An implementation science protocol of the Women’s Health CoOp in healthcare settings in Cape Town, South Africa: A stepped-wedge design

BMC Women's Health

Study Protocol

Ilene S. Speizer¹  Winnifred Gumula²  Felicia A. Browne³  Courtney Peasant³  William A. Zule³  Laura Dunlap³  Wendee M. Wechsberg⁴  Jacqueline W. Ndirangu⁵ 

[1] Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB #7445, 27599, Chapel Hill, NC, USA;Kheth’Impilo, 11th floor Metlife Centre, 7 Walter Sisulu Avenue, 8001, Cape Town, South Africa;RTI International, 3040 Cornwallis Road, 27709, Research Triangle Park, NC, USA;RTI International, 3040 Cornwallis Road, 27709, Research Triangle Park, NC, USA;Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB #7445, 27599, Chapel Hill, NC, USA;Department of Psychology, North Carolina State University, 2310 Katharine Stinson Drive Raleigh, 27607, Raleigh, NC, USA;Psychiatry and Behavioral Sciences, Duke University School of Medicine, 40 Duke Medicine Cir, 27710, Durham, NC, USA;RTI International, 701 13th St. NW #750, 20005, Washington, DC, USA;

关键词: HIV prevention;    ART adherence;    Women;    Substance use;    Healthcare settings;   

DOI  :  10.1186/s12905-017-0433-8

 received in 2017-03-31, accepted in 2017-08-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHIV persists as a public health emergency in South Africa, especially among women of childbearing age. In response to the HIV epidemic, the Joint United Nations Programme on HIV/AIDS has put forth the 90–90-90 global goals to achieve an AIDS-free generation by 2020. This goal aspires to have 90% of people living with HIV diagnosed; 90% of those who test positive on sustained antiretroviral therapy (ART); and 90% of those on ART be virally suppressed. Ensuring access to ART is an important first step in reducing HIV incidence, especially among vulnerable populations such as women who use substances and bear the burden of HIV in South Africa. Additionally, alcohol and other drug (AOD) use and exposure to gender-based violence are associated with increased risk of HIV infection and reduced adherence to ART. However, no research has estimated ART adherence rates for women who use substances in South Africa since the government approved the provision of ART to all people living with HIV.MethodsThe Women’s Health CoOp (WHC) is an evidence-based, woman-focused, behavioral intervention that addresses the intersecting risks of AODs, sex behaviors, and violence and victimization, with the primary goal of increasing skills and knowledge to reduce substance abuse and HIV risks and to improve ART adherence. The WHC has been packaged for further dissemination. This article describes the study protocol used to assess the feasibility and acceptability of implementing the WHC intervention into standard of care in Cape Town health clinics and substance abuse rehabilitation centers to reduce HIV risk behavior and increase ART adherence among women who use substances and are living with HIV.DiscussionBecause few of the interventions that demonstrate efficacy for HIV prevention and ART adherence in randomized trials are sustainable, studies to adapt and test intervention variations are needed to determine the best strategies for implementing them in real-world, high-risk settings. However, implementation in real-world settings presents challenges. Consequently, intervention developers should consider the strengths and limitations of their anticipated implementation setting by engaging with key stakeholders before, during, and after the adaptation and implementation process when developing and attempting to scale-up interventions.Trial registrationNCT 02733003 and date approved 1/21/2016.

【 授权许可】

CC BY   
© The Author(s). 2017