improve effectiveness of existing HIV services, increase uptake of these services by key populations, decrease reported experienced and perceived stigma, increase consistent use of condoms and condom compatible lubricants, increase adherence to HIV treatment regimens, and ultimately decreased community HIV viral load.…”

Section: Introductionmentioning

confidence: 98%

Potential Impact of Integrated Stigma Mitigation Interventions in Improving HIV/AIDS Service Delivery and Uptake for Key Populations in Senegal

Lyons

Ketende

Diouf

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background:Men who have sex with men (MSM) and female sex workers (FSW) are consistently shown to have a higher burden of HIV compared with other adults in Senegal. This study, HIV Prevention 2.0, evaluates the impact of the 3-tiered integrated stigma mitigation interventions (ISMIs) approach to optimizing HIV service delivery for key populations in Senegal.Methods:Baseline assessment includes a questionnaire and biological testing for HIV. A proportion of participants enrolled into a 24-month longitudinal cohort with questionnaires and biological testing every 3 months. In these preliminary analyses, ISMIs are evaluated from participants in the cohort through uptake of HIV services and implementation outcomes.Results:Overall, 724 MSM and 758 FSW participated in the baseline assessment. HIV prevalence is 30.2% (n = 219/724) among MSM and 5.3% (n = 40/758) among FSW. Fear of seeking health services among MSM is 17.7% (n = 128/724) at baseline, 10.5% (n = 18/172) at month 3, and 9.8% (n = 10/102) at month 6 (P < 0.004); and among FSW is 21.9% (n = 166/758) at baseline, 8.1% (n = 15/185) at month 3, and 10.7% (n = 18/168) at month 6 (P < 0.001). Overall, 63.9% (n = 62/97) of MSM and 82.5% (n = 118/143) of FSW agreed that the intervention is effective in addressing stigma; however, loss to follow-up was 41.1% among MSM and 10% among FSW.Conclusion:Baseline data reinforce the need for stigma mitigation interventions, combined with enhanced linkage and retention to optimize HIV treatment. Preliminary results show high levels of HIV-related risk determinants and suggest the potential utility of the ISMI to decrease perceived stigma relating to engagement in HIV prevention, treatment, and care services among key populations in Senegal.

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“…9,10 Consequently, according to the Human Sciences Research Council (HSRC), addressing men's fears of testing and treatment is an issue of major concern. 3,11 …”

Section: Introductionmentioning

confidence: 99%

Development of a National Campaign Addressing South African Men's Fears About HIV Counseling and Testing and Antiretroviral Treatment

Orr

Hajiyiannis

Myers

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction:South African men are less likely to get tested for HIV than women and are more likely to commence antiretroviral treatment (ART) at later stages of disease, default on treatment, and to die from AIDS compared with women. The purpose of this study was to conduct formative research into the ideational and behavioral factors that enable or create obstacles to mens' uptake of HIV counseling and testing (HCT) and ART. The study consulted men with a goal of developing a communication campaign aimed at improving the uptake of HIV testing and ART initiation among men.Methods:Eleven focus groups and 9 in-depth interviews were conducted with 97 male participants in 6 priority districts in 4 South African provinces in rural, peri-urban, and urban localities.Results:Fears of compromised masculine pride and reputation, potential community rejection, and fear of loss of emotional control (“the stress of knowing”) dominated men's rationales for avoiding HIV testing and treatment initiation.Conclusions:A communication campaign was developed based on the findings. Creative treatments aimed at redefining a ‘strong’ man as someone who faces his fears and knows his HIV status. The resultant campaign concept was: “positive or negative—you are still the same person.”

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A Framework for Health Communication Across the HIV Treatment Continuum

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 30 publications

References 204 publications

Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania

Project Shikamana: Baseline Findings From a Community Empowerment–Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania

Potential Impact of Integrated Stigma Mitigation Interventions in Improving HIV/AIDS Service Delivery and Uptake for Key Populations in Senegal

Development of a National Campaign Addressing South African Men's Fears About HIV Counseling and Testing and Antiretroviral Treatment

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