Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho

Behavioral treatments can help people with human immunodeficiency virus (HIV) improve their quality of life and treatment adherence. In Lesotho, where a fifth of adults live with HIV and depression and harmful alcohol use is prevalent among this group, little is known about the local suitability of...

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Main Authors: Grace H. Yoon, Natalie E. Johnson, Moleboheng Mokebe, Palesa Mahlatsi, Malebanye Lerotholi, Niklaus D. Labhardt, Nadine Tschumi, Alastair van Heerden, Jennifer M. Belus, Irene Falgas-Bague
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Cambridge Prisms: Global Mental Health
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Online Access:https://www.cambridge.org/core/product/identifier/S2054425125100174/type/journal_article
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author Grace H. Yoon
Natalie E. Johnson
Moleboheng Mokebe
Palesa Mahlatsi
Malebanye Lerotholi
Niklaus D. Labhardt
Nadine Tschumi
Alastair van Heerden
Jennifer M. Belus
Irene Falgas-Bague
author_facet Grace H. Yoon
Natalie E. Johnson
Moleboheng Mokebe
Palesa Mahlatsi
Malebanye Lerotholi
Niklaus D. Labhardt
Nadine Tschumi
Alastair van Heerden
Jennifer M. Belus
Irene Falgas-Bague
author_sort Grace H. Yoon
collection DOAJ
description Behavioral treatments can help people with human immunodeficiency virus (HIV) improve their quality of life and treatment adherence. In Lesotho, where a fifth of adults live with HIV and depression and harmful alcohol use is prevalent among this group, little is known about the local suitability of established behavioral treatment strategies. We explored preferences regarding two strategies evaluated in other settings: involving phones and trusted individuals in treatment. We thematically analyzed 28 semi-structured interviews with potential service users receiving routine HIV care in the Butha-Buthe and Mokhotlong districts. Key concerns included the feasibility of phone-based treatment in rural areas and issues of limited literacy, electricity and network coverage. Others highlighted potential benefits for younger and working individuals for phone-based treatment, preferring calls over texts. Involving trusted individuals in treatment was favored, as this could foster support and accountability. Behavioral issues related to depression and alcohol use were viewed as complex, requiring face-to-face attention from trusted professionals, such as nurses and counselors, who were seen as knowledgeable and capable of maintaining confidentiality. Peer providers were not favored due to privacy concerns. These findings emphasize the need for face-to-face, confidential and health worker-led approaches for integrating behavioral treatment into HIV care in Lesotho.
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spelling doaj-art-28f3233e295d416cb13cb0e7338c67d22025-08-20T02:37:10ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512025-01-011210.1017/gmh.2025.10017Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in LesothoGrace H. Yoon0https://orcid.org/0000-0002-3849-1947Natalie E. Johnson1https://orcid.org/0000-0001-8379-1183Moleboheng Mokebe2Palesa Mahlatsi3Malebanye Lerotholi4Niklaus D. Labhardt5Nadine Tschumi6Alastair van Heerden7Jennifer M. Belus8Irene Falgas-Bague9Division of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandSolidarMed Lesotho, Butha Buthe, LesothoSolidarMed Lesotho, Butha Buthe, LesothoDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandSAMRC/WITS Developmental Pathways for Health Research Unit, Department of Pediatrics, School of Clinical Medicine, Faculty of Health Sciences, https://ror.org/03rp50x72 University of the Witwatersrand , Johannesburg, South AfricaDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, SwitzerlandDivision of Clinical Epidemiology, Department of Clinical Research, University of Basel/University Hospital Basel, Basel, Switzerland Urban Public Health Unit, https://ror.org/03adhka07 Swiss Tropical and Public Health Institute , Allschwil, SwitzerlandBehavioral treatments can help people with human immunodeficiency virus (HIV) improve their quality of life and treatment adherence. In Lesotho, where a fifth of adults live with HIV and depression and harmful alcohol use is prevalent among this group, little is known about the local suitability of established behavioral treatment strategies. We explored preferences regarding two strategies evaluated in other settings: involving phones and trusted individuals in treatment. We thematically analyzed 28 semi-structured interviews with potential service users receiving routine HIV care in the Butha-Buthe and Mokhotlong districts. Key concerns included the feasibility of phone-based treatment in rural areas and issues of limited literacy, electricity and network coverage. Others highlighted potential benefits for younger and working individuals for phone-based treatment, preferring calls over texts. Involving trusted individuals in treatment was favored, as this could foster support and accountability. Behavioral issues related to depression and alcohol use were viewed as complex, requiring face-to-face attention from trusted professionals, such as nurses and counselors, who were seen as knowledgeable and capable of maintaining confidentiality. Peer providers were not favored due to privacy concerns. These findings emphasize the need for face-to-face, confidential and health worker-led approaches for integrating behavioral treatment into HIV care in Lesotho.https://www.cambridge.org/core/product/identifier/S2054425125100174/type/journal_articledepressionalcohol usebehavioral treatment preferencesLesothopeople with HIV
spellingShingle Grace H. Yoon
Natalie E. Johnson
Moleboheng Mokebe
Palesa Mahlatsi
Malebanye Lerotholi
Niklaus D. Labhardt
Nadine Tschumi
Alastair van Heerden
Jennifer M. Belus
Irene Falgas-Bague
Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
Cambridge Prisms: Global Mental Health
depression
alcohol use
behavioral treatment preferences
Lesotho
people with HIV
title Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
title_full Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
title_fullStr Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
title_full_unstemmed Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
title_short Face-to-face, confidential and health worker-led: Understanding the preferences for behavioral health services among people with HIV in Lesotho
title_sort face to face confidential and health worker led understanding the preferences for behavioral health services among people with hiv in lesotho
topic depression
alcohol use
behavioral treatment preferences
Lesotho
people with HIV
url https://www.cambridge.org/core/product/identifier/S2054425125100174/type/journal_article
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