The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa

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dc.contributor.authorMedina-Marino, Andrew
dc.contributor.authorGlockner, Katherine
dc.contributor.authorGrew, Emily
dc.contributor.authorDe Vos, Lindsey
dc.contributor.authorOlivier, Dawie
dc.contributor.authorKlausner, Jeffrey
dc.contributor.authorDaniels, Joseph
dc.date.accessioned2020-05-06T17:21:29Z
dc.date.available2020-05-06T17:21:29Z
dc.date.issued2020-04-28
dc.date.updated2020-05-03T03:50:07Z
dc.description.abstractAbstract Background Sexually transmitted infections (STIs) during pregnancy result in neonatal morbidity and mortality, and may increase mother-to-child-transmission of HIV. Yet the World Health Organization’s current syndromic management guidelines for STIs leaves most pregnant women undiagnosed and untreated. Point-of-care (POC) diagnostic tests for STIs can drastically improve detection and treatment. Though acceptable and feasible, poor medication adherence and re-infection due to lack of partner treatment threaten the programmatic effectiveness of POC diagnostic programmes. Methods To engender patient-provider trust, and improve medication adherence and disclosure of STI status to sexual partners, we trained study nurses in compassionate care, good clinical practices and motivational interviewing. Using qualitative methods, we explored the role patient-provider communications may play in supporting treatment adherence and STI disclosure to sexual partners. Nurses were provided training in motivational interviewing, compassionate care and good clinical practices. Participants were interviewed using a semi-structured protocol, with domains including STI testing experience, patient-provider communication, and HIV and STI disclosure. Interviews were audio-recorded, transcribed and analyzed using a constant comparison approach. Results Twenty-eight participants treated for Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), and/or Neisseria gonorrhea (NG) were interviewed. Participants described strong communications and trusting relationships with nurses trained in patient-centered care training and implementing POC STI diagnostic testing. However, women described a delayed trust in treatment until their symptoms resolved. Women expressed a limited recall of their exact diagnosis, which impacted their ability to fully disclose their STI status to sexual partners. Conclusions We recommend implementing patient health literacy programmes as part of POC services to support women in remembering and disclosing their specific STI diagnosis to sexual partners, which may facilitate partner treatment uptake and thus decrease the risk of re-infection.
dc.identifier.apacitationMedina-Marino, A., Glockner, K., Grew, E., De Vos, L., Olivier, D., Klausner, J., & Daniels, J. (2020). The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa. <i>BMC Public Health</i>, 20(1), en_ZA
dc.identifier.chicagocitationMedina-Marino, Andrew, Katherine Glockner, Emily Grew, Lindsey De Vos, Dawie Olivier, Jeffrey Klausner, and Joseph Daniels "The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa." <i>BMC Public Health</i> 20, 1. (2020) en_ZA
dc.identifier.citationMedina-Marino, A., Glockner, K., Grew, E., De Vos, L., Olivier, D., Klausner, J. & Daniels, J. 2020. The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa. <i>BMC Public Health.</i> 20(1) en_ZA
dc.identifier.ris TY - Journal Article AU - Medina-Marino, Andrew AU - Glockner, Katherine AU - Grew, Emily AU - De Vos, Lindsey AU - Olivier, Dawie AU - Klausner, Jeffrey AU - Daniels, Joseph AB - Abstract Background Sexually transmitted infections (STIs) during pregnancy result in neonatal morbidity and mortality, and may increase mother-to-child-transmission of HIV. Yet the World Health Organization’s current syndromic management guidelines for STIs leaves most pregnant women undiagnosed and untreated. Point-of-care (POC) diagnostic tests for STIs can drastically improve detection and treatment. Though acceptable and feasible, poor medication adherence and re-infection due to lack of partner treatment threaten the programmatic effectiveness of POC diagnostic programmes. Methods To engender patient-provider trust, and improve medication adherence and disclosure of STI status to sexual partners, we trained study nurses in compassionate care, good clinical practices and motivational interviewing. Using qualitative methods, we explored the role patient-provider communications may play in supporting treatment adherence and STI disclosure to sexual partners. Nurses were provided training in motivational interviewing, compassionate care and good clinical practices. Participants were interviewed using a semi-structured protocol, with domains including STI testing experience, patient-provider communication, and HIV and STI disclosure. Interviews were audio-recorded, transcribed and analyzed using a constant comparison approach. Results Twenty-eight participants treated for Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), and/or Neisseria gonorrhea (NG) were interviewed. Participants described strong communications and trusting relationships with nurses trained in patient-centered care training and implementing POC STI diagnostic testing. However, women described a delayed trust in treatment until their symptoms resolved. Women expressed a limited recall of their exact diagnosis, which impacted their ability to fully disclose their STI status to sexual partners. Conclusions We recommend implementing patient health literacy programmes as part of POC services to support women in remembering and disclosing their specific STI diagnosis to sexual partners, which may facilitate partner treatment uptake and thus decrease the risk of re-infection. DA - 2020-04-28 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Public Health KW - Sexually transmitted infections KW - Point-of-care testing KW - Patient-provider communications KW - Pregnancy KW - HIV KW - South Africa LK - https://open.uct.ac.za PY - 2020 T1 - The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa TI - The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12889-020-08689-3
dc.identifier.urihttps://hdl.handle.net/11427/31828
dc.identifier.vancouvercitationMedina-Marino A, Glockner K, Grew E, De Vos L, Olivier D, Klausner J, et al. The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa. BMC Public Health. 2020;20(1) .en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceBMC Public Health
dc.source.journalissue1
dc.source.journalvolume20
dc.source.pagination577
dc.source.urihttps://bmcpublichealth.biomedcentral.com/
dc.subjectSexually transmitted infections
dc.subjectPoint-of-care testing
dc.subjectPatient-provider communications
dc.subjectPregnancy
dc.subjectHIV
dc.subjectSouth Africa
dc.titleThe role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa
dc.typeJournal Article
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