Taking HIV testing to families: designing a family-based intervention to facilitate HIV testing, disclosure and intergenerational communication

van Rooyen, H., Essack, Z., Rochat, T., Wight, D. , Knight, L., Bland, R. and Celum, C. (2016) Taking HIV testing to families: designing a family-based intervention to facilitate HIV testing, disclosure and intergenerational communication. Frontiers in Public Health, 4, 154. (doi: 10.3389/fpubh.2016.00154) (PMID:27547750) (PMCID:PMC4974258)

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Abstract

Introduction: Facility-based HIV testing does not capture many adults and children who are at risk of HIV in South Africa. This underscores the need to provide targeted, age-appropriate HIV testing for children, adolescents and adults who are not accessing health facilities. While home based counseling and testing has been succesfully delivered in multiple settings, it also often fails to engage adolescents. To date, the full potential for testing entire families and linking them to treatment has not been evaluated. Methods: The steps to expand a successful home-based counseling and testing model to a family-based counseling and testing approach in a high HIV prevalence context in rural South Africa are described. The primary aim of this family-based model is to increase uptake of HIV testing and linkage to care for all family members, through promoting family cohesion and intergenerational communication, increasing HIV disclosure in the family, and improving antiretroviral treatment uptake, adherence and retention. We discuss the three-phased research approach that led to the development of the family-based counseling and testing intervention. Results: The family-based intervention is designed with a maximum of five sessions, depending on the configuration of the family (young, mixed and older families). There is an optional additional session for high-risk or vulnerable family situations. These sessions encourage HIV testing of adults, children and adolescents and disclosure of HIV status. Families with adolescents receive an intensive training session on intergenerational communication, identified as the key causal pathway to improve testing, linkage to care, disclosure and reduced stigma for this group. The rationale for the focus on intergenerational communication is described in relation to our formative work as well as previous literature, and potential challenges with pilot testing the intervention are explored. Conclusion: This paper maps the process for adapting a novel and largely successful home-based counseling and testing intervention for use with families. Expanding the successful home-based counseling and testing model to capture children, adolescents and men could have significant impact if the pilot is successful and scaled-up.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wight, Professor Danny and Bland, Dr Ruth
Authors: van Rooyen, H., Essack, Z., Rochat, T., Wight, D., Knight, L., Bland, R., and Celum, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Frontiers in Public Health
Publisher:Frontiers Media
ISSN:2296-2565
ISSN (Online):2296-2565
Published Online:13 July 2016
Copyright Holders:Copyright: © 2016 van Rooyen, Essack, Rochat, Wight, Knight, Bland and Celum
First Published:First published in Frontiers in Public Health 4:154
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
656641Children, Young People, Families and Health ProgrammeDaniel WightMedical Research Council (MRC)MC_UU_12017/9IHW - MRC/CSO SPHU
727661SPHSU Core Renewal: Complexity in Health Improvement Research ProgrammeLaurence MooreMedical Research Council (MRC)MC_UU_12017/14IHW - MRC/CSO SPHU