Integrated access to care and treatment (I ACT) support groups for adolescents living with HIV in public healthcare facilities in South Africa: feasibility and acceptability for scaling up

James, Shamagonam; Martin, Catherine; Moalusi, Bafentse; Beery, Moira; Pahad, Shenaaz; Imrie, John

doi:10.1080/09540121.2018.1478384

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…It also builds on a small but growing number of HIV program acceptability studies with adolescents and young adults in sub-Saharan Africa [29]. Similar to this research, we found that offering social support within a safe, stigma-free environment is highly acceptable to youth with HIV [14,30]. Such an environment allows youth to feel comfortable discussing personal challenges and developing trusting relationships, thus motivating them to accept their HIV status [29,31].…”

Section: Discussionsupporting

confidence: 71%

Development of “Yima Nkqo,” a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa

Nardell,

Sindelo,

Rousseau

et al. 2023

PLoS ONE

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Aims Half of young adults diagnosed with HIV in South Africa start antiretroviral therapy (ART). We developed and field tested a facilitator-guided peer support group called Yima Nkqo (“Standing Tall” in isiXhosa) to promote treatment initiation for young adults newly diagnosed with HIV in communities around Cape Town. Methods Following an adapted version of the UK Medical Research Council’s framework for developing complex interventions, we 1) identified evidence on previous interventions to improve ART uptake in sub-Saharan Africa; 2) collected and analyzed qualitative data on the acceptability of our proposed intervention; 3) proposed a theoretical understanding of the process of behavior change; and 4) developed an intervention manual and feedback tools. During field-testing, participant feedback on intervention acceptability, and team feedback on consistency of content delivery and facilitation quality, were analyzed using an iterative, rapid-feedback evaluation approach. In-depth written and verbal summaries were shared in weekly team meetings. Team members interpreted feedback, identified areas for improvement, and proposed suggestions for intervention modifications. Results Based on our formative research, we developed three, 90-minute sessions with content including HIV and ART education, reflection on personal resources and strengths, practice disclosing one’s status, strategies to overcome stressors, and goal setting to start treatment. A lay facilitator was trained to deliver intervention content. Two field testing groups (five and four participants, respectively) completed the intervention. Participants highlighted that strengths of Yima Nkqo included peer support, motivation, and education about HIV and ART. Team feedback to the facilitator ensured optimal consistency of intervention content delivery. Conclusions Iteratively developed in collaboration with youth and healthcare providers, Yima Nkqo is a promising new intervention to improve treatment uptake among young adults with HIV in South Africa. The next phase will be a pilot randomized controlled trial of Yima Nkqo (ClinicalTrials.gov Identifier: NCT04568460).

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Section: Discussionsupporting

confidence: 71%

Development of “Yima Nkqo,” a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa

Nardell,

Sindelo,

Rousseau

et al. 2023

PLoS ONE

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“…All 7 support group interventions provided psychosocial or educational support related to HIV, and 5 worked only with young adults living with HIV. One group intervention was delivered through both a social media platform and in-person meetings (53), one was a family based support intervention with adolescent-parent dyads (33), four were linked to public healthcare facilities (42, 47, 54, 55) and one was a community intervention (43).…”

Section: Resultsmentioning

confidence: 99%

“…Fear of the procedure, concerns with the cost and validity of the test, and inadequate emotional support were reasons given for lack of acceptability (64, 75, 76). Support group interventions were considered acceptable because of the emotional support provided and because young adults found the groups to be empowering and were able to discuss HIV-related issues in a stigma-free environment (42, 47, 53, 55).…”

Section: Resultsmentioning

confidence: 99%

A decade of Acceptability Research with Adolescents in Africa: Systematic review and evidence map

Somefun

Casale

Hauptronnie

et al. 2021

Preprint

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Interventions aimed at improving adolescent developmental outcomes are more likely to be successful if the young people they target find them acceptable. However, no standard definitions or indicators exist to assess acceptability, acceptability research with adolescents in LMICs is still limited, and no known reviews synthesise the evidence from Africa.We conducted a systematic review of peer-reviewed studies assessing intervention acceptability with young adults (aged 10-24) in Africa, published between January 2010 and June 2020. This paper maps and qualitatively synthesizes the scope, characteristics, and findings of these studies, including definitions of acceptability, methods used, the type and objectives of interventions assessed, and overall findings on adolescent acceptability.The review was carried out in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key word searches generated 4692 unique records and 55 final eligible studies, assessing 60 interventions. Most studies were conducted in Southern Africa, of which 32 jointly in South Africa and Uganda. The majority of interventions assessed for acceptability could be classified as HIV or HPV vaccine interventions (10), E-health (10), HIV testing interventions (8), support group interventions (7) and contraceptive interventions (6). The objectives of most interventions were linked to SDG3, specifically to HIV and sexual and reproductive health. Acceptability was overall high among these published studies. 22 studies provided reasons for acceptability or lack thereof, some specific to particular types of interventions and others common across intervention types.Our review exposes considerable scope for future acceptability research and review work. This should include: extending acceptability research beyond the health (and particularly HIV) sector and to regions in Africa where this type of research is still scarce; including adolescents earlier, and potentially throughout the intervention process; further conceptualising the construct of acceptability among adolescents and beyond, and examining the relationship between acceptability and uptake.Key QuestionsWhat is already known?Addressing the developmental needs of adolescents in African countries is critical if the continent is to achieve its sustainable development goals (SDGs).Many interventions aimed at strengthening adolescent developmental outcomes have not achieved desired impact, and adolescent involvement is often poorly envisaged and implemented.Uptake and effectiveness of interventions is likely to be higher if these interventions are acceptable to adolescent end-users.What are the new findings?Acceptability of interventions assessed in Africa was generally high among adolescents.Understanding of the intervention, ease of use, adequate emotional support, autonomy, confidentiality and protection from stigma were key overarching themes explaining why young people found interventions acceptableWhat do the new findings imply?Intervention developers and implementers across the continent should pay attention to these key aspects of interventions and their delivery.It is important to strengthen adolescents’ understanding of interventions, involve adolescents early on in intervention development, and engage with the broader context within which adolescent acceptability is shaped.There is a need for more acceptability research in important areas for adolescent development beyond (physical) health and, within the health sector, beyond HIV.

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“…Some, including Ybarra, 2014 [22], and Smith, 2016 [23], developed questionnaires using Likert scales to assess outcomes of acceptability and feasibility. Others, including Barker, 2019 [29] and James, 2018 [27], conducted interviews and focus groups with participants using semi-structured interview guides. Secondary data and process data noting things like consent, continued attendance, and referral requests for additional resources were also documented as implementation science outcomes, particularly acceptability [31,33,38].…”

Section: Implementation Science Characteristicsmentioning

confidence: 99%

Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review

et al. 2022

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Despite many evidence-based adolescent and young adult (AYA) HIV interventions, few are implemented at scale in sub-Saharan Africa (SSA). A growing implementation science literature provides important context for scaling up AYA HIV interventions in this high HIV-burden region. This scoping review examined the use of implementation research in AYA HIV studies conducted in SSA. We searched five databases and included articles which focused on AYA (10–24 years old), addressed HIV prevention or treatment, were conducted exclusively in SSA countries, and included an implementation science outcome. We included 44 articles in 13 SSA countries. Most were in East (52.3%) and South Africa (27.3%), and half focused exclusively on HIV prevention components of the care continuum. Acceptability and feasibility were the most cited implementation science outcomes. Only four articles used an established implementation science framework. The findings informed our recommendations to guide the design, implementation, and dissemination of further studies and health policymaking.

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Integrated access to care and treatment (I ACT) support groups for adolescents living with HIV in public healthcare facilities in South Africa: feasibility and acceptability for scaling up

Cited by 7 publications

References 8 publications

Development of “Yima Nkqo,” a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa

Development of “Yima Nkqo,” a community-based, peer group intervention to support treatment initiation for young adults with HIV in South Africa

A decade of Acceptability Research with Adolescents in Africa: Systematic review and evidence map

Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review

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