Gibbs Andrew, Gumede Dumsani, Adeagbo Oluwafemi, Sikweyiya Yandisa, Chirwa Esnat, Mkhwanazi Smanga, Luthuli Manono, Xulu Zakhele, Herbst Carina, Zuma Thembelihle, Hlongwane Siphesihle, Okesola Nonhlanhla, Dreyer Jaco, Khaula Sivuyile, Washington Laura, Shahmanesh Maryam
Department of Psychology, University of Exeter, Exeter, United Kingdom.
Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.
PLOS Glob Public Health. 2023 Feb 24;3(2):e0001632. doi: 10.1371/journal.pgph.0001632. eCollection 2023.
Men's engagement in HIV prevention and treatment is suboptimal, including in South Africa. We sought to address this through adapting an evidence-based intervention, Stepping Stones and Creating Futures (SSCF), to strengthen its HIV content and provide a more scalable (shorter) intervention in rural South Africa. We then conducted a mixed methods pre-test of the intervention among young men aged 18-35 years. To adapt SSCF, we reviewed the current evidence base and worked with male Peer Navigators to update the SSCF theory of change (ToC) and manual. The revised intervention was ~45 hours (9 sessions) as opposed to ~63 hours and included a greater focus on HIV prevention and treatment technologies. Overall, 64% (n = 60) of men approached agreed to participate in the intervention, uptake (attending one session) among those who agreed was n = 35(58%) and retention (attending 6 or more sessions) was n = 25(71%). Qualitative data emphasized the intervention was acceptable, with young men describing it as something they liked. The qualitative data also broadly supported the intervention ToC, including the normalization of HIV in men's lives, and the importance of health for men in achieving their life goals. However, it also highlighted the need to focus more on HIV-related stigma and fear, and the importance of HIV self-testing kits in encouraging testing. We revised the ToC and manual in light of this data. The adapted SSCF is acceptable and supports the ToC. Next steps is an evaluation to look at effectiveness of the intervention.
男性在艾滋病毒预防和治疗方面的参与度并不理想,在南非也是如此。我们试图通过调整基于证据的干预措施“垫脚石与创造未来”(SSCF)来解决这一问题,加强其艾滋病毒相关内容,并在南非农村地区提供一种更具可扩展性(更简短)的干预措施。然后,我们对18至35岁的年轻男性进行了该干预措施的混合方法预测试。为了调整SSCF,我们审查了当前的证据基础,并与男性同伴导航员合作更新了SSCF的变革理论(ToC)和手册。修订后的干预措施约为45小时(9节课程),而不是约63小时,并且更加注重艾滋病毒预防和治疗技术。总体而言,接触到的男性中有64%(n = 60)同意参与干预措施,同意参与的人中的参与率(参加一节课)为n = 35(58%),留存率(参加6节或更多课程)为n = 25(71%)。定性数据强调该干预措施是可接受的,年轻男性将其描述为他们喜欢的东西。定性数据还广泛支持干预措施的ToC,包括艾滋病毒在男性生活中的正常化,以及健康对男性实现生活目标的重要性。然而,它也强调需要更多地关注与艾滋病毒相关的耻辱感和恐惧,以及艾滋病毒自检试剂盒在鼓励检测方面的重要性。我们根据这些数据修订了ToC和手册。调整后的SSCF是可接受的,并支持ToC。下一步是进行评估,以考察该干预措施的有效性。
Glob Public Health. 2020-9
PLOS Glob Public Health. 2025-4-8