Using Human-Centered Design to Develop a Program to Engage South African Men Living With HIV in Care and Treatment

Cal Bruns

doi:10.9745/GHSP-D-21-00239

Key Messages

HCD’s structured, collaborative problem-solving process inspired the partners and allowed integration with multiple research methodologies. HCD excited seasoned HIV prevention and treatment veterans in the project’s advisory group. The segmentation of at-risk male archetypes allowed men’s attitudes, behaviors, and challenges to be seen through a human lens and informed HCD co-creation problem statements.
HCD, paired with qualitative elicitation methods, allowed a deeper empathy with at-risk men and health professionals, ensuring the design of prototypes that addressed specific needs of men were desirable for them, as well as being feasible and viable for implementers.
By integrating South African organizations, the Department of Health, and other funders into a project conceived with design thinking as an ingredient, our co-created innovations were primed for program integration and rapid scale-up with ongoing improvement through iteration.

Key Implications

Program managers and policy makers should consider using HCD approaches when designing or preparing to scale up interventions. In addition to informing program design, the implementation of HCD will foster stakeholder empathy, trust, and program “ownership” that will optimize acceptability, effectiveness, and sustainability of the intervention.

ABSTRACT

Background:

Although HIV care is widely available in South Africa, men are less likely than women to know their HIV status, begin treatment upon diagnosis, and adhere to treatment. Men are also more likely to die from causes related to HIV compared to women. To overcome this inequity, tailored approaches designed with men’s specific needs are required.

Methods:

As part of the Testing and Treatment for Men project, a 3-year multicomponent, mixed-methods study that aimed to better understand young South African men’s needs concerning HIV testing and treatment, we used human-centered design (HCD) methods to identify, develop, and pilot test a male-friendly peer-support intervention. We engaged key stakeholders in the development of several prototype interventions to improve men’s engagement across the HIV cascade, one of which was selected for further development.

Results:

Use of HCD methods, informed by the results of our team’s prior qualitative and quantitative research, led to the development of Coach Mpilo, a peer-support intervention to engage and retain men living with HIV in South Africa in care and treatment. By designing with empathy for the lived experiences of these men, our intervention achieved the authenticity and credibility required to build trusting relationships in the affected communities. Preliminary results of Coach Mpilo have demonstrated a high level of acceptability by men living with HIV as well as key government and other implementing partners.

Conclusion:

HCD as a critical ingredient became an integral and essential component in developing and field-testing the Coach Mpilo pilot. The key elements of our HCD approach that resulted in the successful generation of the Coach Mpilo pilot intervention and its implementation were understanding and addressing the specific issues identified by men living with HIV and leveraging newly created empathy with men as an approach to solving the issues collaboratively and innovatively.

Received: April 16, 2021.
Accepted: August 26, 2021.
Published: November 29, 2021.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-21-00239

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