title: Masivukeni: development of a multimedia based antiretroviral therapy adherence intervention for counselors and patients in South Africa.
abstract: Effective medical treatment for HIV/AIDS requires patients' optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni ("Let's Wake Up" in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart's Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive #15, New York, NY 10032, USA. rhr1@columbia.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Claude A
authors.initials: CA
authors.lastname: Mellins
authors.forename: Reuben N
authors.initials: RN
authors.lastname: Robbins
authors.forename: Ryan
authors.initials: R
authors.lastname: Kelsey
authors.forename: Jessica
authors.initials: J
authors.lastname: Rowe
authors.forename: Patricia
authors.initials: P
authors.lastname: Warne
authors.forename: Jenifar
authors.initials: J
authors.lastname: Chowdhury
authors.forename: Nuruneesa
authors.initials: N
authors.lastname: Lalkhen
authors.forename: Lara
authors.initials: L
authors.lastname: Hoppe
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Abrams
authors.forename: Nabila
authors.initials: N
authors.lastname: El-Bassel
authors.forename: Susan
authors.initials: S
authors.lastname: Witte
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003376:Counseling / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D019212:Multimedia; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012650:Self Disclosure; D012944:Social Support; D013019:South Africa
chemical_list: D019380:Anti-HIV Agents