Skip to main content

Table 2 The influence of FSW social support on peer-delivered interventions: intervention experiences vs. design

From: Understanding how social support influences peer-delivered HIV prevention interventions among Ugandan female sex workers: a case study from HIV self-testing

Social support domainsa

PE & participant experiencesb

Intervention designc

Informational

The provision of advice, suggestions, and information

• (+) PEs and participants instructed and assisted each other with HIVST kit use and results interpretation

• (+/−) Participants shared with each other positive and negative experiences using the HIVST kit

• (−)d Some PEs and participants spread misinformation on HIV transmission and the HIVST kit (e.g., product safety)

• Verbal: PEs provided instruction on HIV prevention behaviors (e.g., condom use, partner selection, family planning options), HIVST procedures, results interpretation, linkage to HIV care

• Physical: HIVST kit contained written and pictorial instructions (in Luganda and English) from kit manufacturer on use, results interpretation, and linkage to care

Instrumental

The provision of tangible goods and services or aides

• (+) PEs in the direct-delivery arm distributed HIVST kits directly to participants; some PEs in the coupon-delivery arm redeemed coupons for participants and directly distributed HIVST kits to facilitate testing access (which was not part of the intended intervention design)

• (+) PEs and participants supported each other’s access to healthcare services (e.g., pooled financial resources for travel)

• (−)d HIVST kits were not always available at healthcare facilities (coupon-delivery arm) and fostered mistrust of the PEs delivering the interventiond

• PEs delivered to participants HIVST kits (direct-delivery arm) or coupons exchangeable for free HIVST kits at specified, nearby healthcare facilities (coupon-delivery arm)

• PEs gave participants a referral card for free HIV testing (referral-only arm) or confirmatory testing (intervention arms) at nearby healthcare facilities

• PEs provided participants with a study card containing a free phone number for medical doctors and counsellors, which could be used to facilitate interpretation of HIVST results, linkage to confirmatory testing or treatment, or help with adverse events

• PEs distributed free condoms

Emotional

The provision of care, empathy, love, and trust

• (+) Participants felt supported by knowledgeable PEs who acted in their best interests

• (+) PEs and study peers supported participants’ HIVST uptake, confirmatory testing, and treatment adherence

(+/−)d Participants had mixed feelings about disclosure of their HIV status to PEs; some anticipated support (e.g., linkage to care assistance), while others had some concerns (e.g., involuntary HIV status disclosure, social exclusion) d

• The intervention designers assumed that PEs would provide participants with emotional support because PEs were instructed to select individuals for the study whom they perceived to be at HIV risk and thought would be interested in HIVST

  1. aDefinitions of informational, instrumental, and emotional according to House [22] and Heaney and Israel [24]
  2. b In cases where FSW social support motivates or discourages HIVST uptake, this is indicated with a (+) or (-) respectively
  3. c Intervention design elements were provided by authors: DKM, TB, and KFO
  4. d Cases where contextual factors indirectly impacted social support dimensions
Back to article page

BMC Public Health

ISSN: 1471-2458

Contact us