Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]

Background Men living with HIV in sub-Saharan Africa have sub-optimal engagement in antiretroviral therapy (ART) programs. Generic ART counselling in Malawi does not meet men’s needs. Methods We developed a male-specific ART counselling curriculum, adapted from the Malawi Ministry of Health curricul...

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Main Authors: Misheck Mphande, Julie Hubbard, Isabella Robson, Elijah Chikuse, Eric Lungu, Morna Cornell, Khumbo Phiri, Thomas J Coates, Sam Phiri, Kathryn Dovel
Format: Article
Language:English
Published: F1000 Research Ltd 2025-07-01
Series:Gates Open Research
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Online Access:https://gatesopenresearch.org/articles/9-52/v1
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_version_ 1850078859670585344
author Misheck Mphande
Julie Hubbard
Isabella Robson
Elijah Chikuse
Eric Lungu
Morna Cornell
Khumbo Phiri
Thomas J Coates
Sam Phiri
Kathryn Dovel
author_facet Misheck Mphande
Julie Hubbard
Isabella Robson
Elijah Chikuse
Eric Lungu
Morna Cornell
Khumbo Phiri
Thomas J Coates
Sam Phiri
Kathryn Dovel
author_sort Misheck Mphande
collection DOAJ
description Background Men living with HIV in sub-Saharan Africa have sub-optimal engagement in antiretroviral therapy (ART) programs. Generic ART counselling in Malawi does not meet men’s needs. Methods We developed a male-specific ART counselling curriculum, adapted from the Malawi Ministry of Health curriculum, based on literature review of men’s needs and motivations for treatment. We piloted the curriculum with men in six communities, with focus group discussions to assess knowledge of ART, motivators and barriers to care, and perceptions of the male-specific curriculum (n=85). We analysed data in Atlas.ti using grounded theory. We finalised the curriculum in a half-day meeting with Ministry and partner stakeholders (n=5) and implemented it in two randomized trials (IDEaL and ENGAGE). We describe the steps to develop, test and finalize the curriculum. Results We adapted three existing topics (status disclosure, treatment as prevention, and ART side effects) and added four new topics (how treatment contributes to men’s goals, feeling healthy on treatment, navigating health systems, and self-compassion for the cyclical nature of lifelong treatment). Key motivators included: family wellbeing, having additional children, being financially stability, and earning/keeping respect. Men reported little prior understanding of how ART contributed to their personal goals, and were most interested in treatment as prevention, benefits of disclosure/social support, how to navigate health systems, and side effects with new regimens. Respondents stated that the male-specific counselling challenged the idea that men were incapable of overcoming treatment barriers to lifelong medication. Conclusion Men need male-specific ART counselling curriculum to address their needs and increase access to and retention in HIV care. In the Malawi context, topics should include how treatment contributes to men’s goals, navigating health systems, self-compassion for lifelong treatment, and taking treatment while healthy. Other countries with high HIV burdens and limited resources could follow the steps outlined in this paper. This curriculum is being evaluated within the two randomized trials.
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spelling doaj-art-0d386c78e9254269adcaabe7828e1d002025-08-20T02:45:27ZengF1000 Research LtdGates Open Research2572-47542025-07-01910.12688/gatesopenres.16357.117758Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]Misheck Mphande0Julie Hubbard1Isabella Robson2Elijah Chikuse3Eric Lungu4Morna Cornell5Khumbo Phiri6Thomas J Coates7Sam Phiri8Kathryn Dovel9Partners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiUniversity of Cape Town School of Public Health, Observatory, Western Cape, South AfricaPartners in Hope, Lilongwe, MalawiUniversity of California Global Health Institute, San Francisco, California, USAPartners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiBackground Men living with HIV in sub-Saharan Africa have sub-optimal engagement in antiretroviral therapy (ART) programs. Generic ART counselling in Malawi does not meet men’s needs. Methods We developed a male-specific ART counselling curriculum, adapted from the Malawi Ministry of Health curriculum, based on literature review of men’s needs and motivations for treatment. We piloted the curriculum with men in six communities, with focus group discussions to assess knowledge of ART, motivators and barriers to care, and perceptions of the male-specific curriculum (n=85). We analysed data in Atlas.ti using grounded theory. We finalised the curriculum in a half-day meeting with Ministry and partner stakeholders (n=5) and implemented it in two randomized trials (IDEaL and ENGAGE). We describe the steps to develop, test and finalize the curriculum. Results We adapted three existing topics (status disclosure, treatment as prevention, and ART side effects) and added four new topics (how treatment contributes to men’s goals, feeling healthy on treatment, navigating health systems, and self-compassion for the cyclical nature of lifelong treatment). Key motivators included: family wellbeing, having additional children, being financially stability, and earning/keeping respect. Men reported little prior understanding of how ART contributed to their personal goals, and were most interested in treatment as prevention, benefits of disclosure/social support, how to navigate health systems, and side effects with new regimens. Respondents stated that the male-specific counselling challenged the idea that men were incapable of overcoming treatment barriers to lifelong medication. Conclusion Men need male-specific ART counselling curriculum to address their needs and increase access to and retention in HIV care. In the Malawi context, topics should include how treatment contributes to men’s goals, navigating health systems, self-compassion for lifelong treatment, and taking treatment while healthy. Other countries with high HIV burdens and limited resources could follow the steps outlined in this paper. This curriculum is being evaluated within the two randomized trials.https://gatesopenresearch.org/articles/9-52/v1Men HIV antiretroviral therapy counselling curriculum male-specificeng
spellingShingle Misheck Mphande
Julie Hubbard
Isabella Robson
Elijah Chikuse
Eric Lungu
Morna Cornell
Khumbo Phiri
Thomas J Coates
Sam Phiri
Kathryn Dovel
Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
Gates Open Research
Men
HIV
antiretroviral therapy
counselling
curriculum
male-specific
eng
title Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
title_full Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
title_fullStr Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
title_full_unstemmed Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
title_short Developing a male-specific counselling curriculum for HIV treatment in Malawi [version 1; peer review: awaiting peer review]
title_sort developing a male specific counselling curriculum for hiv treatment in malawi version 1 peer review awaiting peer review
topic Men
HIV
antiretroviral therapy
counselling
curriculum
male-specific
eng
url https://gatesopenresearch.org/articles/9-52/v1
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