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Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa

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Abstract

People living with HIV in Sub-Saharan Africa face significant challenges accessing care. Community-based peer support groups can increase linkage to treatment, though the effectiveness of structured, scalable groups has not been demonstrated. This study aimed to measure the impact of the structured Integrated Access to Care and Treatment intervention on clients’ knowledge, attitudes, and practice regarding HIV/AIDS, including their experiences of stigma, in KwaZulu-Natal, South Africa. Data collection involved pre-/post-tests and client interviews. Pre-/post-test data from 66 clients were collected. 17 participants were interviewed. Paired t-tests did not detect significant changes in the main outcomes. Qualitative results suggested a psychosocial benefit as participants connected with their peers, expressed themselves openly, and re-engaged with their communities. Unfortunately, this study did not quantitatively measure psychosocial changes, and the results have limited generalizability to men. I ACT may be an effective complement to clinic-based support services, though further study should quantify the psychosocial benefit.

Resumen

Las personas viviendo con VIH en África subsahariana enfrentan desafíos importantes para acceder a servicios de salud. A pesar que la eficacia de grupos estructurados no se ha demostrado, los grupos de apoyo comunitarios pueden aumentar vinculación con tratamiento. El objetivo del estudio fue medir el impacto de la intervención de Acceso al Cuidado y Tratamiento Integrado en conocimientos, actitudes, y prácticas de clientes en relación con VIH/SIDA, incluyendo sus experiencias con estigma, en KwaZulu-Natal, Sudáfrica. La recolección de datos incluyó pruebas pre/post-test y entrevistas. Se recogieron datos post-test/pre procedentes de 66 clientes. 17 participantes fueron entrevistados. Las pruebas t apareadas no detectaron cambios significativos en los resultados principales. Los resultados cualitativos sugieren beneficios psicosociales para los participantes; al relacionarse con sus compañeros, se expresaron abiertamente, y se re-conectaron con sus comunidades. Desafortunadamente, este estudio no midió cambios psicosociales cuantitativamente y la generalización de los resultados a hombres puede ser limitada. I ACT puede ser un complemento eficaz de los servicios de apoyo basados en clínicas, aunque estudios posteriores deberían cuantificar el beneficio psicosocial.

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Acknowledgments

Thank you to umndeni wethu at Philakahle Wellbeing Centre, to the Referral Network members, to Peace Corps South Africa, to Monty Thomas at Zoë-Life, to Anthony Diesel at South Africa Partners, and to Juan Mateo Espinosa.

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Authors and Affiliations

  1. Department of Global Health, University of Washington, Ninth and Jefferson Building, 13th Floor, 908 Jefferson Street, Box 359932, Seattle, WA, 98104, USA

    Christopher Kemp, Michele Andrasik & Deepa Rao

  2. PATH, 2201 Westlake Ave #200, Seattle, WA, 98121, USA

    Emily Gerth-Guyette

  3. SaveAct, 123 Jabu Ndlovu St, Pietermaritzburg, 3201, South Africa

    Lungile Dube

  4. Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, E3-300, Seattle, WA, 98109, USA

    Michele Andrasik

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Correspondence to Christopher Kemp.

Appendix: Pre/Post Test

Appendix: Pre/Post Test

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Kemp, C., Gerth-Guyette, E., Dube, L. et al. Mixed-Methods Evaluation of a Novel, Structured, Community-Based Support and Education Intervention for Individuals with HIV/AIDS in KwaZulu-Natal, South Africa. AIDS Behav 20, 1937–1950 (2016). https://doi.org/10.1007/s10461-016-1386-x

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