title: A role for health communication in the continuum of HIV care, treatment, and prevention.
abstract: : Health communication has played a pivotal role in HIV prevention efforts since the beginning of the epidemic. The recent paradigm of combination prevention, which integrates behavioral, biomedical, and structural interventions, offers new opportunities for employing health communication approaches across the entire continuum of care. We describe key areas where health communication can significantly enhance HIV treatment, care, and prevention, presenting evidence from interventions that include health communication components. These interventions rely primarily on interpersonal communication, especially individual and group counseling, both within and beyond clinical settings to enhance the uptake of and continued engagement in care. Many successful interventions mobilize a network of trained community supporters or accompagnateurs, who provide education, counseling, psychosocial support, treatment supervision, and other pragmatic assistance across the care continuum. Community treatment supporters reduce the burden on overworked medical providers, engage a wider segment of the community, and offer a more sustainable model for supporting people living with HIV. Additionally, mobile technologies are increasingly seen as promising avenues for ongoing cost-effective communication throughout the treatment cascade. A broader range of communication approaches, traditionally employed in HIV prevention efforts, that address community and sociopolitical levels through mass media, school- or workplace-based education, and entertainment modalities may be useful to interventions seeking to address the full care continuum. Future interventions would benefit from development of a framework that maps appropriate communication theories and approaches onto each step of the care continuum to evaluate the efficacy of communication components on treatment outcomes.
authors.affiliation: *Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ‡Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tomori
authors.forename: Kathryn
authors.initials: K
authors.lastname: Risher
authors.forename: Rupali J
authors.initials: RJ
authors.lastname: Limaye
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Van Lith
authors.forename: Susannah
authors.initials: S
authors.lastname: Gibbs
authors.forename: Marina
authors.initials: M
authors.lastname: Smelyanskaya
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control*; D058015:Health Communication / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care