Table 1.
Description of themes
| Theme | Description |
|---|---|
| Forms of intervention support | |
| Instrumental support | Coordination for appointments; accompaniment to appointments; material assistance for transportation, food, medications; help with personal responsibilities such as child care, cleaning, fixing food |
| Emotional support | Encouragement, listening to problems, providing friendship and/or confidant support (‘like a sister/mother to me’） |
| Directly observed therapy | Direct supervision of HIV and non-HIV medications |
| Build trust of patients and family | Reassurance to patients and families of confidentiality and commitment, utilisation of strategies to overcome disclosure concerns related to home visits |
| Education | Education of patient and/or family members regarding HIV, medications, adherence and other health-related topics |
| Exercise of moral authority | Prescriptive advice from health promoter based on authority as caretaker (‘this is what is best for you’) |
| Advocacy | Speak with providers, family and community members on behalf of patient, in order to obtain better health services, emotional or instrumental support, etc. |
| Prepare for transition to self-administration | Work with patient to develop coping strategies for successful self-administration, remind patients of transient role of health promoter, involve family members to strengthen adherence support as DOT-HAART nearing completion |
| Outcomes | |
| Improved adherence | Ability to adhere to HIV treatment, including medications and appointments |
| Resumed social roles | Recovery of social role, including parenting, work, studies |
| Increased self-efficacy | Confidence in own ability to engage in care, adhere to treatment, take responsibility for own health |
| Hopefulness | Hope and optimism for the future, setting future goals and dreams |
| Change in non-HIV-related behaviour | Changes in non-HIV related behaviour, for example, substance use, interactions with others, maturity, physical appearance |
| Reduced externalised stigma | Decreased enacted stigma by family, friends, providers, others |
| Reduced internalised stigma | Improved self-esteem, diminished internalised stigma, feeling of worth |
| Disclosure | Ability to disclose to family members and/or friends |
| Remaining challenges | |
| Stigma in community | Enacted and perceived stigma by family, friends, providers, others |
| Economic recovery | Persistent challenges in finding work, overcoming poverty |
| Barriers to health services | Persistent difficulty accessing adequate health services, including TB and/or HIV care |