Sutton, R., Lahuerta, M., Abacassamo, F., et al. Journal of Acquired Immune Deficiency Syndromes (January 2017), 74(1):S29–S36. doi:10.1097/QAI.0000000000001208.
This article shared findings from a process evaluation comparing the feasibility and acceptability of a combination intervention strategy to increase linkage and retention among adults recently diagnosed with HIV. The evaluation was part of the Engage4Health implementation science study conducted at 10 health facilities in urban Maputo City and rural Inhambane Province, Mozambique. It included three structural interventions—point-of-care CD4 testing immediately post-diagnosis, fast-tracked antiretroviral therapy (ART) initiation for eligible clients, and noncash financial incentives; and two health communication interventions—pre-ART counseling and cell phone appointment reminders. The study examined the extent to which each intervention was delivered as planned and accepted by clients. For structural interventions, 74 percent of clients received CD4 testing, and 53 percent of those eligible initiated ART within one month. For health communication interventions, 98 percent of eligible clients received pre-ART counseling, and 90 percent of participants received at least one cell phone reminder. Results indicated fewer barriers to the delivery of the health communication interventions as compared with the structural interventions. Challenges with the latter included absorbing the increased number of clients eligible for ART initiation, machine breakdowns, and staff limitations (lack of knowledge, low trust in results, and absenteeism). The authors noted the potential usefulness of implementing health communication interventions within combination intervention strategies.