Impact of Community Support Workers in Rural Ethiopia on Emotional and Psychosocial Health of Persons Living with HIV: Results of a Three-Year Randomized Community Trial

Lifson, Alan R.; Hailemichael, Abera; Workneh, Sale; MacLehose, Richard F.; Horvath, Keith J.; Hilk, Rose; Sites, Anne; Shenie, Tibebe

doi:10.1007/s10461-023-04007-1

Cited by 3 publications

(9 citation statements)

References 55 publications

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“…Three of the included studies were conducted in South Africa [25][26][27], two in Zimbabwe [28,29], two in Kenya [30,31], one in Ethiopia [32], and one in Malawi [33]. All studies were conducted within the community but in different settings.…”

Section: Study Location and Settingsmentioning

confidence: 99%

“…Studies reported varying categories of individuals in both groups. In 4 studies [27,29,31,32] the implementers were known to be living with HIV and thus acted as peer supporters/mentors [27,29], community social workers [32], and volunteers [31]. In 4 studies, the HIV status of implementers was not explicitly stated [25,28,30,33].…”

Section: Actors and Sites Of Interventionsmentioning

confidence: 99%

“…Interventions in three studies [27,29,32] were judged low cost and sustainable. These involved few individuals (PLH working with community social workers/peer adherence supporters/community adolescent treatment supporters) at household level.…”

Section: Cost and Sustainability Of Interventionsmentioning

confidence: 99%

“…All studies were conducted within the community but in different settings. Four studies were conducted in homes of people living with HIV [27,29,30,32], three in schools [25,31,33], and two in unspeci ed settings within the community [26,28].…”

Section: Study Location and Settingsmentioning

confidence: 99%

“…Studies employed 3 different design: a randomized controlled trial design was used in 5 studies [27,[29][30][31][32], a pre-test and post-test design in three [25,26,33], and mixed methods in one [28]. Studies involved both male and female participants of a various categories.…”

Section: Study Design and Participantsmentioning

confidence: 99%

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Community-Based Interventions that are Effective against HIV-Related Stigma. A Systematic Review of Evidence in Sub-Saharan Africa.

kimera,

Alanyo,

Irumba

et al. 2024

Preprint

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Background HIV-related stigma remains a key barrier to the attainment of the UNAIDS global goal of ending AIDS by 2030. Due to the social and contextual nature of HIV-related stigma, community-based interventions may be more effective. In this review we synthesized evidence on features of community-based interventions that have been reported to be effective against HIV-related stigma in Sub-Saharan Africa. Methods We searched MEDLINE, EMBASE, CINAHL, Psych INFO, and Web of science in July 2023. We also searched Google Scholar and reference lists of all selected studies. Included studies were randomized controlled trials, mixed methods studies, as well as pre-test and post-test studies that evaluated the effectiveness of a community-based intervention to reduce HIV-related stigma in the general population or among specific groups. Data extraction was done using a pre-designed and pre-tested form. Framework thematic analysis was used to qualitatively synthesize intervention characteristics of included studies. Results A total of nine journal articles were included, largely with some concerns regarding methodological quality. Most studies involved People Living with HIV (PLH) alone as intervention recipients and as intervention implementers. Community members with unknown HIV status were involved in only 2 studies. The intervention strategies were largely information sharing through workshops and training as well as individualized counselling. In few studies, additional support in form of referrals, nutritional supplements, and adherence support was provided to PLH during the interventions. Most studies were judged to be of moderate to high cost except in 3 where the intervention implementers were PLH within the community, volunteering in the home-based support approach. The involvement of community members in the design of intervention strategies was not seen in all the studies. Conclusion Community-based interventions against HIV-related stigma have been multifariously developed in sub-Saharan Africa. However, comprehensive strategies involving the stigmatized and the ‘stigmatizers’ in a social change approach are lacking. The application of strategies without involvement of community members in their design takes away a sense of community responsibility and this threatens sustainability of such interventions. The HIV-competent framework can act as a benchmark for future design of realistic community-based interventions against HIV-related stigma.

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Section: Study Location and Settingsmentioning

confidence: 99%

Section: Actors and Sites Of Interventionsmentioning

confidence: 99%

Section: Cost and Sustainability Of Interventionsmentioning

confidence: 99%

Section: Study Location and Settingsmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

See 3 more Smart Citations

Community-Based Interventions that are Effective against HIV-Related Stigma. A Systematic Review of Evidence in Sub-Saharan Africa.

kimera,

Alanyo,

Irumba

et al. 2024

Preprint

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The Role of Dimensions of Social Support in the Relationship Between Stigma and Mental Health: A Moderation Analysis

Lo Hog Tian,

Watson,

Cioppa

et al. 2024

AIDS Behav

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Prevalence and factors associated with advanced HIV disease among young people aged 15 - 24 years in a national referral hospital in Sierra Leone: A cross-sectional study

Baldeh,

Kizito,

Lakoh

et al. 2023

Preprint

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BackgroundAdvanced HIV in young people living with HIV is an increasingly pressing public health issue in sub-Saharan Africa. Despite global progress in early HIV testing and reducing HIV-related deaths, many young people with HIV continue to experience HIV disease progression in sub-Saharan Africa. This study provides an overview of the prevalence, clinical manifestations, and factors associated with advanced HIV in young people seeking medical services in a major hospital in Sierra Leone.MethodsWe used a cross-sectional design to collect data from HIV patients aged 15 to 24 years at a major hospital in Sierra Leone between September 2022 and March 2023. Advanced HIV was defined as (i) CD4+ below 200 cells/mm3 or (ii) WHO clinical stage 3 or 4. Logistic regression models determined the association between observable independent characteristics and advanced HIV. The statistical significance level was set at 0.05 for all statistical tests.ResultsAbout 40% (231/574) of patients were recruited; 70.6% (163/231) were inpatients, and 29.4% (68/231) were outpatients. The mean age was approximately 21.6 years (SD ±2.43). The overall prevalence of advanced HIV was 42.9% (99/231), 51.5% (35/68) of outpatients, and 39.3% (64/163) of inpatients. Age of inpatients (OR, 1.23; 95% CI, 1.00-1.52; p= 0.047) was associated with a higher risk. Female sex (OR, 0.51; 95% CI, 0.28-0.94; p= 0.030), higher education (OR, 0.27; 95% CI, 0.10 – 0.78; p= 0.015), and Body Mass (OR, 0.10; 95% CI, 0.01-0.77; p= 0.028) were at lower risk of advance HIV. Common conditions diagnosed in this population are tuberculosis (13.58%), hepatitis B (6.13%), Kaposi sarcoma (3.07%), and esophageal candidiasis (2.45%).ConclusionWe reported a high prevalence of advanced HIV among young patients in a referral Hospital in Sierra Leone. This emphasises the need to strengthen public health measures and policies that address challenges of access to HIV services.Strengths and limitations of this studyThis is the first study in Sierra Leone and the sub-region to examine the burden of advanced HIV and its predictors in young people living with HIV.Calls for a more targeted approach to addressing gaps in health service delivery for young people living with HIV in Sierra Leone.The study is limited by the unavailability of several laboratory investigations to monitor patient progress.

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Impact of Community Support Workers in Rural Ethiopia on Emotional and Psychosocial Health of Persons Living with HIV: Results of a Three-Year Randomized Community Trial

Cited by 3 publications

References 55 publications

Community-Based Interventions that are Effective against HIV-Related Stigma. A Systematic Review of Evidence in Sub-Saharan Africa.

Community-Based Interventions that are Effective against HIV-Related Stigma. A Systematic Review of Evidence in Sub-Saharan Africa.

The Role of Dimensions of Social Support in the Relationship Between Stigma and Mental Health: A Moderation Analysis

Prevalence and factors associated with advanced HIV disease among young people aged 15 - 24 years in a national referral hospital in Sierra Leone: A cross-sectional study

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