Acceptability of a pilot motivational interviewing intervention at public health facilities to improve the HIV treatment cascade among people who inject drugs in Indonesia.

Publisher: BioMed Central Country of Publication: England NLM ID: 101153624 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7517 (Electronic) Linking ISSN: 14777517 NLM ISO Abbreviation: Harm Reduct J Subsets: MEDLINE

Original Publication: [London] : BioMed Central, c2004-

Motivational Interviewing*/methods ; HIV Infections*/drug therapy ; Substance Abuse, Intravenous*/therapy ; Substance Abuse, Intravenous*/drug therapy ; Drug Users*; Humans ; Indonesia ; Anti-Retroviral Agents/therapeutic use ; Health Facilities

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.
(© 2024. The Author(s).)

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D43 TW010935 United States TW FIC NIH HHS

Keywords: Acceptability; Adherence; Antiretroviral therapy; HIV; Motivational interviewing; People who inject drugs; Psychosocial intervention

0 (Anti-Retroviral Agents)

Date Created: 20240402 Date Completed: 20240403 Latest Revision: 20240404

20240404

PMC10985935

10.1186/s12954-024-00989-w

38561793