A Role for Health Communication in the Continuum of HIV Care, Treatment, and Prevention

Abstract

Health communication has played a pivotal role in HIV prevention efforts since the beginning of the epidemic. The recent paradigm of combination prevention, which integrates behavioral, biomedical, and structural interventions, offers new opportunities for employing health communication approaches across the entire continuum of care. We describe key areas where health communication can significantly enhance HIV treatment, care, and prevention, presenting evidence from interventions that include health communication components. These interventions rely primarily on interpersonal communication, especially individual and group counseling, both within and beyond clinical settings to enhance the uptake of and continued engagement in care. Many successful interventions mobilize a network of trained community supporters or accompagnateurs, who provide education, counseling, psychosocial support, treatment supervision and other pragmatic assistance across the care continuum. Community treatment supporters reduce the burden on overworked medical providers, engage a wider segment of the community, and offer a more sustainable model for supporting people living with HIV. Additionally, mobile technologies are increasingly seen as promising avenues for ongoing cost-effective communication throughout the treatment cascade. A broader range of communication approaches, traditionally employed in HIV prevention efforts, that address community and sociopolitical levels through mass media, school- or workplace-based education, and entertainment modalities may be useful to interventions seeking to address the full care continuum. Future interventions would benefit from development of a framework that maps appropriate communication theories and approaches onto each step of the care continuum in order to evaluate the efficacy of communication components on treatment outcomes.

Health-information needs of HIV-positive adults in Latin America and the Caribbean: an integrative review of the literature

“…Finally, information needs assessments are only relevant if healthcare providers and organizations use the data obtained to improve patient care. But when these changes are made, studies have shown that meeting patient health-information needs can lead to better outcomes (Flickinger, Saha, Moore, & Beach, 2013; Tomori et al, 2014). …”

A Framework for Health Communication Across the HIV Treatment Continuum

“…16,73,75,76,87–90 Before support can be received though, disclosure must occur and disclosure has been found to be a major barrier to ART initiation. 77,82,85,91,92 Disclosure to friends and family enables patients to access the psychosocial and material support crucial for initiating and staying on treatment.…”

“…Barriers at the community level include stigma and discrimination, 16,74–76,81,89,94–97 limited ART knowledge within the community, lack of community involvement in program planning, and lack of community mobilization around ART. 74,78,94,96 Inequitable gender norms, including community stereotypes of masculinity and femininity are key determinants of delayed linkage to care and treatment.…”

“…16,25,81,87,89,97,105–110 Interventions engaging traditional practitioners and faith healers yielded mixed results. Although 1 study 111 demonstrated that training traditional healers led to increased referral rates in Mozambique, others 112–114 did not find such an effect.…”

“…This article builds on prior research in the literature 16–19 and expounds the critical role of strategic health communication to influence behaviors throughout the continuum. We define social and behavioral change communication or health communication as the art and science of promoting and protecting public health.…”