TY - JOUR
T1 - Promoting Tuberculosis Preventive Therapy for People Living with HIV in South Africa
T2 - Interventions Hindered by Complicated Clinical Guidelines and Imbalanced Patient-Provider Dynamics
AU - Jarrett, Brooke A.
AU - Woznica, Daniel M.
AU - Tilchin, Carla
AU - Mpungose, Nthabiseng
AU - Motlhaoleng, Katlego
AU - Golub, Jonathan E.
AU - Martinson, Neil A.
AU - Hanrahan, Colleen F.
N1 - Funding Information:
The authors would like to thank the study participants who donated their time. This study was funded by a 2016 Global Health Experience Field Placement fellowship from the Johns Hopkins Center for Global Health. It was also funded by a 2016 developmental Grant from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189) that is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent official views of the NIH.
Funding Information:
The authors would like to thank the study participants who donated their time. This study was funded by a 2016 Global Health Experience Field Placement fellowship from the Johns Hopkins Center for Global Health. It was also funded by a 2016 developmental Grant from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189) that is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent official views of the NIH.
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - 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.
AB - 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.
KW - HIV
KW - Health education
KW - Isoniazid
KW - Mentors
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85073958514&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073958514&partnerID=8YFLogxK
U2 - 10.1007/s10461-019-02675-6
DO - 10.1007/s10461-019-02675-6
M3 - Article
C2 - 31549265
AN - SCOPUS:85073958514
VL - 24
SP - 1106
EP - 1117
JO - AIDS and Behavior
JF - AIDS and Behavior
SN - 1090-7165
IS - 4
ER -