Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services

Background: Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be...

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Main Authors: Howard, B.N., Van Dorn, R., Myers-Franchi, Bronwyn, Zule, W.A., Browne, F.A., Carney, T., Wechsberg, W.M.
Format: Journal Article
Language:English
Published: BIOMED CENTRAL LTD 2017
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85710
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author Howard, B.N.
Van Dorn, R.
Myers-Franchi, Bronwyn
Zule, W.A.
Browne, F.A.
Carney, T.
Wechsberg, W.M.
author_facet Howard, B.N.
Van Dorn, R.
Myers-Franchi, Bronwyn
Zule, W.A.
Browne, F.A.
Carney, T.
Wechsberg, W.M.
author_sort Howard, B.N.
building Curtin Institutional Repository
collection Online Access
description Background: Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women's Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa. Methods: We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. Results: All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. Conclusions: In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women's risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be fully integrated into the services delivered by healthcare facilities. Trial registration: Clinical trials NCT02733003. Date of Registration: January 21, 2016, registered retroactively after participant enrollment.
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spelling curtin-20.500.11937-857102021-10-21T05:55:20Z Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services Howard, B.N. Van Dorn, R. Myers-Franchi, Bronwyn Zule, W.A. Browne, F.A. Carney, T. Wechsberg, W.M. Science & Technology Life Sciences & Biomedicine Health Care Sciences & Services HIV Prevention intervention Substance use Women Implementation science SUB-SAHARAN AFRICA SUBSTANCE USE SEXUAL RISK CAPE-TOWN PARTNER VIOLENCE WOMEN ALCOHOL NEGOTIATION PREVALENCE PREVENTION Background: Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women's Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa. Methods: We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. Results: All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. Conclusions: In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women's risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be fully integrated into the services delivered by healthcare facilities. Trial registration: Clinical trials NCT02733003. Date of Registration: January 21, 2016, registered retroactively after participant enrollment. 2017 Journal Article http://hdl.handle.net/20.500.11937/85710 10.1186/s12913-017-2669-2 English BIOMED CENTRAL LTD fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
HIV
Prevention intervention
Substance use
Women
Implementation science
SUB-SAHARAN AFRICA
SUBSTANCE USE
SEXUAL RISK
CAPE-TOWN
PARTNER VIOLENCE
WOMEN
ALCOHOL
NEGOTIATION
PREVALENCE
PREVENTION
Howard, B.N.
Van Dorn, R.
Myers-Franchi, Bronwyn
Zule, W.A.
Browne, F.A.
Carney, T.
Wechsberg, W.M.
Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title_full Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title_fullStr Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title_full_unstemmed Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title_short Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
title_sort barriers and facilitators to implementing an evidence-based woman-focused intervention in south african health services
topic Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
HIV
Prevention intervention
Substance use
Women
Implementation science
SUB-SAHARAN AFRICA
SUBSTANCE USE
SEXUAL RISK
CAPE-TOWN
PARTNER VIOLENCE
WOMEN
ALCOHOL
NEGOTIATION
PREVALENCE
PREVENTION
url http://hdl.handle.net/20.500.11937/85710