Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers: a pilot study

Abstract

Background: Overwhelmed, under-trained medical staff working in resource-limited settings need efficient resources for HIV disclosure counselling. The objective of this study was to describe providers’ experiences using tablet computers for disclosure-related counselling with HIV-infected children and their caregivers in western Kenya, with additional perspectives from adolescents. Methods: A qualitative study design was implemented at three HIV clinics in western Kenya (Bumala, Busia, and Port Victoria) within Academic Model Providing Access to Healthcare (AMPATH). Twenty-one healthcare providers involved with pediatric disclosure were recruited and enrolled in the study. Initial interviews focused on understanding current disclosure practices and barriers. Tablets containing disclosure-related resources were distributed. Resources included short narrative videos created in this context to highlight issues relevant to child HIV disclosure. Results: Providers reported tablets improved disclosure, child participation, and medication adherence. All reported that reviewing materials increased their knowledge and comfort with disclosure. The most frequently used materials were the narrative videos and an animated video explaining the importance of medication adherence. Time was a major barrier for using the tablet. Clinician self-education persisted at one-year follow-up. Adolescents expressed enjoyment from viewing the tablet resources and had a better understanding of the importance of medication adherence. Conclusions: Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to appropriately train the clinical providers in using the resources in a developmentally appropriate manner, as well as to develop new resources on adolescent-specific and HIV-related topics.

Perspectives of education sector stakeholders on a teacher training module to reduce HIV/AIDS stigma in Western Kenya

“…Adolescents ages 12–18 and enrolled in care at AMPATH participated in focus group discussions (FGDs) to assess the acceptability and effectiveness of the animations. The animations were subsequently used in post-disclosure counseling sessions with children living with HIV to explain the immunologic and physiologic complexities of HIV at an elementary level [ 22 ]. The HIV animation video would be played in the beginning of the training to provide teachers a basic level of HIV understanding prior to continuing with more interactive and discussion-based sections.…”

The role of digital health in palliative care for people living with HIV in sub-Saharan Africa: A systematic review

“… 36 , 48 , 49 Studies included three randomised controlled trials (RCTs), 41 , 43 , 50 three qualitative studies, 47 , 51 , 52 three pre- and post-test studies, 42 , 44 , 53 two observational studies, 49 , 54 two case series, 35 , 36 six cross-sectional studies 37 – 39 , 48 , 55 , 56 and six mixed method studies. 40 , 45 , 46 , 57 – 59 Most studies were published in 2019 ( n = 6), 48 , 49 , 53 – 55 , 57 followed by 2018 ( n = 4), 36 , 40 , 56 , 59 2015 ( n = 4) 41 , 44 , 50 , 51 and 2017 ( n = 3). 45 , 46 , 52 Table 2 summarises the characteristics of the included studies, and Table 3 provides further details of study characteristics.…”

“…Using the MMAT tool (see Supplementary Material 4 ), studies were grouped as qualitative ( n = 3), 47 , 51 , 52 RCTs ( n = 3), 41 , 43 , 50 quantitative non-randomised ( n = 8), 37 , 39 , 42 , 44 , 53 – 56 quantitative descriptive ( n = 5) 35 , 36 , 38 , 48 , 49 and mixed methods ( n = 6). 40 , 45 , 46 , 57 – 59 Most studies met four to five criteria for their study design. Only three studies 36 , 41 , 56 met three or fewer criteria.…”

Comunicação do diagnóstico de infecção pelo HIV: experiência de jovens

“…Para auxiliar familiares e profissionais na compreensão das informações, podem-se utilizar vídeos, brinquedos, desenhos, livros, folhetos, analogias e até mesmo ferramentas de informática, como redes sociais e sites, entre outros 30,32,34,36,37 . Alguns familiares também comunicam seu próprio diagnóstico de HIV primeiro, para que os jovens percebam a importância do uso de ARV e que é possível viver com o vírus mantendo a qualidade de vida, projetos e planos de futuro 33 .…”

“…É possível prevenir esse tipo de situação, pois, se a família representa o vínculo do receptor (criança/adolescente) e se prepara com o auxílio do profissional de saúde, a comunicação da infecção pode ser menos traumática e não resultar em situações de divulgação acidental 37 , que podem desencadear reações emocionais negativas e resistência ao tratamento. Destaca-se que falhas na comunicação implicam a heteronomia do jovem, ou seja, a sujeição deste à vontade de outrem, seja do familiar, seja do profissional, que posterga ou silencia o seu direito de conhecer o diagnóstico.…”