Conceptualizing the integration of HIV treatment and prevention: findings from a process evaluation of a community-based, national capacity-building intervention

Mykhalovskiy, Eric; Patten, San; Sanders, Chris; Bailey, Michael; Taylor, Darien

doi:10.1007/s00038-009-8078-5

Cited by 10 publications

(3 citation statements)

References 25 publications

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“…Integration has been raised as a priority in the context of limited resources for HIV/AIDS responses [ 35 , 36 , 51 ]. In economic theory, this model has the potential advantages on technical (focusing on unit cost of services) and allocative efficiency (focusing on cost-effectiveness of services) [ 52 ]. Recent studies confirmed that integrated HIV/AIDS service delivery was more efficient than stand-alone services [ 9 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Behavioral and quality-of-life outcomes in different service models for methadone maintenance treatment in Vietnam

et al. 2016

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BackgroundIntegrating HIV/AIDS and methadone maintenance treatment (MMT) services with existing health care delivery system is critical in sustaining efforts to fight HIV/AIDS in large injection-driven epidemics. However, efficiency of different integrative service models is unknown. This study assessed behavioral and health-related quality-of-life (HRQOL) outcomes of MMT in four service delivery models and explored factors associated with these outcomes of interest.MethodsA cross-sectional survey was conducted in two HIV epicenters in Vietnam: Hanoi and Nam Dinh Province. All patients in five selected MMT clinics were invited to participate, and 1016 were interviewed (80–90 % response rate).ResultsRespondents had a mean age of 35.8, taken MMT for average 16.5 months and 3.3 % on MMT for 36–60 months. The MMT integrated with rural district health center (DHC) has the highest prevalence of concurrent drug use (11.3 %). The percentage of condom use (last sexual intercourse) with primary and casual partners was lowest in the MMT at urban DHCs. Patients at the rural DHC reported very high proportions of pain/discomfort (37.8 %), anxiety/depression (43.1 %), and mobility (13.3 %). In regression models, poorer HRQOL outcomes were found in MMT models in the rural areas or without general health care, and among those patients who were HIV positive, reported concurrent drug use, and had higher numbers of previous drug rehabilitation episodes. Mobility and anxiety/depression are factors that increased the likelihood of concurrent drug use among MMT patients.ConclusionsOutcomes of MMT were diverse across different integrative service models. Policies on rapid expansion of the MMT program in Vietnam should also emphasize on the integration with comprehensive health care services including psychological supports for patients.

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Section: Discussionmentioning

confidence: 99%

Behavioral and quality-of-life outcomes in different service models for methadone maintenance treatment in Vietnam

et al. 2016

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“…Although there is limited reliable data on immigrants' health status and the prevalence of infectious diseases within this population, they are considered particularly vulnerable to HIV infection (Del Amo et al 2004;Hamers et al 2006). Underutilization of HIV health services for prevention, testing and treatment has been identified as a factor that contributes to vulnerability (Chee et al 2005;Mykhalovskiy et al 2009;Shedlin and Shulman 2004). Knowledge on HIV testing among immigrants is limited and the available data suggests a wide variation across countries; nevertheless, they tend to present high rates of undiagnosed HIV infection and to utilize HIV health services at a later stage of disease (Burns et al 2007;Sinka et al 2003;Williamson et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with HIV testing among immigrants in Portugal

Dias

Gama

Severo

et al. 2010

Int J Public Health

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“…10,14 The political grievances expressed in this study indicates weakness in interpretation of integration of CHW strategy in health systems. 37 Furthermore, it is suggested that CHWs program sustainability should not end up handing over program to Local Government without support in training, allowances and supervision of CHWs. 38 The lack of appropriate trainings in maternal health services on majority of CHWs in Bagamoyo and Mkuranga districts is an indication of the bigger picture characterizing the whole country and as well in other low-and-middle income countries about the value of CHWs and their contributing factor in the primary health system.…”

Section: Discussionmentioning

confidence: 99%

Challenges facing community health workers in promoting maternal and neonatal health in Bagamoyo and Mkuranga districts, Tanzania

Jumanne¹,

Pasape²,

Moshi³

et al. 2021

gmj

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Objectives: Community health workers (CHWs) play significant roles in areas where professional health workforce succumb to serious human resource deficiencies. This study explored challenges the CHWs face in promoting maternal and neonatal health in two districts of Tanzania.Design: A cross-sectional study design was conducted in Bagamoyo and Mkuranga districts from March to May 2019.Methods: Qualitative data were collected using in-depth interviews from 30 CHWs, thematic analysis was carried out by identifying major key themes emerging from the data.Results: The study found little community support resulted from jealousy of male household heads, mistrust, socialcultural believes and lack of community appreciation on the role of CHWs. Little support from local government resulted by political grievances among local leaders due to change in political administration. Other challenges were lack of basic knowledge in maternal and neonatal health, including breastfeeding. Irregular working schedules dueto poor supervision, huge workload, old age and tirednessConclusion: CHWs programs in Bagamoyo and Mkuranga districts were inactive and required innovative strategies to raise community and local government cooperation. Jealousy among male household’s heads and CHWs need community members to participate in establishment of selection criteria. Socio-cultural beliefs call for community sensitization on how they affect maternal and neonatal health. Lack of community appreciation on the role of CHWs, irregular working schedule implied poor supervision and defined age limit would overcome challenges related to old age.

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Conceptualizing the integration of HIV treatment and prevention: findings from a process evaluation of a community-based, national capacity-building intervention

Abstract: Study findings help distinguish a community-based concept of HIV-related integration from alternative uses of the term while pointing out key tensions associated with efforts to integrate HIV prevention and treatment in a community-based context.

Cited by 10 publications

References 25 publications

Behavioral and quality-of-life outcomes in different service models for methadone maintenance treatment in Vietnam

Behavioral and quality-of-life outcomes in different service models for methadone maintenance treatment in Vietnam

Factors associated with HIV testing among immigrants in Portugal

Challenges facing community health workers in promoting maternal and neonatal health in Bagamoyo and Mkuranga districts, Tanzania

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