Role of Support Reciprocity in HIV Viral Suppression Among People Living with HIV and Their Treatment Partners in Botswana

Interpersonal relations of pregnant women post-HIV diagnosis in Thembisile Hani, South Africa

Background

HIV is a major public health issue in South Africa, with around 7.7 million people living with the virus by 2023, including 4.9 million women. In 2022, 257 171 pregnant women received antiretroviral therapy to prevent mother-to-child transmission.

Objectives

To explore and describe the interpersonal relationships of pregnant women following HIV diagnosis in the Thembisile Hani Municipality, South Africa.

Method

An exploratory descriptive qualitative design was used. Twenty (20) women aged 18-35 years, who were diagnosed with HIV during pregnancy, were purposively selected from a local clinic in Thembisile Hani Municipality. Data were collected through unstructured face-to-face interviews and analysed using thematic analysis.

Results

Two themes emerged from the analysis; namely: (1) altered relationships with loved ones and (2) the role of psychosocial support to improve interpersonal relationships. These results indicate that being diagnosed with HIV during pregnancy has a negative impact on the interpersonal relationships of women.

Conclusion

HIV diagnosis during pregnancy affects relationships, necessitating psychosocial support services such as counselling and support groups to improve well-being and relationship quality in pregnant women.

Qualitative Evaluation of Treatment Partners for People With HIV in Botswana: Current Healthcare Provider Practices and Recommendations for Improvement

Botswana has an adult HIV prevalence of 20.8% and annual incidence of 0.2%. We aimed to evaluate current practices and advance recommendations for treatment partners (informal adherence supporters) for people with HIV in Botswana. In January-February 2020, we conducted seven focus groups with 36 healthcare providers at seven HIV clinics in Gaborone, Botswana. Providers perceived treatment partners to be critical for quality patient care. They shared that in the new era of universal antiretroviral therapy (ART) initiation immediately after diagnosis ("test-and-treat"), providers no longer require patients to select treatment partners at ART initiation. Providers suggested a renewed emphasis on treatment partners. They believed that standard guidance for providers around treatment partner selection would ensure that providers cover similar topics across patients and endorsed implementation of workshops to educate treatment partners on how to support patients. However, streamlined ART initiation policies require innovative strategies, including eHealth interventions, to engage treatment partners.

Exploring the willingness toward HIV immediate test and treat among MSM in Nairobi and its environs: a cross-sectional study

Background

In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods

This cross-sectional exploratory study targeted MSM (aged 18-60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was used to identify data collection sites, and then snowballing was employed to reach the respondents. Data analysis was performed using SPSS version 23, and binary logistics regression was used for inferential analysis.

Results

Between July 2018 and June 2019, 391 MSM were recruited to fill out a self-administered questionnaire, out of which 345 complete questionnaires were analyzed. Never been tested for HIV, private/NGO as the facility of the last HIV test, and had unprotected anal sex were listed as the reasons for taking the most recent test, and the results of the most recent HIV test and seeking a post self-test confirmation were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Additionally, a preference for a health provider as the first source of support, belief in the efficacy of ARVs, and disclosure about being on ART were the other reasons. Additionally, being aged 25+ years, having more than 60 USD monthly income, and having inconsistent condom use during sex were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Barriers to the immediate test and treat strategy included stigma from healthcare providers and concerns about disruptions in lifestyle through antiretroviral therapy (ART) use.

Conclusion

Interventions aimed at increasing the HIV test and treat initiative in Kenya may need to take into account the demographic and social characteristics of MSM, including age, lack of habitual HIV testing, and lifestyle changes before and upon enrollment in ART. Projects should also consider working closely with healthcare facilities to strengthen treatment preparation, especially for asymptomatic MSM and those who may not be immediately willing to choose the test and treat strategy.