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Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial

Barnabas, Ruanne V ; Szpiro, Adam A ; van Rooyen, Heidi ; [et al.]

Elsevier BV ; 2020

In: The Lancet Global Health Vol. 8, No. 10 ( 2020-10), p. e1305-e1315

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In: The Lancet Global Health, Elsevier BV, Vol. 8, No. 10 ( 2020-10), p. e1305-e1315

Type of Medium: Online Resource

ISSN: 2214-109X

URL: Article

DOI: 10.1016/S2214-109X(20)30313-2

Language: English

Publisher: Elsevier BV

Publication Date: 2020

detail.hit.zdb_id: 2723488-5

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Optimising a couples-focused intervention to increase couples’ HIV testing and counselling using the person-based approach: a qualitative study in Kwa-Zulu Natal, South Africa

Morton, Katherine ; Mhlakwaphalwa, Tembeka ; Msimango, Lindani ; [et al.]

BMJ ; 2021

In: BMJ Open Vol. 11, No. 12 ( 2021-11), p. e047408-

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In: BMJ Open, BMJ, Vol. 11, No. 12 ( 2021-11), p. e047408-

Abstract: This qualitative study explored how to optimise a couples-focused intervention to promote couples HIV testing and counselling (CHTC). Setting Community setting in Kwa-Zulu Natal, South Africa. Participants Qualitative interviews were conducted with 20 couples who had participated in a couples-focused intervention and five staff members delivering the intervention. Partners were interviewed individually by researchers of the same gender. Intervention A couples-focused intervention comprised of two group sessions and four couples counselling sessions was previously shown to significantly increase uptake to CHTC in Kwa-Zulu Natal, South Africa. However, more than half of couples participating in the intervention still chose not to test together during follow-up. Analysis The transcripts were analysed using the table of changes from the person-based approach. Proposed optimisations were discussed with a community group to ensure the intervention was as persuasive and acceptable as possible. Results Many couples found it challenging to discuss CHTC with their partner due to an implied lack of trust. Optimisations to the intervention were identified to increase readiness to discuss CHTC, including education about serodiscordance, discussions about CHTC by peer mentors and open discussion of personal barriers to CHTC during couples’ counselling sessions. Additional training for staff in open questioning techniques could help them feel more comfortable to explore couples’ perceived barriers to CHTC, rather than advising couples to test. A logic model was developed to show anticipated mechanisms through which the optimised intervention would increase uptake to CHTC, including increasing knowledge, increasing positive outcome beliefs and managing negative emotions. Conclusions In-depth qualitative research informed optimisations to a couples-focused intervention for further evaluation in South Africa to encourage uptake to CHTC. Suggestions are made for optimal methods to gain open feedback on intervention experiences where participants may be reluctant to share negative views.

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2020-047408

Language: English

Publisher: BMJ

Publication Date: 2021

detail.hit.zdb_id: 2599832-8

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Alcohol consumption among HIV-positive pregnant women in KwaZulu-Natal, South Africa: Prevalence and correlates

Desmond, Katherine ; Milburn, Norweeta ; Richter, Linda ; [et al.]

Elsevier BV ; 2012

In: Drug and Alcohol Dependence Vol. 120, No. 1-3 ( 2012-1), p. 113-118

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In: Drug and Alcohol Dependence, Elsevier BV, Vol. 120, No. 1-3 ( 2012-1), p. 113-118

Type of Medium: Online Resource

ISSN: 0376-8716

URL: Article

DOI: 10.1016/j.drugalcdep.2011.07.004

Language: English

Publisher: Elsevier BV

Publication Date: 2012

detail.hit.zdb_id: 2004927-4

SSG: 15,3

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Perceived mHealth barriers and benefits for home-based HIV testing and counseling and other care: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa

van Heerden, Alastair ; Harris, Danielle M. ; van Rooyen, Heidi ; [et al.]

Elsevier BV ; 2017

In: Social Science & Medicine Vol. 183 ( 2017-06), p. 97-105

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In: Social Science & Medicine, Elsevier BV, Vol. 183 ( 2017-06), p. 97-105

Type of Medium: Online Resource

ISSN: 0277-9536

URL: Article

DOI: 10.1016/j.socscimed.2017.04.046

Language: English

Publisher: Elsevier BV

Publication Date: 2017

detail.hit.zdb_id: 1500748-0

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Qualitative interviews with mentor mothers living with HIV: potential impacts of role and coping strategies

Dhlamini, Lebohang ; Knight, Lucia ; van Rooyen, Heidi ; [et al.]

Wiley ; 2012

In: Journal of the International AIDS Society Vol. 15, No. S2 ( 2012-07)

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In: Journal of the International AIDS Society, Wiley, Vol. 15, No. S2 ( 2012-07)

Abstract: In South Africa where HIV prevalence is high, mentor mother programmes have been used to promote the health and wellbeing of women enrolled in government programmes preventing vertical transmission. The Masihambisane Project trained mentors to be educators and facilitators as “expert patients” in self‐help groups. While this and other similar interventions demonstrate positive outcomes for mothers and their children, the long‐term repercussions for mentors delivering the intervention are seldom considered. This article explores the personal impact of being a mentor, the potentially traumatizing effects of repeatedly sharing their experiences of living with HIV and the coping strategies they adopt. Results Towards the end of the Masihambisane intervention, 10 semi‐structured qualitative interviews were conducted with locally recruited mentors living with HIV and were thematically analysed. Mentors found the repeated telling of their stories a painful reminder of adverse personal experiences. In some cases, retelling caused a physical reaction. Mentors relied on coping strategies like taking breaks, writing their experiences down and debriefing sessions. Despite the difficulties associated with their role, some mentors found being advisors and the group sessions therapeutic and empowering. Conclusions These findings indicate that the inclusion of peer mentors comes with certain responsibilities. While the mentors were resilient and some found the experience therapeutic and empowering found creative ways to cope with secondary trauma, the negative implications cannot be ignored. To effectively deliver a mentor‐driven intervention to mothers enrolled in a programme to prevent vertical transmission, the possibilities of secondary trauma should be considered and mentors provided with ongoing counselling, training on coping skills and regular debriefing sessions.

Type of Medium: Online Resource

ISSN: 1758-2652 , 1758-2652

URL: Article

DOI: 10.7448/IAS.15.4.17391

Language: English

Publisher: Wiley

Publication Date: 2012

detail.hit.zdb_id: 2467110-1

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Secondary Distribution of HIV Self-Testing Kits to Social and Sexual Networks of PLWH in KwaZulu-Natal, South Africa. A Brief Report

Sithole, Nsika ; Koole, Olivier ; Sausi, Kombi ; [et al.]

Frontiers Media SA ; 2022

In: Frontiers in Public Health Vol. 10 ( 2022-4-27)

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In: Frontiers in Public Health, Frontiers Media SA, Vol. 10 ( 2022-4-27)

Abstract: To reach 95% of persons living with HIV (PLWH) knowing their HIV status, alternative testing approaches such as HIV self-testing (HIVST) and secondary HIVST kit distribution are needed. We investigated if secondary HIVST kit distribution from male and female PLWH in South Africa would successfully lead to their contacts testing for HIV and linking to care if positive. Methods Male and female PLWH participating in an HIV treatment trial between July and November 2018 in KwaZulu-Natal, South Africa were offered participation as “HIVST kit distributors” in a pilot of secondary distribution of HIVST kits to give to sexual partners and social networks. Univariate descriptive statistics were used to describe the characteristics of volunteer distributors, proportion of HIVST recipients who reported their results, and linkage to care among those who tested positive using HIVST were assessed. Results Sixty-three participant kit distributors accepted kits to disperse to contacts, of whom 52% were female, median age was 34 years (IQR 26-42.5), 84% reported 1 sexual partner and 76% did not know their partner's HIV status. HIVST kit distributors took 218 kits, with 13/218 (6%) of kits reported to be intended to be given to a sexual partner. A total of 143 HIVST recipients reported their HIVST results; 92% reported their results were negative, 11 recipients reported positive results and 1 HIVST-positive recipient was linked to HIV care. Conclusion Secondary distribution of HIVST to social networks and sexual partners from South African PLWH is feasible, with two thirds of contacts reporting use of the HIVST kits. Additional support is necessary to facilitate linkage to care.

Type of Medium: Online Resource

ISSN: 2296-2565

URL: Article

DOI: 10.3389/fpubh.2022.855625

Language: Unknown

Publisher: Frontiers Media SA

Publication Date: 2022

detail.hit.zdb_id: 2711781-9

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Supporting Treatment for Anti-Retroviral Therapy (START) Together: Protocol for a pilot, randomized, couple-based intervention to promote women's ART adherence and men's engagement in HIV care in KwaZulu-Natal, South Africa

Belus, Jennifer M. ; van Heerden, Alastair ; van Rooyen, Heidi ; [et al.]

Elsevier BV ; 2022

In: Contemporary Clinical Trials Communications Vol. 29 ( 2022-10), p. 100970-

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In: Contemporary Clinical Trials Communications, Elsevier BV, Vol. 29 ( 2022-10), p. 100970-

Type of Medium: Online Resource

ISSN: 2451-8654

URL: Article

DOI: 10.1016/j.conctc.2022.100970

Language: English

Publisher: Elsevier BV

Publication Date: 2022

detail.hit.zdb_id: 2858947-6

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Population health impact, cost-effectiveness, and affordability of community-based HIV treatment and monitoring in South Africa: A health economics modelling study

Sahu, Maitreyi ; Bayer, Cara J. ; Roberts, D. Allen ; [et al.]

Public Library of Science (PLoS) ; 2023

In: PLOS Global Public Health Vol. 3, No. 9 ( 2023-9-5), p. e0000610-

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In: PLOS Global Public Health, Public Library of Science (PLoS), Vol. 3, No. 9 ( 2023-9-5), p. e0000610-

Abstract: Community-based delivery and monitoring of antiretroviral therapy (ART) for HIV has the potential to increase viral suppression for individual- and population-level health benefits. However, the cost-effectiveness and budget impact are needed for public health policy. We used a mathematical model of HIV transmission in KwaZulu-Natal, South Africa, to estimate population prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 2020 to 2060 for two scenarios: 1) standard clinic-based HIV care and 2) five-yearly home testing campaigns with community ART for people not reached by clinic-based care. We parameterised model scenarios using observed community-based ART efficacy. Using a health system perspective, we evaluated incremental cost-effectiveness and net health benefits using a threshold of $750/DALY averted. In a sensitivity analysis, we varied the discount rate; time horizon; costs for clinic and community ART, hospitalisation, and testing; and the proportion of the population receiving community ART. Uncertainty ranges (URs) were estimated across 25 best-fitting parameter sets. By 2060, community ART following home testing averted 27.9% (UR: 24.3–31.5) of incident HIV infections, 27.8% (26.8–28.8) of HIV-related deaths, and 18.7% (17.9–19.7) of DALYs compared to standard of care. Adolescent girls and young women aged 15–24 years experienced the greatest reduction in incident HIV (30.7%, 27.1–34.7). In the first five years (2020–2024), community ART required an additional $44.9 million (35.8–50.1) annually, representing 14.3% (11.4–16.0) of the annual HIV budget. The cost per DALY averted was $102 (85–117) for community ART compared with standard of care. Providing six-monthly refills instead of quarterly refills further increased cost-effectiveness to $78.5 per DALY averted (62.9–92.8). Cost-effectiveness was robust to sensitivity analyses. In a high-prevalence setting, scale-up of decentralised ART dispensing and monitoring can provide large population health benefits and is cost-effective in preventing death and disability due to HIV.

Type of Medium: Online Resource

ISSN: 2767-3375

URL: Article

DOI: 10.1371/journal.pgph.0000610

DOI: 10.1371/journal.pgph.0000610.g001

DOI: 10.1371/journal.pgph.0000610.g002

DOI: 10.1371/journal.pgph.0000610.g003

DOI: 10.1371/journal.pgph.0000610.g004

DOI: 10.1371/journal.pgph.0000610.t001

DOI: 10.1371/journal.pgph.0000610.t002

DOI: 10.1371/journal.pgph.0000610.t003

DOI: 10.1371/journal.pgph.0000610.s001

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2023

detail.hit.zdb_id: 3101394-6

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Pregnant Women Living with HIV (WLH) Supported at Clinics by Peer WLH: A Cluster Randomized Controlled Trial

Richter, Linda ; Rotheram-Borus, Mary Jane ; Van Heerden, Alastair ; [et al.]

Springer Science and Business Media LLC ; 2014

In: AIDS and Behavior Vol. 18, No. 4 ( 2014-4), p. 706-715

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In: AIDS and Behavior, Springer Science and Business Media LLC, Vol. 18, No. 4 ( 2014-4), p. 706-715

Type of Medium: Online Resource

ISSN: 1090-7165 , 1573-3254

URL: Article

DOI: 10.1007/s10461-014-0694-2

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2014

detail.hit.zdb_id: 2014832-X

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Cost of Integrating Noncommunicable Disease Screening Into Home-Based HIV Testing and Counseling in South Africa

Golovaty, Ilya ; Sharma, Monisha ; Van Heerden, Alastair ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2018

In: JAIDS Journal of Acquired Immune Deficiency Syndromes Vol. 78, No. 5 ( 2018-08-15), p. 522-526

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In: JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 78, No. 5 ( 2018-08-15), p. 522-526

Abstract: Integrated HIV–noncommunicable disease (NCD) services have the potential to avert death and disability but require data on program costs to assess the impact of integrated services on affordability. Methods: We estimated the incremental costs of NCD screening as part of home-based HIV testing and counseling (HTC) and referral to care in KwaZulu-Natal, South Africa. All adults in the households were offered integrated HIV–NCD screening (for HIV, diabetes, hypertension, hypercholesterolemia, obesity, depression, tobacco, and alcohol use), counseling, and linkage to care. We conducted comprehensive program microcosting including ingredient-based and activity-based costing, staff interviews, and time assessment studies. Sensitivity analyses varied cost inputs and screening efficiency. Results: Integrating all-inclusive NCD screening as part of home-based HTC in a high HIV prevalence setting increased program costs by $3.95 (42%) per person screened (from $9.36 to $13.31 per person). Integrated NCD screening, excluding point-of-care cholesterol testing, increased program costs by $2.24 (24%). Furthermore, NCD screening integrated into HTC services reduced the number of persons tested by 15%–20% per day. Conclusions: Integrated HIV–NCD screening has the potential to efficiently use resources compared with stand-alone services. Although all-inclusive NCD screening could increase the incremental cost per person screened for integrated HIV–NCD services over 40%, a less costly lipid assay or targeted screening would result in a modest increase in costs with the potential to avert NCD death and disability. Our analysis highlights the need for implementation science studies to estimate the cost-effectiveness of integrated HIV–NCD screening and linkage per disability-adjusted life year and death averted.

Type of Medium: Online Resource

ISSN: 1525-4135

URL: Article

DOI: 10.1097/QAI.0000000000001713

RVK:

XA 10000

RVK:

XA 51942

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2018

detail.hit.zdb_id: 2038673-4

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