Preparing for highly active antiretroviral therapy rollout in rural South Africa: an assessment using the information, motivation, and behavioral skills model.
Identifieur interne : 000A73 ( Ncbi/Checkpoint ); précédent : 000A72; suivant : 000A74Preparing for highly active antiretroviral therapy rollout in rural South Africa: an assessment using the information, motivation, and behavioral skills model.
Auteurs : Margo D. Simon [États-Unis] ; Frederick L. Altice ; Anthony P. Moll ; Mbuso Shange ; Gerald H. FriedlandSource :
- AIDS care [ 1360-0451 ] ; 2010.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient, Adolescent, Adulte, Comportement sexuel sans risque, Connaissances, attitudes et pratiques en santé, Femelle, Humains, Infections à VIH (psychologie), Infections à VIH (traitement médicamenteux), Jeune adulte, Modèles psychologiques, Motivation, Mâle, Observance du traitement médicamenteux, Prise de risque, Préservatifs masculins (utilisation), République d'Afrique du Sud, Thérapie antirétrovirale hautement active (psychologie), Études transversales.
- MESH :
- psychologie : Infections à VIH, Thérapie antirétrovirale hautement active.
- traitement médicamenteux : Infections à VIH.
- utilisation : Préservatifs masculins.
- Acceptation des soins par le patient, Adolescent, Adulte, Comportement sexuel sans risque, Connaissances, attitudes et pratiques en santé, Femelle, Humains, Jeune adulte, Modèles psychologiques, Motivation, Mâle, Observance du traitement médicamenteux, Prise de risque, République d'Afrique du Sud, Études transversales.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Adolescent, Adult, Antiretroviral Therapy, Highly Active (psychology), Condoms (utilization), Cross-Sectional Studies, Female, HIV Infections (drug therapy), HIV Infections (psychology), Health Knowledge, Attitudes, Practice, Humans, Male, Medication Adherence, Models, Psychological, Motivation, Patient Acceptance of Health Care, Risk-Taking, Safe Sex, South Africa, Young Adult.
- MESH :
- geographic : South Africa.
- drug therapy : HIV Infections.
- psychology : Antiretroviral Therapy, Highly Active, HIV Infections.
- utilization : Condoms.
- Adolescent, Adult, Cross-Sectional Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Medication Adherence, Models, Psychological, Motivation, Patient Acceptance of Health Care, Risk-Taking, Safe Sex, Young Adult.
Abstract
Following a controversial history and before South Africa started the world's largest highly active antiretroviral therapy (HAART) rollout, little was known about community-level information, motivation, and behavioral skills (IMB) regarding HAART in high-HIV-prevalence rural communities. The IMB model has been shown to predict behaviors that are associated with desirable HAART outcomes. We conducted an anonymous, cross-sectional "HAART-Felt Prospects" survey among HIV-serostatus-unknown young adults in Tugela Ferry, KwaZulu-Natal. We aimed to identify behavioral aspects of HAART preparedness that could be targeted by local interventions to enhance HAART outcomes. Data analysis included: percent correct, thematic means based on a four-point Likert-scale, and composite quotients. Subjects (N=176) were Zulu (99%), young (mean 19 years), and severely impoverished (55%). Relatively high levels of information were reported: overall correct score was 46%, secondary-transmission-of-resistance information was highest (81%), and only 15% reported traditional or government-advocated folk remedies cure or treat HIV/AIDS. Motivation quotient was "consistent" with favorable HAART behaviors; attitudes toward medication-taking behaviors (3.48) and condom use during HAART (3.43) ranked the highest. Desire for HIV testing (71%) was associated with HIV treatment optimism [adjusted odds ratio (AOR)=4.0, p=0.0004] and previous experience with good treatment outcome [AOR=3.2, p=0.01]. Acceptance of HAART (93%) was associated with HIV optimism [AOR=18.0, p=0.001] and not believing government-advocated folk remedies cure or treat HIV/AIDS [AOR=10.0, p=0.04]. Behavioral skills quotient was "neutral" for favorable HAART behaviors; side effects self-efficacy was the highest (3.16); and medication-taking self-efficacy the lowest (2.51). Only 47% believed disclosing HIV-serostatus would be easy. Despite controversy surrounding HAART initiation, these results suggest that local South African at-risk youth were relatively well-poised for HAART rollout. This conclusion is supported by subsequent successful HAART rollout locally. Community-based assessments are urgently needed as HAART rollouts continue. Adaptation of this IMB-based survey may better inform efforts to enhance HAART-program implementation in resource-limited settings globally.
DOI: 10.1080/09540120903220253
PubMed: 20204909
Affiliations:
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<term>Adult</term>
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<term>Condoms (utilization)</term>
<term>Cross-Sectional Studies</term>
<term>Female</term>
<term>HIV Infections (drug therapy)</term>
<term>HIV Infections (psychology)</term>
<term>Health Knowledge, Attitudes, Practice</term>
<term>Humans</term>
<term>Male</term>
<term>Medication Adherence</term>
<term>Models, Psychological</term>
<term>Motivation</term>
<term>Patient Acceptance of Health Care</term>
<term>Risk-Taking</term>
<term>Safe Sex</term>
<term>South Africa</term>
<term>Young Adult</term>
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<term>Adolescent</term>
<term>Adulte</term>
<term>Comportement sexuel sans risque</term>
<term>Connaissances, attitudes et pratiques en santé</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infections à VIH (psychologie)</term>
<term>Infections à VIH (traitement médicamenteux)</term>
<term>Jeune adulte</term>
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<term>Mâle</term>
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<term>Préservatifs masculins (utilisation)</term>
<term>République d'Afrique du Sud</term>
<term>Thérapie antirétrovirale hautement active (psychologie)</term>
<term>Études transversales</term>
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<term>Thérapie antirétrovirale hautement active</term>
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<front><div type="abstract" xml:lang="en">Following a controversial history and before South Africa started the world's largest highly active antiretroviral therapy (HAART) rollout, little was known about community-level information, motivation, and behavioral skills (IMB) regarding HAART in high-HIV-prevalence rural communities. The IMB model has been shown to predict behaviors that are associated with desirable HAART outcomes. We conducted an anonymous, cross-sectional "HAART-Felt Prospects" survey among HIV-serostatus-unknown young adults in Tugela Ferry, KwaZulu-Natal. We aimed to identify behavioral aspects of HAART preparedness that could be targeted by local interventions to enhance HAART outcomes. Data analysis included: percent correct, thematic means based on a four-point Likert-scale, and composite quotients. Subjects (N=176) were Zulu (99%), young (mean 19 years), and severely impoverished (55%). Relatively high levels of information were reported: overall correct score was 46%, secondary-transmission-of-resistance information was highest (81%), and only 15% reported traditional or government-advocated folk remedies cure or treat HIV/AIDS. Motivation quotient was "consistent" with favorable HAART behaviors; attitudes toward medication-taking behaviors (3.48) and condom use during HAART (3.43) ranked the highest. Desire for HIV testing (71%) was associated with HIV treatment optimism [adjusted odds ratio (AOR)=4.0, p=0.0004] and previous experience with good treatment outcome [AOR=3.2, p=0.01]. Acceptance of HAART (93%) was associated with HIV optimism [AOR=18.0, p=0.001] and not believing government-advocated folk remedies cure or treat HIV/AIDS [AOR=10.0, p=0.04]. Behavioral skills quotient was "neutral" for favorable HAART behaviors; side effects self-efficacy was the highest (3.16); and medication-taking self-efficacy the lowest (2.51). Only 47% believed disclosing HIV-serostatus would be easy. Despite controversy surrounding HAART initiation, these results suggest that local South African at-risk youth were relatively well-poised for HAART rollout. This conclusion is supported by subsequent successful HAART rollout locally. Community-based assessments are urgently needed as HAART rollouts continue. Adaptation of this IMB-based survey may better inform efforts to enhance HAART-program implementation in resource-limited settings globally.</div>
</front>
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<name sortKey="Moll, Anthony P" sort="Moll, Anthony P" uniqKey="Moll A" first="Anthony P" last="Moll">Anthony P. Moll</name>
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<country name="États-Unis"><region name="Connecticut"><name sortKey="Simon, Margo D" sort="Simon, Margo D" uniqKey="Simon M" first="Margo D" last="Simon">Margo D. Simon</name>
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