Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa
Achieving the promise of antiretroviral therapy (ART) to reduce HIV-associated mortality and transmission in sub-Saharan Africa relies on increasing behavioral change toward earlier engagement and sustained retention in HIV care after HIV diagnosis. Health communication may be an important component of increasing care seeking during the period between testing HIV positive and entry into care. Such communication may take several forms, including interpersonal health communication (IPC). IPC can bring constructs of client autonomy and shared decision making to health communication. By being as relevant as possible using a “precision health communication” approach, the chance of behavior change may be maximized. Such precision communication may bring the client to move more rapidly from testing positive to accessing care and initiating ART.
Although the value of IPC is appreciated in HIV care, there has been a limited application of structured approaches of IPC for the step of the care continuum from testing positive to entry into care. Furthermore, much of the published literature describes the effect of communication strategies on specific outcomes without description or analysis of the communication itself. We explored how IPC using a structured, strength-based, and motivational counseling approach can assist clients in enunciating their goals, describe pathways to achieving those goals, and identify potential challenges to consider along those pathways. This may enable clients to consider specific barriers and embrace a specific care-seeking plan. Using data collected from a randomized entry-into-care study (Thol'impilo study), we analyzed the content of longitudinal counseling sessions to describe how structured IPC can provide precision health communication to encourage care seeking.