Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories. (June 2018)

• Record Type: Journal Article
• Authors: Sikkema, Kathleen J.; Choi, Karmel W.; Robertson, Corne; Knettel, Brandon A.; Ciya, Nonceba; Knippler, Elizabeth T.; Watt, Melissa H.; Joska, John A.
• Is Part Of: Evaluation and program planning. Volume 68(2018)
• Page Start: 148
• Page End: 156
• Publication Date: 2018-06
• Subjects: South Africa -- Sexual trauma -- Coping -- Intervention development -- ART adherence; Health planning -- Periodicals; Medical care -- Evaluation -- Periodicals; 362.1068
• DOI: 10.1016/j.evalprogplan.2018.02.007
• Languages: English
• ISSNs: 0149-7189

Abstract

Highlights: We developed a coping intervention for HIV+ South African women with sexual trauma. Formative qualitative data provided context and informed intervention content. We describe cultural adaptations and modifications to improve delivery. Trial run feedback supported the feasibility and acceptability of the intervention. Abstract: This paper describes the development and preliminary trial run of ImpACT ( Improving AIDS Care after Trauma ), a brief coping intervention to address traumatic stress and HIV care engagement among South African women with sexual trauma histories. We engaged in an iterative process to culturally adapt a cognitive-behavioral intervention for delivery within a South African primary care clinic. This process involved three phases: (a) preliminary intervention development, drawing on content from a prior evidence-based intervention; (b) contextual adaptation of the curriculum through formative data collection using a multi-method qualitative approach; and (c) pre-testing of trauma screening procedures and a subsequent trial run of the intervention. Feedback from key informant interviews and patient in-depth interviews guided the refinement of session content and adaptation of key intervention elements, including culturally relevant visuals, metaphors, and interactive exercises. The trial run curriculum consisted of four individual sessions and two group sessions. Strong session attendance during the trial run supported the feasibility of ImpACT. Participants responded positively to the logistics of the intervention delivery and the majority of session content. Trial run feedback helped to further refine intervention content and delivery towards a pilot randomized clinical trial to assess the feasibility and potential efficacy of this intervention.