Promoting Tuberculosis Preventive Therapy for People Living with HIV in South Africa: Interventions Hindered by Complicated Clinical Guidelines and Imbalanced Patient-Provider Dynamics

Brooke A. Jarrett, Daniel M. Woznica, Carla Tilchin, Nthabiseng Mpungose, Katlego Motlhaoleng, Jonathan E. Golub, Neil A. Martinson, Colleen F. Hanrahan

Research output: Contribution to journalArticlepeer-review

Abstract

Isoniazid preventive therapy (IPT) reduces the risk of active tuberculosis among people living with HIV, but implementation of IPT in South Africa and elsewhere remains slow. The objective of this study was to examine both nurse perceptions of clinical mentorship and patient perceptions of in-queue health education for promoting IPT uptake in Potchefstroom, South Africa. We measured adoption, fidelity, acceptability, and sustainability of the interventions using both quantitative and qualitative methods. Adoption, fidelity, and acceptability of the interventions were moderately high. However, nurses believed they could not sustain their increased prescriptions of IPT, and though many patients intended to ask nurses about IPT, few did. Most patients attributed their behavior to an imbalance of patient-provider power. National IPT guidelines should be unambiguous and easily implemented after minimal training on patient eligibility and appropriate medication durations, nurse-patient dynamics should empower the patient, and district-level support and monitoring should be implemented.

Original languageEnglish (US)
Pages (from-to)1106-1117
Number of pages12
JournalAIDS and behavior
Volume24
Issue number4
DOIs
StatePublished - Apr 1 2020

Keywords

  • HIV
  • Health education
  • Isoniazid
  • Mentors
  • Tuberculosis

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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