Health educational strategies for people living with HIV: scoping review

This is a scoping review in which the selection of articles was carried out in April 2021 and updated in October 2022 in ten data sources; the review followed the assumptions established by the Joanna Briggs Institute and the checklist of Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The results were descriptively analyzed and summarized in a chart.

Results

A total of 17 studies were selected, predominantly published in 2017; The USA and Brazil were the countries with the largest number of productions. Most studies sought to evaluate the impact and effectiveness of strategies and develop or validate health education instruments and prevention activities. Concerning the content covered by the strategies, five categories were formed: initial guidance on HIV/AIDS, general care, healthy living, sexual health, and emotional support. The educational strategies that stood out concerning greater patient adherence to treatment are related to the development of systems, programs, and multimedia. The booklets promoted empowerment and autonomy for people living with HIV.

Conclusion

The main educational strategies were mapped, with emphasis on booklets, printed material, multimedia resources, systems, forms, and workshops, covering initial guidance on HIV/AIDS, pharmacological treatment, general care, healthy living, sexual health, and social and emotional support. Open Science Framework (OSF): https://osf.io/754uk/?view_only=6491865a3d12424d81af2c4099c112c3

HIV infections; Acquired immunodeficiency syndrome; Health education; Teaching; Educational technology

ID*, Country, Year	Educational strategies	Content of Educational Strategies	Content Categories
Santos et al. (2019)⁽²⁾ Brazil	Educational game	General knowledge about HIV/AIDS; Quality of life in PLWHA; Knowledge about treatment and adherence; myths and truths.	General Care Healthy life
Teixeira et al. (2019)⁽⁹⁾ Brazil	Printed booklet	Forms of transmission, personal, environmental, and food hygiene; Daily care to live well; General care.	General Care Healthy life
Gustafson et al. (1994)⁽¹⁴⁾ USA	CHESS (Comprehensive Health Enhancement Support System)	General information about HIV, referrals to service providers, support in making difficult decisions, and networking with experts.	Initial Guidelines on HIV/AIDS
Woods et al. (1998)⁽¹⁵⁾ USA	HAPPENS Program	HIV counseling, testing in support services, mental health care; health status screening, care, and multidisciplinary support.	General Care Emotional Support
Kalichman, Hudd, Diberto (2010)⁽¹⁶⁾ USA	HIV prevention program - Healthy Relationships	Skills in communicating HIV status to friends, family, and sexual partners; management skills for safe sex and reducing the risk of HIV transmission.	Sexual Health
Rivera et al. (2015)⁽¹⁷⁾ UK	Multicomponent video	Education on general HIV concepts, HIV testing, counseling, and reduction in HIV stigma.	Emotional support General Care
Tanner et al. (2016)⁽¹⁸⁾ USA	Social media (weCare)	Diagnosis time, specific care, family challenges, sexual education, and pre-exposure prophylaxis.	Emotional support General Care
Killingo, Taro, Mosime (2017)⁽¹⁹⁾ South Africa	Workshops	Education about treatment, organization of mobilization workshops for knowledge construction and testing.	General Care
Leadbal et al. (2017)⁽²⁰⁾ Brazil	Structured form (sociodemographic characterization)	Guidance on family planning, nutrition, side effects of antiretroviral medications, and information on participation in Non-Governmental Organizations (NGOs).	Sexual Health Healthy life General Care
Bayona et al. (2017)⁽²¹⁾ EUA	Mobile Phone Technology (mHealth)	Mental health, coping behaviors, interpersonal support, physical symptoms, knowledge about HIV, and care coordination.	Emotional Support Initial Guidelines
Lima et al. (2017)⁽²²⁾ Brazil	Printed booklet	Prevention of vertical transmission of HIV; general concept of HIV/AIDS; forms of transmission; diagnostic tests, and care during the antenatal and postpartum periods.	Initial guidelines General Care
Brasil et al. (2018)⁽²³⁾ Brazil	Printed booklet	Specific questions about HIV, aspects related to way of life, and notary information; patients' rights.	General Care Healthy life
Atanga et al. (2018)⁽²⁴⁾ UK	Composite Adhesion Score (CAS) (Questionnaire)	Treatment and correct use of antiretroviral medications (general care), and side effects of antiretroviral drugs.	General Care
Neumann et al. (2018)⁽²⁵⁾ USA	Educational Video	General concepts about HIV, treatment, the importance of consultations, monitoring, and overcoming barriers to starting treatment.	General Care
Jesus et al. (2020)⁽²⁶⁾ Brazil	Printed-type instructional educational material	Quality of life, nutrition, physical exercise, coping with the diagnosis of HIV seropositivity, sexuality, and sexual health.	Healthy life Emotional Support Sexual Health
Maloney et al. (2020)⁽²⁷⁾ USA	Electronic and multimedia technologies	Emphasis on education about diagnosis and treatment, behavior change, and diagnostic testing.	General Care
Frazão, Gusmão, Guedes (2022),⁽²⁸⁾ Brazil	Printed booklet	Sexual and reproductive health, combined prevention, pre- and post-exposure prophylaxis, and family planning.	Sexual Health

Standards	Advances	Gaps	Evidence for practice	Search recommendations
Booklets and educational material^{(2,9,22-23,26)}	They promoted the empowerment and autonomy of people living with HIV.	Reduced number of participants.	Nurses, the professionals who promote health education in their daily practices, must use these educational materials.	To carry out research to validate the materials and booklets and their effectiveness.
Systems^(14-16)	They improved quality of life and encouraged adherence to medical care.	Difficulties in implementing programs.	Need to make programs and systems accessible to all people.	Need for research comparing non-technological methods with educational programs and systems.
Forms and interviews^(20,24)	Promotion of therapeutic adherence and prevention, with significant responses on viral suppression.	Small sample number.	Need to expand the study to more than one service, in addition to including both genders.	To expand the study from/on a professional and management perspective, as well as evaluate result indicators.
Multimedia^{(17-18,21,25,27)}	Effective communication, reduced stigma, and improved adherence to medication treatment.	Study population restricted to urban areas.	Expand the study to areas with poor internet access, especially for people with difficult access to information (e.g., rural areas).	To develop information sheets to facilitate access. Promote privacy and safe browsing among participants. Involvement of a multidisciplinary team.
Instant Messaging⁽²²⁾	Promoting greater involvement in their care and feeling of being supported.	The study population was recruited at a single location and only information about the initial phases of care is illustrated.	The instrument can be used as a type of telehealth intervention to elucidate gaps in the continuum of care.	To apply the study in other locations and expand it to other phases of care.
Workshops ⁽¹⁹⁾	Ability to apply on a larger scale and be adapted to national and regional contexts.	All stages of the model require high investments of time and resources and indicators have not yet been developed to assess the effectiveness of the instrument.	Education, along with donations to partner organizations in society, can create positive results by increasing the applicability of the instrument.	To establish structures to evaluate the effectiveness of the instrument and create alternative content delivery methods to reduce investments.

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[1] Corresponding author: Silmara de Oliveira Silva Email: silmaraolyveira@gmail.com