Applying the Biopsychosocial Model to Unpack a Psychosocial Support Intervention Designed to Improve Antiretroviral Treatment Outcomes for Adolescents in South Africa

Overview

Journal Pan Afr Med J

Date 2022 Jun 3

PMID 35655671

Authors

Emeka Francis Okonji

Brian van Wyk

Ferdinand Che Mukumbang

Affiliations

Soon will be listed here.

Abstract

Adolescents (10 to 19 years) living with HIV (ALHIV) experience disproportionately poor adherence to antiretroviral treatment (ART) compared to other age groups. Several barriers, including psychosocial challenges, contribute to this observation. Psychosocial support (PSS) interventions show promising results as a strategy to deal with the biological and psychosocial challenges faced by ALHIV. However, there is dearth of information on how psychosocial support interventions designed to improve treatment adherence and retention in care among ALHIV are effective. In this commentary, we used the biopsychosocial model to formulate hypotheses on how the components of a PSS intervention could improve adherence and retention in ART care. Psychological wellbeing, coping strategies, social support, self-efficacy, and disclosure are key components in the intervention designed to improve ART adherence and retention in care. The management of ALHIV for improved ART adherence and retention requires recognising and addressing the complex biological, psychological and social issues peculiar to them.

Citing Articles

Comparing pill counts and patient self-reports versus DBS tenofovir concentrations as ART adherence measurements with virologic outcomes and HIV drug resistance in a cohort of adolescents and young adults failing ART in Harare, Zimbabwe.

Mtisi T, Kouamou V, Morse G, Dzinamarira T, Ndhlovu C J Infect Public Health. 2024; 17(9):102500.

PMID: 39173560 PMC: 11393767. DOI: 10.1016/j.jiph.2024.102500.

Health System Responses to Address Treatment Gaps of Unsuppressed Adolescents on HIV Treatment in Public Primary Health Care Facilities in Windhoek, Namibia.

Munyayi F, van Wyk B HIV AIDS (Auckl). 2024; 16:259-273.

PMID: 39006217 PMC: 11246627. DOI: 10.2147/HIV.S459124.

Awareness and knowledge of integrated counselling and testing centres (ICTC) counsellors about depression among people with human immunodeficiency virus (HIV): A descriptive study from Karnataka.

Kumar P, John S, Cherian A, Pandian R, Anand N, Rao T Ind Psychiatry J. 2024; 33(1):48-53.

PMID: 38853816 PMC: 11155658. DOI: 10.4103/ipj.ipj_31_23.

Psychosocial Support Programme Improves Adherence and Health Systems Experiences for Adolescents on Antiretroviral Therapy in Mpumalanga Province, South Africa.

Okonji E, van Wyk B, Hughes G, Mukumbang F Int J Environ Res Public Health. 2022; 19(23).

PMID: 36497544 PMC: 9739873. DOI: 10.3390/ijerph192315468.

Implementation of a Psychosocial Support Intervention for Adolescents on Antiretroviral Treatment: Challenges and Experiences from Ehlanzeni District, South Africa.

Okonji E, van Wyk B, Hughes G, Mukumbang F J Int Assoc Provid AIDS Care. 2022; 21:23259582221121094.

PMID: 35993156 PMC: 9403444. DOI: 10.1177/23259582221121094.

References

Kahana S, Rohan J, Allison S, Frazier T, Drotar D . A meta-analysis of adherence to antiretroviral therapy and virologic responses in HIV-infected children, adolescents, and young adults. AIDS Behav. 2012; 17(1):41-60. DOI: 10.1007/s10461-012-0159-4. View

Shubber Z, Mills E, Nachega J, Vreeman R, Freitas M, Bock P . Patient-Reported Barriers to Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis. PLoS Med. 2016; 13(11):e1002183. PMC: 5127502. DOI: 10.1371/journal.pmed.1002183. View

Hudelson C, Cluver L . Factors associated with adherence to antiretroviral therapy among adolescents living with HIV/AIDS in low- and middle-income countries: a systematic review. AIDS Care. 2015; 27(7):805-16. DOI: 10.1080/09540121.2015.1011073. View

Callaghan P, Morrissey J . Social support and health: a review. J Adv Nurs. 1993; 18(2):203-10. DOI: 10.1046/j.1365-2648.1993.18020203.x. View

Johnson M, Chesney M, Goldstein R, Remien R, Catz S, Gore-Felton C . Positive provider interactions, adherence self-efficacy, and adherence to antiretroviral medications among HIV-infected adults: A mediation model. AIDS Patient Care STDS. 2006; 20(4):258-68. PMC: 2432422. DOI: 10.1089/apc.2006.20.258. View

Tuller D, Bangsberg D, Senkungu J, Ware N, Emenyonu N, Weiser S . Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav. 2009; 14(4):778-84. PMC: 2888948. DOI: 10.1007/s10461-009-9533-2. View

Umar E, Levy J, Bailey R, Donenberg G, Hershow R, Mackesy-Amiti M . Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi. AIDS Behav. 2018; 23(2):513-522. PMC: 8896833. DOI: 10.1007/s10461-018-2255-6. View

Slogrove A, Mahy M, Armstrong A, Davies M . Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic. J Int AIDS Soc. 2017; 20(Suppl 3):21520. PMC: 5719718. DOI: 10.7448/IAS.20.4.21520. View

Nostlinger C, Bakeera-Kitaka S, Buyze J, Loos J, Buve A . Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa. AIDS Care. 2015; 27 Suppl 1:36-46. PMC: 4685614. DOI: 10.1080/09540121.2015.1051501. View

10.

Johnson M, Neilands T, Dilworth S, Morin S, Remien R, Chesney M . The role of self-efficacy in HIV treatment adherence: validation of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). J Behav Med. 2007; 30(5):359-70. PMC: 2423379. DOI: 10.1007/s10865-007-9118-3. View

11.

Mannheimer S, Hirsch-Moverman Y . What we know and what we do not know about factors associated with and interventions to promote antiretroviral adherence. Curr Infect Dis Rep. 2015; 17(4):466. DOI: 10.1007/s11908-015-0466-9. View

12.

Bertagnolio S, De Luca A, Vitoria M, Essajee S, Penazzato M, Hong S . Determinants of HIV drug resistance and public health implications in low- and middle-income countries. Antivir Ther. 2012; 17(6):941-53. DOI: 10.3851/IMP2320. View

13.

Bangsberg D . Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006; 43(7):939-41. DOI: 10.1086/507526. View

14.

Toska E, Gittings L, Hodes R, Cluver L, Govender K, Chademana K . Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa. Afr J AIDS Res. 2016; 15(2):123-40. PMC: 5558245. DOI: 10.2989/16085906.2016.1194299. View

15.

Mi T, Li X, Zhou G, Qiao S, Shen Z, Zhou Y . HIV Disclosure to Family Members and Medication Adherence: Role of Social Support and Self-efficacy. AIDS Behav. 2019; 24(1):45-54. DOI: 10.1007/s10461-019-02456-1. View

16.

Biadgilign S, Deribew A, Amberbir A, Deribe K . Barriers and facilitators to antiretroviral medication adherence among HIV-infected paediatric patients in Ethiopia: A qualitative study. SAHARA J. 2010; 6(4):148-54. DOI: 10.1080/17290376.2009.9724943. View

17.

Folayan M, Caceres C, Sam-Agudu N, Odetoyinbo M, Stockman J, Harrison A . Psychological Stressors and Coping Strategies Used by Adolescents Living with and Not Living with Hiv Infection in Nigeria. AIDS Behav. 2016; 21(9):2736-2745. PMC: 6510022. DOI: 10.1007/s10461-016-1534-3. View

18.

Chen W, Wantland D, Reid P, Corless I, Eller L, Iipinge S . Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV. J AIDS Clin Res. 2014; 4(11):256. PMC: 3932545. DOI: 10.4172/2155-6113.1000256. View

19.

Rendina H, Weaver L, Millar B, Lopez-Matos J, Parsons J . Psychosocial Well-Being and HIV-Related Immune Health Outcomes among HIV-Positive Older Adults: Support for a Biopsychosocial Model of HIV Stigma and Health. J Int Assoc Provid AIDS Care. 2019; 18:2325958219888462. PMC: 6893929. DOI: 10.1177/2325958219888462. View

20.

Estripeaut D, Luciani K, Garcia R, Banus R, Aguais T, Berrio E . Analysis of the social and psychosocial factors associated with adherence to antiretroviral therapy in adolescents with perinatal HIV-1 infection in Panama from a gender perspective. AIDS Care. 2016; 28 Suppl 2:66-72. PMC: 4991224. DOI: 10.1080/09540121.2016.1176669. View