Tomori Cecilia, Risher Kathryn, Limaye Rupali J, Van Lith Lynn M, Gibbs Susannah, Smelyanskaya Marina, Celentano David D
*Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ‡Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA.
J Acquir Immune Defic Syndr. 2014 Aug 15;66 Suppl 3(0 3):S306-10. doi: 10.1097/QAI.0000000000000239.
: Health communication has played a pivotal role in HIV prevention efforts since the beginning of the epidemic. The recent paradigm of combination prevention, which integrates behavioral, biomedical, and structural interventions, offers new opportunities for employing health communication approaches across the entire continuum of care. We describe key areas where health communication can significantly enhance HIV treatment, care, and prevention, presenting evidence from interventions that include health communication components. These interventions rely primarily on interpersonal communication, especially individual and group counseling, both within and beyond clinical settings to enhance the uptake of and continued engagement in care. Many successful interventions mobilize a network of trained community supporters or accompagnateurs, who provide education, counseling, psychosocial support, treatment supervision, and other pragmatic assistance across the care continuum. Community treatment supporters reduce the burden on overworked medical providers, engage a wider segment of the community, and offer a more sustainable model for supporting people living with HIV. Additionally, mobile technologies are increasingly seen as promising avenues for ongoing cost-effective communication throughout the treatment cascade. A broader range of communication approaches, traditionally employed in HIV prevention efforts, that address community and sociopolitical levels through mass media, school- or workplace-based education, and entertainment modalities may be useful to interventions seeking to address the full care continuum. Future interventions would benefit from development of a framework that maps appropriate communication theories and approaches onto each step of the care continuum to evaluate the efficacy of communication components on treatment outcomes.
自艾滋病流行伊始，健康传播就在艾滋病预防工作中发挥了关键作用。近期的综合预防模式，融合了行为、生物医学和结构干预措施，为在整个护理连续过程中运用健康传播方法提供了新机遇。我们描述了健康传播能够显著增强艾滋病治疗、护理和预防效果的关键领域，并展示了包含健康传播成分的干预措施的相关证据。这些干预措施主要依赖人际传播，特别是在临床环境内外的个体和团体咨询，以提高护理的接受度并促进持续参与护理。许多成功干预措施动员了经过培训的社区支持者或陪伴者网络，他们在整个护理连续过程中提供教育、咨询、心理社会支持、治疗监督及其他实际帮助。社区治疗支持者减轻了过度劳累的医疗服务提供者的负担，让更广泛的社区群体参与进来，并为支持艾滋病毒感染者提供了更具可持续性的模式。此外，移动技术日益被视为在整个治疗过程中进行持续且具成本效益的沟通的有前景途径。传统上用于艾滋病预防工作的更广泛的传播方法，通过大众媒体、学校或工作场所教育以及娱乐方式来解决社区和社会政治层面的问题，可能对旨在应对整个护理连续过程的干预措施有用。未来的干预措施将受益于制定一个框架，该框架将适当的传播理论和方法映射到护理连续过程的每一步，以评估传播成分对治疗结果的功效。
