Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa

Sikkema, Kathleen J.; Mulawa, Marta; Robertson, Corné; Watt, Melissa H.; Ciya, Nonceba; Stein, Dan J.; Cherenack, Emily M.; Choi, Karmel W.; Kombora, Matapelo; Joska, John A.

doi:10.1007/s10461-017-2013-1

Cited by 51 publications

(102 citation statements)

References 62 publications

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“…While previous studies have described how avoidant approaches to dealing with life stressors can lead to drinking and depression among PLWH [32,38], far less attention has been given to the role of traumatic life experiences and social circumstances. Although there have been some efforts to develop interventions that address traumatic stress among South African women who are living with HIV [39,40], these interventions have not included a focus on alcohol use and depression which intersect with experiences of trauma; other trauma-focused substance use interventions have been developed but have not focused on young women using ART specifically [35,41]. Our findings suggest that helping young women living with HIV to find ways of accepting problems and life circumstances that cannot change, including strategies for helping women manage their emotional responses to these experiences, is key to enabling them to move on with their lives, change their health risk behaviors, and optimize their use of ART.…”

Section: Discussionmentioning

confidence: 99%

Young South African Women on Antiretroviral Therapy Perceptions of a Psychological Counselling Program to Reduce Heavy Drinking and Depression

Williams

Brooke-Sumner

Joska

et al. 2020

IJERPH

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Young women in South Africa remain most at risk for HIV infection. Several factors contribute to the high incidence rate in this population, including hazardous drinking and depression. Addressing common mental disorders (CMDs) such as depression and alcohol use disorders is key to effective HIV treatment. We explored the experiences and perceptions of young South African women on antiretroviral therapy (ART) of a lay health worker (LHW)-delivered psychosocial intervention based on motivational interviewing (MI) and problem-solving therapy (PST) to reduce heavy drinking and depression. We conducted 27 in-depth interviews with young women (aged 18–35) recruited from 16 primary care clinics in the Western Cape province of South Africa. Discussion topics included young women’s life experiences leading to their enrollment in the program, their perceptions of the counselling sessions and the quality of their interaction with the counsellor. Qualitative data were analyzed using a framework approach. The findings highlighted the impact adverse life experiences and stressful life circumstances have on young women’s use of alcohol and symptoms of depression and the effect this has on ART adherence. The findings suggest that women found the intervention components that helped them develop strategies for coping with their past experiences, managing current life stressors, and regulating negative thoughts and emotions most beneficial. Taken together, these findings confirm the acceptability of LHW-delivered MI-PST counselling for this population, but suggest that the relevance of the MI-PST intervention for this highly vulnerable population could be further enhanced by including a focus on psychological trauma.

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Section: Discussionmentioning

confidence: 99%

Young South African Women on Antiretroviral Therapy Perceptions of a Psychological Counselling Program to Reduce Heavy Drinking and Depression

Williams

Brooke-Sumner

Joska

et al. 2020

IJERPH

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“…Several studies of potentially promising interventions have not shown gains for ART initiation. No benefit was seen in a South African study involving a conditional economic incentive (39% intervention versus 45% control; adjusted odds ratio (AOR) = 0.67; 95% CI = 0.26-1.78) [30] or in a Kenyan study involving weekly text message (WelTel Retain; 82% versus control 78%) [31], or a sexual trauma coping intervention for women with a history of sexual abuse in South Africa (91% intervention versus 88% SoC) [32].…”

Section: General Adult Populationsmentioning

confidence: 99%

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

et al. 2020

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Purpose of Review We reviewed interventions to improve uptake and adherence to antiretroviral therapy (ART) in African countries in the Treat All era. Recent Findings ART initiation can be improved by facilitated rapid receipt of first prescription, including community-based linkage and point-of-care strategies, integration of HIV care into antenatal care and peer support for adolescents. For people living with HIV (PLHIV) on ART, scheduled SMS reminders, ongoing intensive counselling for those with viral non-suppression and economic incentives for the most deprived show promise. Adherence clubs should be promoted, being no less effective than facility-based care for stable patients. Tracing those lost to follow-up should be targeted to those who can be seen face-to-face by a peer worker. Summary Investment is needed to promote linkage to initiating ART and for differentiated approaches to counselling for youth and for those with identified suboptimal adherence. More evidence from within Africa is needed on cost-effective strategies to identify and support PLHIV at an increased risk of non-adherence across the treatment cascade.

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“…Interpersonal violence and sexual trauma are highly prevalent among this population [5,6]. Our group has previously shown that nearly two-thirds of WLHIV have experienced sexual trauma and that many do not disclose this history unless asked under research or strict clinical conditions [7,8]. The consequences of these experience(s) include increased rates of depression and post-traumatic stress disorder [9], and increased likelihood of behavioural avoidance patterns [6,[10][11][12]].…”

Section: Interpersonal Violence and Sexual Traumamentioning

confidence: 99%

“…WLHIV with a history of sexual trauma already live with high levels of anxiety, including hyper-arousal and avoidance symptoms [8]. They cope poorly with additional stressors [11,15].…”

Section: Interpersonal Violence and Sexual Traumamentioning

confidence: 99%

“…Our group has previously piloted a coping intervention with HIV-infected women aimed at reducing avoidant coping and improving medication adherence and retention in care [8]. A randomised controlled trial to test the effectiveness of the intervention is scheduled to commence in Cape Town, South Africa in the coming months (1R01MH118004).…”

Section: A Coherent Response Is Neededmentioning

confidence: 99%

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COVID-19: Increased Risk to the Mental Health and Safety of Women Living with HIV in South Africa

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Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa

Abstract: ClinicalTrials.gov NCT02223390.

Cited by 51 publications

References 62 publications

Young South African Women on Antiretroviral Therapy Perceptions of a Psychological Counselling Program to Reduce Heavy Drinking and Depression

Young South African Women on Antiretroviral Therapy Perceptions of a Psychological Counselling Program to Reduce Heavy Drinking and Depression

A Cascade of Interventions to Promote Adherence to Antiretroviral Therapy in African Countries

COVID-19: Increased Risk to the Mental Health and Safety of Women Living with HIV in South Africa

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