Medical Research Council
World Health Organization
Health Systems Trust
2011-2012 Education Sector HIV and AIDS: Global Progress Survey- Progression, Regression or Stagnation?UNAIDS
The Global Forum on MSM & HIV (MSMGF)
The evaluation of a video-based health education strategy to improve sexually transmitted disease partner notification in South Africa
was acceptable to patients and clinic staff
increased patients&rsquo understanding of the motivation for partner notification
improved patient self efficacy in notifying partners
and increased the number of partners presenting at the STD clinics in the district.
The research setting was a busy public health clinic in a rural district in KwaZulu Natal, South Africa. A before/after quantitative study design was used to measure the effect of the health education intervention by comparing measures collected from a pre-intervention (control) phase and an intervention phase. A qualitative evaluation assessed whether the intervention accurately portrayed the intended educational messages and whether unintended messages were also portrayed.
150 Index patients (55% female) were interviewed in the control phase, and 185 index patients (64% female) in the intervention phase. The age (mean 25 years), education level, and number of contact cards received did not differ across phases. During the intervention phase, 99.5% of patients saw the video, and 98% reported that they found it gave useful advice about partner notification.
There were no significant improvements in knowledge about partner notification among patients in the intervention phase. For example, 78% in the control phase and 86% in the intervention phase correctly answered a question about the role of partner treatment in preventing re-infection (p=0.09). There were improvements on several measures of self-efficacy about notifying casual partners. For example, index patients in the intervention phase, when compared with those in the pre-intervention phase, believed that a greater proportion of their casual partners would see the importance of seeking treatment, as a result of their notification interaction. The rate of contact cards returned per index patient was 0.27 in the intervention phase, compared with 0.20 in the control phase (95% CI for the rate difference: -0.05, 0.17). The qualitative research found that clinic staff and patients accepted the intervention enthusiastically, identified with the characters portrayed, and responded positively to the partner notification messages. However, a fundamental problem with the video was that patients received confused messages about the relation between HIV/AIDS and other STDs. This has potentially negative consequences for partner notification.
This type of intervention provides a cost-effective model for health education in primary care clinics in developing countries. The next phase of research needs to involve the development of a video that addresses the problems identified in the qualitative research, and the evaluation of its effects on partner referral using a randomised controlled trial.