scholarly journals HIV- and Drug Use–Related Stigma and Service Provision Among Community Health Workers in Vietnam

2020 ◽  
Vol 32 (2) ◽  
pp. 169-179
Author(s):  
Li Li ◽  
Chunqing Lin ◽  
Li-Jung Liang ◽  
Jun Chen ◽  
Nan Feng ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Service Provision ◽  
Health Workers ◽  
People Who Use Drugs ◽  
People Living With Hiv ◽  
Related Services ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Relationship

This study compared community health workers' (CHW) stigma towards people living with HIV (PLH) and people who use drugs (PWUD) and explored the relationship between stigma and CHWs' confidence level in providing HIV/drug-related services. Using two sets of identically worded questions, levels of stigma towards PWUD and PLH were measured among 120 CHW from 60 communes in Vietnam. The associations between CHWs' confidence in service provision and stigma towards PWUD and PLH were examined using a linear mixed-effects regression model. The majority of the CHW reported higher levels of stigma towards PWUD than towards PLH. Compared to the CHW reporting higher stigma towards PWUD, those with higher stigma towards PLH were significantly less confident in service provision. Social opprobrium attached to drug-using behaviors can be a major driver behind the overall HIV stigma. CHWs' fear of HIV infection should be tackled to boost their confidence in HIV/drug-related care provision.

scholarly journals Acceptability and Feasibility of Group Interpersonal Therapy (IPT-G) for Depressed HIV+ Postpartum Adolescents Delivered by Community Health Workers: A Protocol Paper

2020 ◽  
Vol 11 ◽  
pp. 117955732095122
Author(s):  
Obadia Yator ◽  
Lincoln I Khasakhala ◽  
Grace John-Stewart ◽  
Manasi Kumar
Keyword(s):  
Primary Care ◽  
Postpartum Depression ◽  
Community Health ◽  
Social Functioning ◽  
Community Health Workers ◽  
Young Women ◽  
Health Workers ◽  
Treatment As Usual ◽  
Related Stigma ◽  
Living With Hiv

Introduction: Postpartum depression affects mothers at 4 to 6 weeks after delivery. Adolescent pregnancy can lead the expectant girl to drop out of school, receive poor obstetric care, and family support. Adolescent mothers are prone to severe postpartum depression as compared to older women. Early sexual initiation increases the risk of unintended pregnancies and potentially increases HIV exposure. WHO recommends Group interpersonal psychotherapy (IPT-G) as an evidence-based intervention for use in both primary care and community settings. We will assess the acceptability and feasibility of community health workers (CHWs), delivering IPT-G among postpartum adolescents (PPA) living with HIV. Method: This is a pilot feasibility study testing CHWs’ delivery of IPT-G to postpartum adolescents and young women living with HIV who will be attending the prevention of mother-to-child HIV transmission (PMTCT) clinics in 2 primary care health centers. Young women aged 15 to 24 years and 6 to 12 weeks postpartum will be eligible for participation. Our study is a two-arm intervention implementation study with one receiving group IPT and another one treatment-as-usual (TAU). We intend to treat the TAU group so that we will offer IPT-G post-intervention. There will be 2 groups running in the 2 facilities. Depression will be assessed using the Edinburgh postnatal depression scale (EPDS); those with EPDS >10 become eligible for the intervention. Besides, HIV-related stigma would be screened using HIV/AIDS Stigma Instrument (HASI–P), and social functioning rated using the World Health Organization’s Disability Assessment Schedule 2.0 (WHODAS 2.0). CHWs will deliver IPT-G for 8 sessions (1 session per week). The intervention group will receive immediate IPT-G, and the wait-list control group will receive deferred IPT-G as part of our intent to treat the group. Primary outcome measure and analysis: Descriptive statistics will be used to compare changes in depressive symptoms, HIV-related stigma, and social functioning between baseline and 8 weeks, and between 16 weeks and 24 weeks. The changes will be explored along with the differences between intervention and treatment as usual groups reporting effect sizes (Cohen’s d). Longitudinal continuous outcome variables across the time points will be analyzed using the Generalized Linear Model. For qualitative data, any emerging themes from KIIs and FGDs will be identified: framework matrixes, queries, and cross-tabulations will be used to analyze and interpret the data in view of assessing acceptability and feasibility of IPT-G. Ethics and dissemination The Kenyatta National Hospital-University of Nairobi approved this study of Nairobi Ethics and Research Committee (Approval No. P97/02/2018). The findings will be published in peer-reviewed journals and also shared with Kenya’s National AIDS Control Council.

scholarly journals Acceptability of patient-centered hypertension education delivered by community health workers among people living with HIV/AIDS in rural Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charles Batte ◽  
John Mukisa ◽  
Natalie Rykiel ◽  
David Mukunya ◽  
William Checkley ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
People Living With Hiv ◽  
Specific Information ◽  
Patient Centered ◽  
Middle Income ◽  
Education Delivery ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting. Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.

scholarly journals Physiotherapy Intervention in Palliative Care for HIV Comorbidities: Can it be a Best Practice for Public Policy for Palliative Care in Zambia?

2020 ◽  
Vol 2 (1) ◽  
pp. 92-104
Author(s):  
Esther Munalula Nkandu ◽  
◽  
Micah Mutuna Simpamba ◽  
Hastings Kachingwe Shula ◽  
Theresa Lesa Chisoso ◽  
...  
Keyword(s):  
Palliative Care ◽  
Community Health ◽  
Community Health Workers ◽  
Quantitative Data ◽  
Health Workers ◽  
Rehabilitation Services ◽  
People Living With Hiv ◽  
Community Based ◽  
Physiotherapy Intervention ◽  
Living With Hiv

Introduction:The prolonged life expectancy for people living with HIV has led to an increase in the prevalence of people living with HIV and AIDS.Most of these patients are experiencing episodes of wellness and illness with related disability. In Zambia, many HIV patients who required rehabilitation services were not able to access these services.A community based physiotherapy intervention programme using Community Health Workers who were equipped with basic physiotherapy skills was set up in Mtendere and Chawama Townships of Lusaka, Zambia from 2008 to 2015.This study set out to assess the intervention output in relation to patients’ trends, process of the intervention and challenges experienced for the period October, 2012 to September, 2014.Methods: This evaluation reviewed monthly and annual reports of the programme from October, 2012 to September, 2014.A desk review of palliative care related reports and policy was also reviewed. Both qualitative and quantitative data was extracted from these reports, with quantitative data being analyzed using excel while qualitative data was analysed usingQSR NVIVO 10 after being transcribed and translated from texts.Results: The patients’ trends during this period showed a steady increase in the proportion of new patients being enrolled onto the programme compared to those who were being lost to follow up, death, discharge or other loss such as transfers and many others. Themes under qualitative analysis were Community Health Workers, procurements, service delivery programme challenges and palliative care policy.The programme planned to conduct two trainings for each of the years under review but only managed one in each year. There were many challenges identified under this programme and all of them bordered on inconsistencies in the release of funds.Conclusion: This evaluation shows that the prevalence of HIV patients presenting with disabling conditions has been increasing and there is need to provide the needed rehabilitation services through the community based programme. Using Community Health Workers to provide physiotherapy services in the community enables many patients to access these services and hence a policy that supports this would be ideal. Keywords:palliative care; physiotherapy; HIV comorbidity; public policy

scholarly journals Acceptability of Patient-centered Hypertension Education Delivered by Community Health Workers among People Living with HIV/AIDS in Rural Uganda

2020 ◽  
Author(s):  
Charles Batte ◽  
John Mukisa ◽  
Natalie Rykiel ◽  
David Mukunya ◽  
William Checkley ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
People Living With Hiv ◽  
Specific Information ◽  
Patient Centered ◽  
Middle Income ◽  
Education Delivery ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material ( PocketDoktor Ô ) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor Ô , financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktorÔ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.

scholarly journals Knowledge and Perceptions of People Living With HIV Regarding The HIV Services That Are Offered By The Community Health Workers in KwaZulu-Natal, South Africa

2021 ◽  
Author(s):  
Gugulethu Eve Khumalo ◽  
Bontle Segobe ◽  
Elizabeth Lutge ◽  
Tivani P Mashamba-Thompson
Keyword(s):  
South Africa ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
P Value ◽  
People Living With Hiv ◽  
Positive Perception ◽  
Hiv Services ◽  
Kwazulu Natal ◽  
Living With Hiv

Abstract Background: KwaZulu-Natal (KZN) is the province with the highest HIV prevalence in South Africa (SA). Community Health Workers (CHWs) are key to delivery of HIV services at community level. Evidence on knowledge and perceptions of people living with HIV (PLWH) regarding the HIV services that are offered by the CHWs is limited. Therefore, this study seeks to determine knowledge and perceptions of PLWH regarding the HIV services that are offered by the CHWs in KZN.Methods: The study design was a quantitative survey using an administrator-administered questionnaire. A total of 303 PLWH from 3 selected KZN clinics were interviewed to determine their knowledge and perceptions of HIV services offered by the CHWs. Statistical Package for Social Sciences (SPSS) version 27 was used to describe the population and testing for associations between variables. The significant level was set at a p value ≤ 0.05 and at 95% confidence internal.Results: Among the 303 PLWH surveyed, 24 (8%), knew about the HIV services offered by the CHWs and of the 89 (29%) participants that were visited by CHWs, 73 (82%) had a positive perception about these services. Participants who were visited by a CHW were more likely (OR=1.57, 95% CI: 0.57-4.35) to know about the HIV services. Knowledge of HIV services was significantly associated with the positive perception of the HIV services (p<0.05). Knowledge and perception of the HIV services was not associated with age, gender, level of education or duration of visiting the clinic.Conclusion: The majority of PLWH in KZN have poor knowledge of HIV services offered by the CHWs and most of them have never been visited by a CHW in their homes. Those that were visited by CHWs were more likely to have positive perceptions regarding their HIV services. The findings of the study should trigger the scaling up of HIV community targeted initiatives that are delivered by CHWs in order to curb the HIV epidemic in the province.

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