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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Development of "Yima Nkqo," a communitybased, peer group intervention to support treatment initiation for young adults with HIV in South Africa
PLoS ONE, Volume 18, No. 6 JUNE, Article e0280895, Year 2023
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Description
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, rapidfeedback 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. © 2023 Nardell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Authors & Co-Authors
Nardell, Maria F.
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard Medical School
United States, Boston
Beth Israel Deaconess Medical Center
Sindelo, Siyaxolisa
South Africa, Cape Town
Desmond Tutu Health Foundation
Rousseau, Elzette
South Africa, Cape Town
Desmond Tutu Health Foundation
Siko, Nomakaziwe
South Africa, Cape Town
Desmond Tutu Health Foundation
Fuzile, Pamela
South Africa, Cape Town
Desmond Tutu Health Foundation
Julies, Robin F.
South Africa, Cape Town
Desmond Tutu Health Foundation
Bassett, Ingrid V.
United States, Boston
Harvard Medical School
United States, Boston
Massachusetts General Hospital
Mellins, Claude Ann
United States, New York
Columbia University
Bekker, Linda-Gail Gail
South Africa, Cape Town
Desmond Tutu Health Foundation
South Africa, Cape Town
University of Cape Town
Switzerland, Geneva
Unaids
Butler, Lisa M.
United States, Storrs
University of Connecticut
Katz, Ingrid T.
United States, Boston
Harvard Medical School
United States, Boston
Brigham and Women's Hospital
United States, Cambridge
Harvard University
Statistics
Authors: 11
Affiliations: 10
Identifiers
Doi:
10.1371/journal.pone.0280895
ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Exploratory Study
Study Approach
Qualitative
Quantitative
Study Locations
South Africa