Predictive ability of the Health Belief Model in HIV prevention and management in sub-Saharan Africa: a systematic review

Abstract

ABSTRACT Around 70% of global Human Immunodeficiency Virus (HIV) diagnoses are in sub-Saharan Africa (SSA), where sexual transmission remains the primary mode of HIV transmission. Poor outcomes among persons living with HIV (PLHIV) in SSA are linked to delayed diagnosis (HIV Testing and Counselling [HTC] uptake), poor linkage to HIV care and suboptimal adherence to antiretroviral therapy (ART). This study is a systematic review of published articles on the predictive ability of the Health Belief Model in HIV prevention (condom use and sexual abstinence, Pre-Exposure Prophylaxis [PrEP], Voluntary Medical Male circumcision [VMMC]) and management (HTC uptake, Post-Exposure Prophylaxis [PEP] and ART adherence) in SSA. A systematic search was conducted in PubMed, Science Direct, Google Scholar, Scopus and institutional library databases. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The HBM as a holistic model was useful in predicting HIV prevention and management in SSA. Perceived benefit, susceptibility, self-efficacy, barrier and cues to action were important predictors of the likelihood of uptake of HIV prevention and management intervention. Overall, the perceived benefit was found by the majority of the studies and showed high variance to predict the likelihood of individuals taking up interventions to prevent and manage HIV in SSA. Interventions should, therefore, focus on increasing perceived benefits associated with preventing and managing HIV.