{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:02:36Z","timestamp":1792004556062,"version":"4.4.0"},"reference-count":51,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"unspecified","delay-in-days":237,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA041901"],"award-info":[{"award-number":["K23DA041901"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["F31MH123020"],"award-info":[{"award-number":["F31MH123020"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Glob. Ment. Health"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S2054425122000474_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Despite a high prevalence of problematic substance use among people living with HIV in South Africa, there remains limited access to substance use services within the HIV care system. To address this gap, our team previously developed and adapted a six-session, peer-delivered problem-solving and behavioral activation-based intervention (<jats:italic>Khanya<\/jats:italic>) to improve HIV medication adherence and reduce substance use in Cape Town. This study evaluated patient and provider perspectives on the intervention to inform implementation and future adaptation.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000474_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Following intervention completion, we conducted semi-structured individual interviews with patients (<jats:italic>n<\/jats:italic> = 23) and providers (<jats:italic>n<\/jats:italic> = 9) to understand perspectives on the feasibility, acceptability, and appropriateness of <jats:italic>Khanya<\/jats:italic> and its implementation by a peer. Patients also quantitatively ranked the usefulness of individual intervention components (problem solving for medication adherence \u2018Life-Steps\u2019, behavioral activation, mindfulness training, and relapse prevention) at post-treatment and six months follow-up, which we triangulated with qualitative feedback to examine convergence and divergence across methods.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000474_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Patients and providers reported high overall acceptability, feasibility, and appropriateness of <jats:italic>Khanya<\/jats:italic>, although there were several feasibility challenges. Mindfulness and Life-Steps were identified as particularly acceptable, feasible, and appropriate components by patients across methods, whereas relapse prevention strategies were less salient. Behavioral activation results were less consistent across methods.<\/jats:p><\/jats:sec><jats:sec id=\"S2054425122000474_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Findings underscore the importance of examining patients\u2019 perspectives on specific intervention components within intervention packages. While mindfulness training and peer delivery models were positively perceived by consumers, they are rarely used within task-shared behavioral interventions in low- and middle-income countries.<\/jats:p><\/jats:sec>","DOI":"10.1017\/gmh.2022.47","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T09:02:12Z","timestamp":1661504532000},"page":"439-447","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Patient and provider perceptions of a peer-delivered intervention (\u2018<i>Khanya<\/i>\u2019) to improve anti-retroviral adherence and substance use in South Africa: a mixed methods analysis"],"prefix":"10.1017","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9689-0834","authenticated-orcid":false,"given":"Alexandra L.","family":"Rose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-4889","authenticated-orcid":false,"given":"Jennifer M.","family":"Belus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-6903","authenticated-orcid":false,"given":"Abigail C.","family":"Hines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issmatu","family":"Barrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen S.","family":"Regenauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena S.","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Joska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonceba","family":"Ciya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibabalwe","family":"Ndamase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"Bronwyn","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Safren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica F.","family":"Magidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"S2054425122000474_ref49","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20532"},{"key":"S2054425122000474_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)30053-4"},{"key":"S2054425122000474_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2018.11.004"},{"key":"S2054425122000474_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/add.14049"},{"key":"S2054425122000474_ref23","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25720"},{"key":"S2054425122000474_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112516"},{"key":"S2054425122000474_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpra.2013.10.002"},{"key":"S2054425122000474_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/2633489520936644"},{"key":"S2054425122000474_ref29","doi-asserted-by":"publisher","DOI":"10.1037\/10327-000"},{"key":"S2054425122000474_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113680"},{"key":"S2054425122000474_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpra.2020.10.003"},{"key":"S2054425122000474_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12229"},{"key":"S2054425122000474_ref37","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4587"},{"key":"S2054425122000474_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-020-00405-3"},{"key":"S2054425122000474_ref51","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2020.1"},{"key":"S2054425122000474_ref9","doi-asserted-by":"publisher","DOI":"10.1177\/160940690600500107"},{"key":"S2054425122000474_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-020-00301-6"},{"key":"S2054425122000474_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-021-00751-9"},{"key":"S2054425122000474_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0587-9"},{"key":"S2054425122000474_ref5","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.082784"},{"key":"S2054425122000474_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-017-0827-6"},{"key":"S2054425122000474_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-020-00004-w"},{"key":"S2054425122000474_ref34","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024277"},{"key":"S2054425122000474_ref42","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0707-y"},{"key":"S2054425122000474_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S1077-7229(99)80052-2"},{"key":"S2054425122000474_ref38","article-title":"Intercoder reliability in qualitative research: debates and practical guidelines","volume":"19","author":"O'Connor","year":"2020","journal-title":"International Journal of Qualitative Methods"},{"key":"S2054425122000474_ref45","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25823"},{"key":"S2054425122000474_ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026674"},{"key":"S2054425122000474_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2021.103252"},{"key":"S2054425122000474_ref24","first-page":"85","volume-title":"Relapse Prevention: A Self-Control Strategy for the Maintenance of Behavior Change","author":"Marlatt","year":"1985"},{"key":"S2054425122000474_ref1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105316643375"},{"key":"S2054425122000474_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/da.22860"},{"key":"S2054425122000474_ref36","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12470"},{"key":"S2054425122000474_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-020-01023-4"},{"key":"S2054425122000474_ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-010-0319-7"},{"key":"S2054425122000474_ref41","unstructured":"QSR International Pty Ltd (2020) NVivo (released March 2020)."},{"key":"S2054425122000474_ref48","doi-asserted-by":"publisher","DOI":"10.2196\/15572"},{"key":"S2054425122000474_ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004089"},{"key":"S2054425122000474_ref16","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S55547"},{"key":"S2054425122000474_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12117"},{"key":"S2054425122000474_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113424"},{"key":"S2054425122000474_ref4","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S2054425122000474_ref20","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000257"},{"key":"S2054425122000474_ref46","doi-asserted-by":"publisher","DOI":"10.1177\/2374373520951670"},{"key":"S2054425122000474_ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.732800"},{"key":"S2054425122000474_ref50","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-020-00372-9"},{"key":"S2054425122000474_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.metip.2021.100067"},{"key":"S2054425122000474_ref33","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S176356"},{"key":"S2054425122000474_ref30","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2018.0138"},{"key":"S2054425122000474_ref31","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00325"},{"key":"S2054425122000474_ref40","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-8-139"}],"container-title":["Global Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2054425122000474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T09:39:14Z","timestamp":1668764354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2054425122000474\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":51,"alternative-id":["S2054425122000474"],"URL":"https:\/\/doi.org\/10.1017\/gmh.2022.47","relation":{},"ISSN":["2054-4251"],"issn-type":[{"value":"2054-4251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}