Video-Based Intervention for Improving Maternal Retention and Adherence to HIV Treatment: Patient Perspectives and Experiences.

Steven Masiano,Mtisunge Mphande,Edwin Machine,Mike Chitani,Angella Mkandawire,Tapiwa Tembo,Maria Kim,Saeed Ahmed,Alick Mazenga,Christine Markham

doi:10.3390/ijerph18041737

Abstract

VITAL Start is a video-based intervention aimed to improve maternal retention in HIV care and adherence to antiretroviral therapy (ART) in Malawi. We explored the experiences of pregnant women living with HIV (PWLHIV) not yet on ART who received VITAL Start before ART initiation to assess the intervention’s acceptability, feasibility, fidelity of delivery, and perceived impact. Between February and September 2019, we conducted semi-structured interviews with a convenience sample of 34 PWLHIV within one month of receiving VITAL Start. The participants reported that VITAL Start was acceptable and feasible and had good fidelity of delivery. They also reported that the video had a positive impact on their lives, encouraging them to disclose their HIV status to their sexual partners who, in turn, supported them to adhere to ART. The participants suggested using a similar intervention to provide health-related education/counseling to people with long term conditions. Our findings suggest that video-based interventions may be an acceptable, feasible approach to optimizing ART retention and adherence amongst PWLHIV, and they can be delivered with high fidelity. Further exploration of the utility of low cost, scalable, video-based interventions to address health counseling gaps in sub-Saharan Africa is warranted.

Highlights

Despite global progress in reducing the number of new HIV infections, mother-tochild transmission of HIV remains a critical challenge
One of the aims of VITAL Start was to help pregnant women living with HIV (PWLHIV) disclose their status to their partners, and our findings suggest that nearly 90% disclosed—which compares favorably with reports from many studies in sub-Saharan Africa aimed to improve HIV status disclosure among sexual partners [43,44], as well as other video-based interventions globally [45]
The video intervention encourages HIV status disclosure to sexual partners and results in behavioral changes that impact antiretroviral therapy (ART) adherence because it addresses the key issues in the ART cascade—from initial HIV diagnosis to achieving viral suppression

Summary

Introduction

Despite global progress in reducing the number of new HIV infections, mother-tochild transmission of HIV remains a critical challenge. Antiretroviral therapy (ART) to prevent vertical transmission of HIV and optimize maternal and infant health outcomes is widely available, but pregnant and lactating women living with HIV must continue to receive and adhere to ART to realize these benefits. Adherence to ART is necessary to achieve viral suppression and confer maximal health benefits, including reduced risk of vertical HIV transmission [2,3,4,5]. Suboptimal maternal retention and adherence to ART remain significant global challenges to halting the HIV epidemic and eliminating vertical HIV transmissions [6,7].

Methods

Results

Discussion

Conclusion