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      Health Communication and the HIV Continuum of Care

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          Abstract:

          Health communication is a broad term that applies to the fundamental need for practitioners, policy makers, patients, and community members to understand one another around health promotion and health care issues. Whether in a consultation between nurse and patient, a health clinic director's engagement with the health ministry, or a community campaign for encouraging HIV testing, all have critical health communication elements. When people's needs are not perceived by them to be addressed or clients/patients do not understand what is being communicated, they are unmotivated to engage. Health communication may be deployed at multiple levels to encourage positive behavior change and affect HIV treatment outcomes. As countries move to treatment for all as soon as possible after testing, health communication can help address significant losses at each stage of the HIV continuum of care, thereby contributing to achieving the 90-90-90 global treatment goals. This JAIDS supplement presents compelling studies that are anchored on the health communication exigencies in highly diverse HIV and AIDS contexts in low and middle income settings. Our special focus is health communication needs and challenges within the HIV continuum of care. We introduce the supplement with thumbnails summaries of the work presented by an experienced array of public health, behavioral, and clinical scientists.

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          Most cited references16

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          The information-motivation-behavioral skills model of antiretroviral adherence and its applications.

          Suboptimal adherence to highly active antiretroviral therapy (HAART) may have serious consequences for HIV patients, and for public health overall. The Information-Motivation-Behavioral Skills (IMB) model of HAART adherence can be used to understand the dynamics of HAART adherence and to intervene with patients to promote more optimal levels of adherence. This article reviews the core hypotheses of the IMB model of HAART adherence and describes available correlational and experimental evaluations of the model, outcomes of adherence intervention trials that applied the model, and IMB model-based interventions that are currently under evaluation. It then explores one potential promising application of the model that uses a protocol originally developed and demonstrated as a structured patient-centered, provider-delivered risk reduction intervention to deliver information, motivation, and behavioral skills-based adherence-promotion strategies. This protocol could be incorporated into clinical practice as a valuable tool in working with patients individually.
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            Effectiveness of mass media interventions for HIV prevention, 1986-2013: a meta-analysis.

            This meta-analysis was conducted to synthesize evaluations of mass media-delivered HIV prevention interventions, assess the effectiveness of interventions in improving condom use and HIV-related knowledge, and identify moderators of effectiveness.
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              Taking Control: The Efficacy and Durability of a Peer-Led Uncertainty Management Intervention for People Recently Diagnosed With HIV

              HIV creates substantial uncertainty for people infected with the virus, which subsequently affects a host of psychosocial outcomes critical to successful management of the disease. This study assessed the efficacy and durability of a theoretically driven, one-on-one peer support intervention designed to facilitate uncertainty management and enhance psychosocial functioning for patients newly diagnosed with HIV. Using a pretest-posttest control group design, 98 participants received information and training in specific communication strategies (e.g., disclosing to friends and family, eliciting social support, talking to health care providers, using the Internet to gather information, and building social networks through AIDS service organizations). Participants in the experimental group attended six 1-hour sessions, whereas control participants received standard of care for 12 months (after which they received the intervention). Over time, participants in the intervention fared significantly better regarding (a) illness uncertainty, (b) depression, and (c) satisfaction with social support than did those in the control group. Given the utility and cost-effectiveness of this intervention and the uncertainty of a multitude of medical diagnoses and disease experiences, further work is indicated to determine how this program could be expanded to other illnesses and to address related factors, such as treatment adherence and clinical outcomes.
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                Author and article information

                Journal
                J Acquir Immune Defic Syndr
                J. Acquir. Immune Defic. Syndr
                qai
                Journal of Acquired Immune Deficiency Syndromes (1999)
                JAIDS Journal of Acquired Immune Deficiency Syndromes
                1525-4135
                1944-7884
                1 January 2017
                08 December 2016
                : 74
                : Suppl 1
                : S1-S4
                Affiliations
                [* ]Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN;
                []Johns Hopkins Center for Communication Programs, Baltimore, MD; and
                []Department of Medicine, Anova Health Institute, Johannesburg, South Africa and Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa.
                Author notes
                Correspondence to: Sten H. Vermund, MD, PhD, Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, TN 37203 (e-mail: sten.vermund@ 123456vanderbilt.edu ).
                Article
                QAIV17416 00001
                10.1097/QAI.0000000000001211
                5147028
                27930605
                5fa31d28-7686-4619-b685-e3a19ebbc080
                Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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                health communication,hiv testing,hiv continuum of care,treatment,retention,africa

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