Abstract #24  -  A Public Health Evaluation of the Healthy Relationships Positive Prevention Intervention Programme in South Africa: Findings from a Pilot Study
Authors:   Presenting Author:   Ms Allanise Cloete - Human Sciences Research Council
Additional Authors:  Prof Leickness Simbayi, Prof Anna Strebel, Prof Thembeka Mdleleni-Bookholane, Mr Sean Jooste, Mrs Nokhona Lewa,
Aim: An alternative approach of HIV prevention known as positive prevention includes the provision of strategies to reduce HIV transmission risk behaviour specifically tailored for people who are aware of their HIV positive status. This study reports on an evidence-based positive prevention programme that was originally developed in the USA known as Healthy Relationships. Healthy Relationships promotes disclosure of HIV status to family, friends and sexual partners as well as provide for HIV risk reduction counseling. Findings are presented from the pilot phase of a public health evaluation which we are currently undertaking in a mainly rural part of the Eastern Cape Province of South Africa.
Method / Issue: Altogether 140 PLHIV organized into 12 groups (n = 8-12 each) were recruited from existing support group structures. A one group pretest-posttest quasi-experimental design was employed. In addition, two formative evaluations were also undertaken with the three pairs of intervention group facilitators (who consisted of one male and one female in each pair) keeping notes on their experiences whilst PLHIV completed brief session surveys. Furthermore, 12 focus groups were held with the same PLHIV, six of the groups which were done before the intervention whilst the other six were done afterwards. Finally, all intervention sessions were audiotape recorded.
Results / Comments: It was found that it was possible to implement the Healthy Relationships intervention in a rural setting in South Africa. PLHIV who took part in the study indicated their willingness and satisfaction with the content whilst participating in the intervention. The group facilitators reported that they had been able to implement the full intervention as was planned although they experienced some minor problems during early stages of intervention implementation. The intervention was delivered with fidelity and included all requisite intervention steps. Although a high level of disclosure efficacy among the PLHIV was found overall, a majority (56%) had not disclosed to others about their HIV-positive status. Similarly, although PLHIV generally held positive attitudes towards condoms use and condom use efficacy skills, over one third of those who had had sex (36.1%) indicated that they had not used condoms during the last sex act.
Discussion: Healthy Relationships can be delivered with fidelity as a positive prevention strategy in South Africa. More importantly, it also has the potential to both promote disclosure of HIV status to family, friends and sexual partners as well as reduce HIV transmission risk behaviour. The implementation of the intervention could be done simultaneously with the roll out of antiretroviral treatment. This approach could be particularly useful in Southern Africa where most countries with the heaviest burden of HIV/AIDS in the world are found.
Go Back