The family members will be interviewed once consent has been obtained from the participant who is a member of the therapy club. Due to the sensitive nature of the recordings, they will be placed in a different iALARM Dropbox folder. They will be advised that their withdrawal from the study will not affect their participation in the club.
Study Budget
Bashir 2018- resercher safety /Bloor, Finchamb & Sampson 2010
Key words
A case study evaluating the effectiveness of adherence clubs in Gugulethu as a strategy for mobilizing and engaging men in HIV treatment. The systematic, structural, social and gender-related factors that contribute to men's failure to participate in HIV services. Furthermore, there are the barriers associated with the prevention and treatment of HIV/AIDS among men in South Africa and worldwide, leading to poor health outcomes for men compared to women.
There is a need for effective strategies and policies to improve men's engagement with HIV/AIDS services. It shows what works to improve HIV-positive men's engagement with HIV services and retention in care, and how these efforts work. The study shows that a multi-level systems and resource approach is important to identify and understand the factors that drive adherence among men living with HIV in South Africa.
Responsive healthcare strategies that are aware of men's needs are better able to engage and retain men in HIV services, even in unprecedented times like Covid-19. In addition, HIV/AIDS intervention programs that take into account multi-level contextual and cultural considerations have the potential to be effective in involving more men in HIV care.
Introduction
Researchers argue that men living with HIV, compared to women, face challenges in accessing preventive services and antiretroviral therapy (ART), viral load suppression, and retention in care (3,4). To address the challenges associated with HIV care in clinics and to improve access to HIV services for the entire population, membership clubs were introduced in 2007 and have since been established in South Africa. It is a substudy of the iALARM project, "Using information to align services and connect and retain men in the HIV cascade."
This study is a qualitative thematic exploration of men's engagement and retention in HIV services. Gugulethu has been highlighted as a peri-urban setting with one of the highest HIV prevalence rates in the Western Cape (13). A purposive sampling method was used to sample 12 participants who are part of a membership club to understand how different domains in the socio-ecological context contribute to facilitating better health outcomes among men who participate in clubs.
The ecological perspective shows how different levels in the system obviously influence the individual and his development. All participants expressed willingness to participate in the study and were informed about the wider iALARM project.
Findings
The family members understood the perceived benefits of being in the club and engaging in care. They understood the club's values in relation to accepting one's status and dealing with stigmatization in the community environment. A South African Xhosa-speaking, unemployed male patient who receives some relief from the club and her sister started attending AC in 2017.
As a result of their efforts and the patient's willingness, some come back to the clinic and through consistent dedication end up back at the club. So they chose to abide by the club rules rather than be sent back to the clinic. They are confident that the club staff will continue to provide them with efficient services as they have done in the past compared to the clinic staff.
They also stated that these positive relationships help them understand that they are 'not alone' and that they have strong pillars within the club that they can rely on. Positive relationships with caregivers seem to improve men's experiences with the club and help foster their continued positive involvement in HIV services.
Discussion
Their awareness and knowledge of AC's impact on their loved one is influential to men who join the club. 17 In this relationship too, trust in the healthcare worker is seen as the key element, and this translates into the provider having the client's best interests at heart (33, 34). The findings show that the power of the provider framework encourages men in their engagement with HIV services.
The strength of this study is its demonstration of the socio-ecological approach of one strategy to facilitate the engagement of HIV services by men. The results of this study show that the different levels of the socio-ecological model are important for men to be followers. Healthcare professionals have also indicated that AC is only once every 2 or 3 months, so the patients and their families do most of the heavy lifting.
Further research could examine the role of the CCWs in the engagement and re-engagement of men in HIV services. Further research will be required to evaluate the implementation of the study findings in another setting.
Authors note
20 resources that matter, but the ability to use them in ways that speak to their willingness to obey regardless of the challenges. As the community workers portray the challenges and the causes of the non-compliance, it highlights how although there are enough resources in the club, their motivation and attitude to stay in the club is one of the driving forces for their involvement. The relationship between the AC and family members and its impact on men who attend the club can also be explored.
Additionally, research could focus on evaluating the perceived effectiveness of other strategies developed to engage men in HIV services. As highlighted in this study, the number of men using HIV services in this HQ is increasing. However, other studies have found that it is still lower than women, as a result there is a need to improve policies and strategies for the intentional inclusion of men in HIV services.
There is also a need to improve strategies to engage men globally in the HIV cascade, and this will be possible through multi-stakeholder collaboration and knowledge and understanding of what hardware and software factors promote engagement and health-seeking behavior to facilitate their retention and engagement of men in HIV services. Future research could evaluate the perceived effectiveness of other strategies used to engage men in HIV services either through testing or treatment.
Acknowledgements
Declaration of Conflicting of Interest
ORCID
Russell S, Seeley J. The transition to living with HIV as a chronic condition in rural Uganda
Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review. An integrated approach to community health worker support for HIV/AIDS and tuberculosis care in Angonia District, by community health worker support for HIV/AIDS and tuberculosis care in Angonia District, Mozambique. Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV.
Leaving no one behind: how differentiated service delivery models increase men's engagement in HIV care. Engaging gay men and other men who have sex with men (MSM) in the response to HIV: A critical step in other men who have sex with men (MSM) in the response to HIV: A critical step in achieving an AIDS-free Generation. Tsai AC, Siedner MJ. The missing men: HIV treatment scale and life expectancy in sub-43.
Tsai AC, Siedner MJ. The Missing Men: HIV Treatment Scale-Up and Life Expectancy in Sub-. Title: A case study evaluating the effectiveness of ACs in Gugulethu as a strategy to mobilize and engage men in HIV treatment.
PRINCIPAL INVESTIGATOR/UMPHANDI OPHAMBILI Name/Igama: Petronella Ncube
INFORMATION SHEET/IPHEPHA ELINENKCUKACHA
PROCESS/INKQUBO
BENEFITS/IINZUZO
WITHDRAWAL/UKURHOXA
Ungarhoxa nangaliphi na ixesha ngaphandle kokunika isizathu, ngaphandle kokuvalelwa okanye ukohlwaywa okanye ukuthatha kwakho inxaxheba kwiklabhu yokuthotyelwa. Ukuba unayo nayiphi na inkxalabo okanye imiba nangaliphi na ixesha ngexesha lophononongo, ungaqhagamshelana ne-UK Human Research Ethics Committee apha [email protected] okanye ufikelele kuSihlalo we-MREC yase-UK kule nombolo yabaphathi bam; UChristopher Colvin.
Consent Form/IFom yeMvume
Consent for a Family member to participate
Title: A case study evaluating the effectiveness of ACs in Gugulethu as a strategy for mobilizing and engaging men in HIV treatment
PROCESS
Participants are asked to sit in a quiet area so that there is clear communication between them and the researcher. With your permission, the interview will be recorded and the recording will be securely stored on the researcher's computer. To protect your identity and data, pseudonyms are used and only the study supervisors, with the exception of the researcher, have access to the data. Once the investigation is complete, the recording will be kept safe and deleted after five years.
RISKS
BENEFITS
WITHDRAWAL
By signing this document
- What has been your experience with the Adherence Club?
- How well are you managing your health day to day ever since you started coming to the club?
- What is your attitude towards your treatment?
- Has coming to the club motivated you to adhere to your pills and encourage your peers to do likewise?
- What has been the benefits of attending the Adherence Club?
- How is your relationship like with the people at the club? The facilitator? The club members?
- Is there information that is provided at the club which you find helpful?
- Does anyone at home know about the club? Do they come collect pills for you?
- What has been the challenges that you have faced at the club? What can be done differently?
How well are you managing your health every day since you started coming to the club? Coming to the club has motivated you to stick to your pills and encourage your peers to do the same.
Semi- Interview schedule for facilitators
- How would you describe your role in the adherence club?
- What are the benefits of attending the club?
- Are there any disparities between men and women who attend the club?
- What are your thoughts around patients who stop coming to the club?
- What can be improved that is of concern to them?
- What are the challenges that you face?
- How do you encourage your family member to attend the club?
- Do you believe the club is beneficial to them?
- Has the family environment changed in any way to encourage help the, eat well or go to the clinic?
- What impact do you see the club having on the patients that attend?
- Are there any disparities between men and women in terms of attendance and adherence?
- What has been their reasons for coming regularly?
- What reasons do men (those who stop) have that have stopped coming?
- How are family members attitude towards you and the adherence club?
- What strategies does the club have in place to reengage them?
- Are there any recommendations that you think will help foster adherence and retention?
Has the family environment changed in any way to encourage helping, eating well, or going to the clinic.
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