{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:23:05Z","timestamp":1780611785291,"version":"3.54.1"},"reference-count":63,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01-TW011484-01"],"award-info":[{"award-number":["K01-TW011484-01"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-001423"],"award-info":[{"award-number":["INV-001423"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01-MH122308"],"award-info":[{"award-number":["R01-MH122308"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["gatesopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Gates Open Res"],"abstract":"<ns3:p>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\u2019s needs. Methods We developed a male-specific ART counselling curriculum, adapted from the Malawi Ministry of Health curriculum, based on literature review of men\u2019s 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\u2019s 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\u2019s 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.<\/ns3:p>","DOI":"10.12688\/gatesopenres.16357.1","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:30:08Z","timestamp":1753713008000},"page":"52","update-policy":"https:\/\/doi.org\/10.12688\/gatesopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Developing a male-specific counselling curriculum for HIV treatment in Malawi"],"prefix":"10.12688","volume":"9","author":[{"given":"Misheck","family":"Mphande","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Hubbard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Lungu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elijah","family":"Chikuse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khumbo","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morna","family":"Cornell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Coates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Dovel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"539-553","DOI":"10.1080\/17441690902942464","article-title":"Questioning gender norms with men to improve health outcomes: evidence of impact.","volume":"5","author":"G Barker","year":"2010","journal-title":"Glob. Public Health."},{"key":"ref2","first-page":"125-132","article-title":"Understanding barriers to HIV testing and treatment: a study of young men and healthcare providers in KwaZulu-Natal and Mpumalanga.","volume":"2019","author":"S Sharma","year":"2019","journal-title":"S. Afr. Health Rev."},{"key":"ref3","first-page":"2023.03. 16.23287351","article-title":"Growing gender disparity in HIV infection in Africa: sources and policy implications.","author":"M Monod","year":"2023","journal-title":"medRxiv."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e25169","DOI":"10.1002\/jia2.25169","article-title":"HIV knowledge trends during an era of rapid antiretroviral therapy scale-up: an analysis of 33 sub-Saharan African countries.","volume":"21","author":"B Chan","year":"2018","journal-title":"J. Int. AIDS Soc."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"274-287","DOI":"10.1521\/aeap.2017.29.3.274","article-title":"Men\u2019s perceptions of treatment as prevention in South Africa: implications for engagement in HIV care and treatment.","volume":"29","author":"A Mooney","year":"2017","journal-title":"AIDS Educ. Prev."},{"key":"ref6","article-title":"Ending AIDS: Progress towards 90-90-90 targets.","year":"2017"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e25517","DOI":"10.1002\/jia2.25517","article-title":"Gendered health institutions: examining the organization of health services and men\u2019s use of HIV testing in Malawi.","volume":"23","author":"K Dovel","year":"2020","journal-title":"J. Int. AIDS Soc."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"904-913","DOI":"10.1111\/j.1365-3156.2008.02091.x","article-title":"Barriers to access to antiretroviral treatment in developing countries: a review.","volume":"13","author":"M Posse","year":"2008","journal-title":"Trop. Med. Int. Health."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"291-300","DOI":"10.1177\/2325957415593635","article-title":"Identifying perceived barriers along the HIV care continuum: Findings from providers, peer educators, and observations of provider\u2013patient interactions in Ethiopia.","volume":"15","author":"S Kulkarni","year":"2016","journal-title":"J. Int. Assoc. Provid. AIDS Care."},{"key":"ref11","article-title":"Uptake and Short-Term Retention in HIV Treatment Among Men in South Africa: The Coach Mpilo Pilot Project.","volume":"10","author":"M Hlongwa","year":"2022","journal-title":"Global Health: Science and Practice."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"82-88","DOI":"10.1080\/17290376.2011.9724989","article-title":"\u2018Clinics aren\u2019t meant for men\u2019: sexual health care access and seeking behaviours among men in Gauteng province, South Africa.","volume":"8","author":"J Leichliter","year":"2011","journal-title":"SAHARA-J."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1-10","DOI":"10.1186\/1471-2458-12-966","article-title":"Home-based HIV counseling and testing: client experiences and perceptions in Eastern Uganda.","volume":"12","author":"D Kyaddondo","year":"2012","journal-title":"BMC Public Health."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1583-1596","DOI":"10.1007\/s10461-020-03075-x","article-title":"Is HIV post-test counselling aligned with universal test and treat goals? A qualitative analysis of counselling session content and delivery in South Africa.","volume":"25","author":"T Mabuto","year":"2021","journal-title":"AIDS Behav."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e25889","DOI":"10.1002\/jia2.25889","article-title":"Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.","volume":"25","author":"M Nardell","year":"2022","journal-title":"J. Int. AIDS Soc."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.3389\/fpubh.2022.861431","article-title":"Hearing From Men Living With HIV: Experiences With HIV Testing, Treatment, and Viral Load Suppression in Four High-Prevalence Countries in Sub-Saharan Africa.","volume":"10","author":"J Wiginton","year":"2022","journal-title":"Front. Public Health."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"59-73","DOI":"10.1521\/aeap.2006.18.supp.59","article-title":"Adapting evidence\u2013based behavioral interventions for new settings and target populations.","volume":"18","author":"V McKleroy","year":"2006","journal-title":"AIDS Educ. Prev."},{"key":"ref18","article-title":"Improving men\u2019s uptake of HIV testing and linkage to services: policy brief.","year":"2021"},{"key":"ref19","article-title":"Male engagement in HIV testing, treatment and prevention in eastern and southern Africa \u2014 A framework for action.","year":"2022"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e20190250","DOI":"10.1590\/0034-7167-2019-0250","article-title":"Thematic content analysis using ATLAS. ti software: Potentialities for researchs in health.","volume":"73","author":"J Soratto","year":"2020","journal-title":"Rev. Bras. Enferm."},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2050312118822927","DOI":"10.1177\/2050312118822927","article-title":"Grounded theory research: A design framework for novice researchers.","volume":"7","author":"Y Chun Tie","year":"2019","journal-title":"SAGE Open Med."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1186\/s12889-019-7685-1","article-title":"A systematic review of qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa.","volume":"19","author":"B Njau","year":"2019","journal-title":"BMC Public Health."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1096-1103","DOI":"10.1111\/j.1525-1497.2004.30418.x","article-title":"Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection.","volume":"19","author":"J Schneider","year":"2004","journal-title":"J. Gen. Intern. Med."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e25950","DOI":"10.1002\/jia2.25950","article-title":"Improving ART initiation among men who use HIV self-testing in Malawi: a qualitative study.","volume":"25","author":"J Hubbard","year":"2022","journal-title":"J. Int. AIDS Soc."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"774-788","DOI":"10.1080\/13691058.2018.1516299","article-title":"Masculinity and engagement in HIV care among male fisherfolk on HIV treatment in Uganda.","volume":"21","author":"K Sileo","year":"2019","journal-title":"Cult. Health Sex."},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1-14","DOI":"10.1186\/1744-8603-7-13","article-title":"Masculinity as a barrier to men\u2019s use of HIV services in Zimbabwe.","volume":"7","author":"M Skovdal","year":"2011","journal-title":"Glob. Health."},{"key":"ref28","article-title":"Mobility and ART retention among men in Malawi: a mixed methods study.","author":"M Thorp","year":"2022","journal-title":"medRxiv."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e26066","DOI":"10.1002\/jia2.26066","article-title":"Mobility and ART retention among men in Malawi: a mixed-methods study.","volume":"26","author":"M Thorp","year":"2023","journal-title":"J. Int. AIDS Soc."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"674-685","DOI":"10.1007\/s10461-021-03427-1","article-title":"How HIV Clients Find Their Way Back to the ART Clinic: A Qualitative Study of Disengagement and Re-engagement with HIV Care in Malawi.","volume":"26","author":"S Chamberlin","year":"2022","journal-title":"AIDS Behav."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2468-2479","DOI":"10.1007\/s10461-018-2160-z","article-title":"What Role Do Masculine Norms Play in Men\u2019s HIV Testing in Sub-Saharan Africa?: A Scoping Review.","volume":"22","author":"K Sileo","year":"2018","journal-title":"AIDS Behav."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"15579883221120987","DOI":"10.1177\/15579883221120987","article-title":"Barriers and Facilitating Factors to HIV Treatment Among Men in a High-HIV-Burdened District in KwaZulu-Natal, South Africa: A Qualitative Study.","volume":"16","author":"M Hlongwa","year":"2022","journal-title":"Am. J. Mens Health."},{"key":"ref33","first-page":"1-11","article-title":"Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda.","volume":"14","author":"G Siu","year":"2014","journal-title":"BMC Public Health."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1215-1229","DOI":"10.1080\/13691058.2021.1941261","article-title":"HIV testing attitudes and practices amongst \u2019wealthy men\u2019: qualitative evidence from Tanzania.","volume":"24","author":"K Deane","year":"2022","journal-title":"Cult. Health Sex."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.1186\/s12889-019-7768-z","article-title":"Factors influencing adherence to antiretroviral treatment among adults accessing care from private health facilities in Malawi.","volume":"19","author":"L Chirambo","year":"2019","journal-title":"BMC Public Health."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e0223414","DOI":"10.1371\/journal.pone.0223414","article-title":"Bringing fear into focus: The intersections of HIV and masculine gender norms in C\u00f4te d\u2019Ivoire.","volume":"14","author":"D Naugle","year":"2019","journal-title":"PLoS One."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"253-261","DOI":"10.1093\/inthealth\/ihaa041","article-title":"Community and health system factors associated with antiretroviral therapy initiation among men and women in Malawi: a mixed methods study exploring gender-specific barriers to care.","volume":"13","author":"K Phiri","year":"2020","journal-title":"Int. Health."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e1001167","DOI":"10.1371\/journal.pmed.1001167","article-title":"Engaging men in prevention and care for HIV\/AIDS in Africa.","volume":"9","author":"E Mills","year":"2012","journal-title":"PLoS Med."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"72-84","DOI":"10.1016\/j.socscimed.2018.05.048","article-title":"Why do people living with HIV not initiate treatment? A systematic review of qualitative evidence from low- and middle-income countries.","volume":"213","author":"S Ahmed","year":"2018","journal-title":"Soc. Sci. Med."},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1-13","DOI":"10.1186\/s12889-021-12314-2","article-title":"\u201cDeadly\u201d, \u201cfierce\u201d, \u201cshameful\u201d: notions of antiretroviral therapy, stigma and masculinities intersecting men\u2019s life-course in Blantyre, Malawi.","volume":"21","author":"A Berner-Rodoreda","year":"2021","journal-title":"BMC Public Health."},{"key":"ref42","doi-asserted-by":"crossref","first-page":"1-14","DOI":"10.1186\/s12879-021-06851-9","article-title":"Patient experiences of switching from Efavirenz-to Dolutegravir-based antiretroviral therapy: a qualitative study in Uganda.","volume":"21","author":"A Twimukye","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"100573","DOI":"10.1016\/j.eclinm.2020.100573","article-title":"Comparative efficacy, tolerability and safety of dolutegravir and efavirenz 400mg among antiretroviral therapies for first-line HIV treatment: a systematic literature review and network meta-analysis.","volume":"28","author":"S Kanters","year":"2020","journal-title":"EClinicalMedicine."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e052971","DOI":"10.1136\/sextrans-2016-052971","article-title":"\u2018Side effects\u2019 are \u2018central effects\u2019 that challenge retention in HIV treatment programmes in six sub-Saharan African countries: a multicountry qualitative study.","volume":"93","author":"J Renju","year":"2017","journal-title":"Sex. Transm. Infect."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1766-1775","DOI":"10.1007\/s10461-022-03909-w","article-title":"Understanding the Unique Barriers and Facilitators that Affect Men\u2019s Initiation and Retention in HIV Care: A Qualitative Study to Inform Interventions for Men Across the Treatment Cascade in Malawi.","volume":"27","author":"K Coursey","year":"2022","journal-title":"AIDS Behav."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"218-229","DOI":"10.1177\/1359105312467391","article-title":"Self-compassion and reactions to serious illness: The case of HIV.","volume":"19","author":"J Brion","year":"2014","journal-title":"J. Health Psychol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"480-487","DOI":"10.1097\/QAI.0000000000002379","article-title":"Addressing Uptake of HIV Testing and Linkage to Care Among Men in C\u00f4te d\u2019Ivoire: An Evaluation of the Brothers for Life Program Implementation.","volume":"84","author":"D Naugle","year":"2020","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e1002262","DOI":"10.1371\/journal.pmed.1002262","article-title":"Community-based strategies to strengthen men\u2019s engagement in the HIV care cascade in sub-Saharan Africa.","volume":"14","author":"M Sharma","year":"2017","journal-title":"PLoS Med."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"37","DOI":"10.11604\/pamj.2020.37.88.24009","article-title":"What do we know about patient-provider interactions in sub-Saharan Africa? A scoping review.","volume":"37","author":"B Camara","year":"2020","journal-title":"Pan Afr. Med. J."},{"key":"ref50","article-title":"Between empathy and anger: healthcare workers\u2019 perspectives on patient disengagement from antiretroviral treatment in Khayelitsha, South Africa-a qualitative study.","author":"T Nhemachena","year":"2022","journal-title":"Preprint."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"483-488","DOI":"10.1089\/apc.2014.0077","article-title":"\u201cI pray that they accept me without scolding:\u201d Experiences with disengagement and re-engagement in HIV care and treatment services in Tanzania.","volume":"28","author":"E Layer","year":"2014","journal-title":"AIDS Patient Care STDs."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e0186458","DOI":"10.1371\/journal.pone.0186458","article-title":"Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence.","volume":"12","author":"L Nafradi","year":"2017","journal-title":"PLoS One."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e1001369","DOI":"10.1371\/journal.pmed.1001369","article-title":"Toward an Understanding of Disengagement from HIV Treatment and Care in Sub-Saharan Africa: A Qualitative Study.","volume":"10","author":"N Ware","year":"2013","journal-title":"PLoS Med."},{"key":"ref54","first-page":"2022.11. 15.22282343","article-title":"Health care workers\u2019 internal bias toward men as HIV clients in Malawi and Mozambique: A qualitative study.","author":"K Dovel","year":"2022","journal-title":"medRxiv."},{"key":"ref55","doi-asserted-by":"crossref","first-page":"2325958220935691","DOI":"10.1177\/2325958220935691","article-title":"Health worker experiences of and perspectives on engaging men in HIV care: A qualitative study in Cape Town, South Africa.","volume":"19","author":"N Mbokazi","year":"2020","journal-title":"J. Int. Assoc. Provid. AIDS Care."},{"key":"ref56","doi-asserted-by":"crossref","first-page":"88-88","DOI":"10.11604\/pamj.2020.37.88.24009","article-title":"What do we know about patient-provider interactions in sub-Saharan Africa? a scoping review.","volume":"37","author":"B Camara","year":"2020","journal-title":"Pan Afr. Med. J."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e25526","DOI":"10.1002\/jia2.25526","article-title":"Shifting the narrative: from \u201cthe missing men\u201d to \u201cwe are missing the men\u201d.","volume":"23","author":"A Grimsrud","year":"2020","journal-title":"J. Int. AIDS Soc."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1-7","DOI":"10.4102\/phcfm.v8i2.996","article-title":"Factors contributing to men\u2019s reluctance to seek HIV counselling and testing at primary health care facilities in Vhembe District of South Africa.","volume":"8","author":"P Mambanga","year":"2016","journal-title":"Afr. J. Prim. Health Care Fam. Med."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"45-51","DOI":"10.2147\/HIV.S8993","article-title":"Strategies to improve HIV treatment adherence in developed countries: clinical management at the individual level.","volume":"3","author":"M Enriquez","year":"2011","journal-title":"HIV AIDS (Auckl)."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"153-157","DOI":"10.1016\/j.pec.2004.05.008","article-title":"Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm.","volume":"57","author":"R Anderson","year":"2005","journal-title":"Patient Educ. Couns."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"120-127","DOI":"10.1016\/j.msksp.2018.06.004","article-title":"Patient education and health literacy.","volume":"38","author":"H Wittink","year":"2018","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"582200","DOI":"10.3389\/fphar.2021.582200","article-title":"Medication adherence and the role of pictograms in medication counselling of chronic patients: a review.","volume":"12","author":"P Merks","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"479-493","DOI":"10.1111\/tmi.13746","article-title":"Systematic review: Development of a person-centered care framework within the context of HIV treatment settings in sub-Saharan Africa.","volume":"27","author":"M Duffy","year":"2022","journal-title":"Trop. Med. Int. Health."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"e0192983","DOI":"10.1371\/journal.pone.0192983","article-title":"Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi.","volume":"13","author":"M Kim","year":"2018","journal-title":"PLoS One."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1-20","DOI":"10.1186\/s12889-019-7566-7","article-title":"Systematic review of burnout among healthcare providers in sub-Saharan Africa.","volume":"19","author":"B Dubale","year":"2019","journal-title":"BMC Public Health."},{"key":"ref68","article-title":"Client-Centered HIV Services.","year":"2020"}],"container-title":["Gates Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/gatesopenresearch.org\/articles\/9-52\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/9-52\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/9-52\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:30:11Z","timestamp":1753713011000},"score":1,"resource":{"primary":{"URL":"https:\/\/gatesopenresearch.org\/articles\/9-52\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":63,"URL":"https:\/\/doi.org\/10.12688\/gatesopenres.16357.1","relation":{"has-preprint":[{"id-type":"doi","id":"10.12688\/verixiv.83.2","asserted-by":"subject"}]},"ISSN":["2572-4754"],"issn-type":[{"value":"2572-4754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]},"assertion":[{"value":"Awaiting Peer Review","URL":"https:\/\/gatesopenresearch.org\/articles\/9-52\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"The IDEaL trial is supported by the Bill and Melinda Gates Foundation (INV-001423), The ENGAGE trial is supported by the National Institute for Mental Health (R01-MH122308) and the National Institute of Health Fogarty International Center (K01-TW011484-01). KD is supported by Health Fogarty International Center. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":0,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}