Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia
Abstract Background HIV-positive people who inject drugs (PWID) experience challenges in initiating and adhering to antiretroviral treatment (ART). Counselling using motivational interviewing (MI) techniques may help them formulate individualised strategies, and execute actions to address these chal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-024-00989-w |
| _version_ | 1797219912624635904 |
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| author | Lydia V. Wongso Arie Rahadi Evi Sukmaningrum Miasari Handayani Rudi Wisaksana |
| author_facet | Lydia V. Wongso Arie Rahadi Evi Sukmaningrum Miasari Handayani Rudi Wisaksana |
| author_sort | Lydia V. Wongso |
| collection | DOAJ |
| description | Abstract Background HIV-positive people who inject drugs (PWID) experience challenges in initiating and adhering to antiretroviral treatment (ART). Counselling using motivational interviewing (MI) techniques may help them formulate individualised strategies, and execute actions to address these challenges collaboratively with their providers. We evaluated the acceptability of MI from a pilot implementation at three public health facilities in Indonesia. Methods Adapting the acceptability constructs developed by Sekhon (2017) we assessed the acceptability to HIV-positive PWID clients (n = 12) and providers (n = 10) in four synthesised constructs: motivation (attributes that inspire engagement); cost consideration (sacrifices made to engage in MI); learned understanding (mechanism of action); and outcomes (ability to effect change with engagement). We included all providers and clients who completed ≥ 2 MI encounters. Qualitative analysis with an interpretive paradigm was used to extract and categorise themes by these constructs. Results In motivation, clients valued the open communication style of MI, while providers appreciated its novelty in offering coherent structure with clear boundaries. In cost consideration, both groups faced a challenge in meeting MI encounters due to access or engagement in other health care areas. In learned understanding, clients understood that MI worked to identify problematic areas of life amenable to change to support long-term ART, with reconciliation in family life being the most targeted change. By contrast, providers preferred targeting tangible health outcomes to such behavioural proxies. In outcomes, clients were confident in their ability to develop behaviours to sustain ART uptakes, whereas providers doubted the outcome of MI on younger PWID or those with severe dependence. Conclusions There is broad acceptability of MI in motivating engagement for both actors. Relative to providers, clients were more acceptable in its mechanism and had greater confidence to perform behaviours conducive to ART engagement. Design innovations to improve the acceptability of MI for both actors are needed. |
| first_indexed | 2024-04-24T12:41:11Z |
| format | Article |
| id | doaj.art-1fcaeb6f8c8e44e19449c74fa2643fb7 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-24T12:41:11Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-1fcaeb6f8c8e44e19449c74fa2643fb72024-04-07T11:13:03ZengBMCHarm Reduction Journal1477-75172024-04-0121111210.1186/s12954-024-00989-wAcceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in IndonesiaLydia V. Wongso0Arie Rahadi1Evi Sukmaningrum2Miasari Handayani3Rudi Wisaksana4University Center of Excellence - AIDS Research Center, Health Policy and Social Innovation, Atma Jaya Catholic University of IndonesiaUniversity Center of Excellence - AIDS Research Center, Health Policy and Social Innovation, Atma Jaya Catholic University of IndonesiaUniversity Center of Excellence - AIDS Research Center, Health Policy and Social Innovation, Atma Jaya Catholic University of IndonesiaResearch Center for Care and Control of Infectious Diseases, Universitas PadjadjaranResearch Center for Care and Control of Infectious Diseases, Universitas PadjadjaranAbstract Background HIV-positive people who inject drugs (PWID) experience challenges in initiating and adhering to antiretroviral treatment (ART). Counselling using motivational interviewing (MI) techniques may help them formulate individualised strategies, and execute actions to address these challenges collaboratively with their providers. We evaluated the acceptability of MI from a pilot implementation at three public health facilities in Indonesia. Methods Adapting the acceptability constructs developed by Sekhon (2017) we assessed the acceptability to HIV-positive PWID clients (n = 12) and providers (n = 10) in four synthesised constructs: motivation (attributes that inspire engagement); cost consideration (sacrifices made to engage in MI); learned understanding (mechanism of action); and outcomes (ability to effect change with engagement). We included all providers and clients who completed ≥ 2 MI encounters. Qualitative analysis with an interpretive paradigm was used to extract and categorise themes by these constructs. Results In motivation, clients valued the open communication style of MI, while providers appreciated its novelty in offering coherent structure with clear boundaries. In cost consideration, both groups faced a challenge in meeting MI encounters due to access or engagement in other health care areas. In learned understanding, clients understood that MI worked to identify problematic areas of life amenable to change to support long-term ART, with reconciliation in family life being the most targeted change. By contrast, providers preferred targeting tangible health outcomes to such behavioural proxies. In outcomes, clients were confident in their ability to develop behaviours to sustain ART uptakes, whereas providers doubted the outcome of MI on younger PWID or those with severe dependence. Conclusions There is broad acceptability of MI in motivating engagement for both actors. Relative to providers, clients were more acceptable in its mechanism and had greater confidence to perform behaviours conducive to ART engagement. Design innovations to improve the acceptability of MI for both actors are needed.https://doi.org/10.1186/s12954-024-00989-wMotivational interviewingPsychosocial interventionAcceptabilityHIVPeople who inject drugsAdherence |
| spellingShingle | Lydia V. Wongso Arie Rahadi Evi Sukmaningrum Miasari Handayani Rudi Wisaksana Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia Harm Reduction Journal Motivational interviewing Psychosocial intervention Acceptability HIV People who inject drugs Adherence |
| title | Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia |
| title_full | Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia |
| title_fullStr | Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia |
| title_full_unstemmed | Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia |
| title_short | Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia |
| title_sort | acceptability of a pilot motivational interviewing intervention at public health facilities to improve the hiv treatment cascade among people who inject drugs in indonesia |
| topic | Motivational interviewing Psychosocial intervention Acceptability HIV People who inject drugs Adherence |
| url | https://doi.org/10.1186/s12954-024-00989-w |
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