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Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling

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Abstract

Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa. In this programmatic and descriptive narrative report, we describe the application; lay-counsellors’ response to open-ended questions regarding their experience with using Masivukeni; and perspectives of the City of Cape Town and Western Cape Government DoH, obtained through ongoing engagements and feedback sessions. Counsellors reported Masivukeni empowered them to provide high quality counselling. DoH indicated strong support for a future implementation study assessing feasibility for larger scale roll-out. Masivukeni has potential as a counselling tool in resource-limited settings.

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References

  1. Statistics South Africa. Mid-year population estimates 2016. Pretoria: South African Government; 2016 25 August 2016. Report No.: P0302 Contract No.: P0302.

  2. Department of Health. National HIV Testing Services: Policy 2016. Pretoria, South Africa: Department of Health, Health Do; 2016. Contract No.: 19 September 2017.

  3. Meintjes G, Moorhouse MA, Carmona S, Davies N, Dlamini S, van Vuuren C, et al. Adult antiretroviral therapy guidelines 2017. South Afr J HIV Med. 2017;18:1–24.

    Article  Google Scholar 

  4. Bekker LG, Venter F, Cohen K, Goemare E, Van Cutsem G, Boulle A, et al. Provision of antiretroviral therapy in South Africa: the nuts and bolts. Antivir Ther. 2014;19(Suppl 3):105–16.

    Article  PubMed  Google Scholar 

  5. Robbins RN, Spector AY, Mellins CA, Remien RH. Optimizing ART adherence: update for HIV treatment and prevention. Curr HIV/AIDS Rep. 2014;11(4):423–33.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hosseinipour MC, Gupta RK, Van Zyl G, Eron JJ, Nachega JB. Emergence of HIV drug resistance during first- and second-line antiretroviral therapy in resource-limited settings. J Infect Dis. 2013;207(Suppl 2):S49–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Gouse H, Henry M, Robbins RN, Lopez-Rios J, Mellins CA, Remien RH, et al. Psychosocial aspects of ART counseling: a comparison of HIV beliefs and knowledge in PMTCT and ART-naive women. J Assoc Nurses AIDS Care. 2017;28(4):504–17.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Govindasamy D, Meghij J, Kebede Negussi E, Clare Baggaley R, Ford N, Kranzer K. Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings—a systematic review. J Int AIDS Soc. 2014;17:19032.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Health SADo. National HIV counseling and testing policy guidelines. Pretoria; 2015 May 2015.

  10. Peltzer K, Davids A. Lay counsellors’ experiences of delivering HIV counselling services in public health facilities in a Eastern Cape Province district of South Africa. J Psychol Afr. 2011;21(1):53–61.

    Article  Google Scholar 

  11. Mwisongo A, Mehlomakhulu V, Mohlabane N, Peltzer K, Mthembu J, Van Rooyen H. Evaluation of the HIV lay counselling and testing profession in South Africa. BMC Health Serv Res. 2015;15:278.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Coetzee B, Kagee A, Bland R. Shortcomings of adherence counselling provided to caregivers of children receiving antiretroviral therapy in rural South Africa. AIDS Care. 2016;28(Suppl 2):60–5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Robbins RN, Mellins CA, Leu CS, Rowe J, Warne P, Abrams EJ, et al. Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology. AIDS Behav. 2015;19(Suppl 2):163–76.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Remien RH, Stirratt MJ, Dolezal C, Dognin JS, Wagner GJ, Carballo-Dieguez A, et al. Couple-focused support to improve HIV medication adherence: a randomized controlled trial. AIDS. 2005;19(8):807–14.

    Article  PubMed  Google Scholar 

  15. Braun R, Catalani C, Wimbush J, Israelski D. Community health workers and mobile technology: a systematic review of the literature. PLoS ONE. 2013;8(6):e65772.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Hersch RK, Cook RF, Billings DW, Kaplan S, Murray D, Safren S, et al. Test of a web-based program to improve adherence to HIV medications. AIDS Behav. 2013;17(9):2963–76.

    Article  PubMed  Google Scholar 

  17. Remien RH, Mellins CA, Robbins RN, Gouse H, Leu CS, Rowe J, et al. Masivukeni. A multimedia ART initiation and adherence intervention for resource-limited settings. In: 21st International AIDS Conference; 18–22 July 2016, Durban, South Africa; 2016.

  18. Remien RH, Mellins CA, Robbins RN, Kelsey R, Rowe J, Warne P, et al. Masivukeni: development of a multimedia based antiretroviral therapy adherence intervention for counselors and patients in South Africa. AIDS Behav. 2013;17(6):1979–91.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Spies G, Stein DJ, Roos A, Faure SC, Mostert J, Seedat S, et al. Validity of the Kessler 10 (K-10) in detecting DSM-IV defined mood and anxiety disorders among pregnant women. Arch Womens Ment Health. 2009;12(2):69–74.

    Article  CAS  PubMed  Google Scholar 

  20. Breuer E, Stoloff K, Myer L, Seedat S, Stein DJ, Joska JA. The validity of the substance abuse and mental illness symptom screener (SAMISS) in people living with HIV/AIDS in primary HIV care in Cape Town, South Africa. AIDS Behav. 2014;18(6):1133–41.

    Article  PubMed  Google Scholar 

  21. McKinstry LA, Zerbe A, Hanscom B, Farrior J, Kurth AE, Stanton J, et al. A randomized-controlled trial of computer-based prevention counseling for HIV-positive persons (HPTN 065). J AIDS Clin Res. 2017;8(7):714.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Catalani C, Philbrick W, Fraser H, Mechael P, Israelski DM. mHealth for HIV treatment & prevention: a systematic review of the literature. Open AIDS J. 2013;7:17–41.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Henny KD, Wilkes AL, McDonald CM, Denson DJ, Neumann MS. A rapid review of eHealth interventions addressing the continuum of HIV care (2007–2017). AIDS Behav. 2018;22(1):43–63.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Haberer JE, Sabin L, Amico KR, Orrell C, Galarraga O, Tsai AC, et al. Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations. J Int AIDS Soc. 2017;20:21371.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ngangue P, Gagnon MP, Bedard E. Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services. BMC Int Health Hum Rights. 2017;17(1):9.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

National Institute of Mental Health (R01-MH09557), National Institute of Mental Health to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520). We would like to thank our research team, Yolizwa Mtingeni, Thandeka Mbonambi, Thandiwe Mxgxuma, Ziyanda Ncusana, Zodwa Makuluma, and Dudu Mbakaza; and our research participants for making this work possible.

Funding

This study was funded by the National Institute of Mental Health (R01-MH09557), National Institute of Mental Health to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520).

Author information

Authors and Affiliations

  1. HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Groote Schuur Hospital, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa

    H. Gouse & J. A. Joska

  2. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, USA

    R. N. Robbins, C. A. Mellins & R. H. Remien

  3. Center for Teaching and Learning (CTL), Columbia University, New York City, USA

    A. Kingon, J. Rowe & A. Pearson

  4. Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa

    M. Henry

  5. Department of Health, People Development Centre, Western Cape Government, Cape Town, South Africa

    F. Victor

Authors
  1. H. Gouse
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  2. R. N. Robbins
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  3. C. A. Mellins
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  4. A. Kingon
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  5. J. Rowe
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  6. M. Henry
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  7. R. H. Remien
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  8. A. Pearson
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  9. F. Victor
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  10. J. A. Joska
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Corresponding author

Correspondence to H. Gouse.

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All the authors declares that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Gouse, H., Robbins, R.N., Mellins, C.A. et al. Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling. AIDS Behav 22, 3345–3356 (2018). https://doi.org/10.1007/s10461-018-2145-y

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  • DOI: https://doi.org/10.1007/s10461-018-2145-y

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