“You could hear their breathing slow down”: insights on a video-based psychosocial support intervention to increase HIV treatment uptake and improve psychosocial well-being among men living with HIV in South Africa

High rates of AIDS-related mortality and HIV incidence persist due to delayed antiretroviral therapy (ART) uptake and retention. We qualitatively assessed the feasibility and acceptability of "From Now On" (FNO) - a short video-based psychosocial support intervention to increase ART uptake and improve psychosocial well-being among men newly diagnosed with HIV in South Africa. In-depth interviews were conducted with men who were shown FNO during post-test HIV counselling (n = 12) and with counsellors (n = 9) who used FNO. Participants reported that FNO alleviated the immediate shock following their diagnosis; reduced fear (of death, ART side-effects, stigma and rejection) and instilled hope. Counsellors observed men calming down and positive impacts of FNO on counselling: increased attention, engagement and credibility. FNO appeared to reframe the mental model of living with HIV: "life goes on"; that one can not only live a long, healthy life on ART, but also thrive. The video encouraged disclosure and appeared to reduce internalised stigma. These qualitative findings indicate high intervention acceptability and feasibility and the potential of FNO to increase ART uptake through multiple pathways. Findings generate a hypothesis that warrants further investigation: "From Now On" could improve post-test HIV counselling and systematically provide psychosocial support through a low cost and scalable intervention.