Women living with AIDS in rural Southern India: Perspectives on mental health and lay health care worker support

Srivastava, Neha; Nyamathi, Adeline; Sinha, Sanjeev; Carpenter, Catherine L.; Satyanarayana, Veena A.; Ramakrishna, Padma

doi:10.1080/15381501.2016.1274703

Cited by 12 publications

(24 citation statements)

References 38 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Results also provide support for an Asha-based approach to HIV-intervention in DN. WLH/A in India face a number of challenges regarding receipt of adequate care [34]. These difficulties include lack of resources, restricted mobility to reach facilities, stigma, and apathetic or outright abusive behavior by healthcare workers [35].…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India

Nyamathi

Carpenter

Yadav

et al. 2018

Aids

Self Cite

View full text Add to dashboard Cite

Objective: To assess the impact of nurse-led Asha (Accredited Social Health Activist)-support behavioral and nutritional intervention among women living with HIV/AIDS (WLH/A) in rural India. Design: Cluster randomized-controlled trial. Methods: Sixteen Primary Health Centers serving WLH/A in Andhra Pradesh were grouped into four regional clusters that were randomly allocated into one of four arms. All four groups included Asha-support and consisted of: Asha-support only (control group); nutrition education; nutrition supplementation; and the combination of supplementation and education. Differences between baseline and 6-month follow-up for key physiological outcomes (body mass index [BMI], CD4 count) were analyzed using factorial mixed-models that accounted for geographic clustering. Results: At 6 months, all groups improved CD4 count: Asha only (mean difference score [D]=343.97, standard deviation [SD]=106.94), nutrition education (D=356.15, SD=0.69), nutrition supplement (D = 469.66, SD=116.0), and nutrition supplement and education (D=530.82, SD=128.56). In multivariable models, Asha-support plus nutrition and Asha-support support plus supplement interventions demonstrated independent significant improvements in CD4 count; the interaction term was significant (β=529.9; 95% confidence internal [CI]=512.0, 547.8; p=.006). BMI also increased for all groups: Asha only (D=0.95, SD=0.82), Asha plus nutrition education (D=1.28, SD=0.53), Asha plus nutrition supplement (D=2.38, SD=0.60), nutrition supplement and nutrition supplement and education (D=2.72=0.84). Nutrition supplementation and nutrition education demonstrated independent effects on BMI; the interaction term was not significant (β =.27, 95% CI=2.5, 2.7, p = 0.80). Conclusion: Interventions run by community workers were efficacious at improving physiological outcomes and may be beneficial at meeting critical healthcare needs of vulnerable WLH/A in India.

show abstract

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India

Nyamathi

Carpenter

Yadav

et al. 2018

Aids

Self Cite

View full text Add to dashboard Cite

show abstract

“…These barriers have been corroborated in other literature [10,27]. ASHA workers may help mitigate these issues, as shown through their experience with HOPE, and ASHAs have previously acted as friends and advocates for vulnerable patients [29]. Additionally, ASHAs may help sustain long-term effects of the HOPE study -as members of the communities they serve, they continue to check in frequently with their patients and spread knowledge with others in their village.…”

Section: Discussionmentioning

confidence: 69%

“…ASHA workers have been effectively involved in a variety of interventions targeting conditions like HIV [17][18][19][20]29], mental health [2], and NCD [14], among others. However, studies have noted that ASHA workers display stereotyped beliefs about people with mental illness [24], and have very little understanding of clinical depression [1].…”

mentioning

confidence: 99%

Perceptions of Asha Workers in the Hope Collaborative Care Mental Health Intervention in Rural South India: A Qualitative Analysis

Bansal

Sriniva

2020

Preprint

View full text Add to dashboard Cite

Background:Common mental disorders are responsible for a heavy disease burden in India and are often highly co-morbid with non-communicable diseases like diabetes and cardiovascular disease, which are increasing in prevalence across India as well. There is a severe lack of mental health resources in India, particularly in rural areas. Rural health care is often dependent on ASHA workers (Accredited Social Health Activists), high school-educated village women trained as community health workers. ASHA workers have been effectively involved in a variety of interventions, including a handful targeting mental illness, but perspectives of ASHA workers have been greatly overlooked.Methods:One-on-one qualitative interviews were conducted with 15 ASHA workers, all of whom completed the parent HOPE study, a collaborative-care randomized controlled trial that aims to integrate mental health care into existing primary care systems in rural Karnataka. The 15 ASHA workers in this substudy were asked questions about their role in HOPE, as well as their perspectives on patient health, mental illness, and the HOPE study.Results:ASHA workers mostly had positive interactions with patients, including encouraging them to attend sessions, helping to explain the topics and techniques, and checking in on the patients frequently. Occasionally ASHAs had negative relationships with patients. ASHA workers were able to identify key barriers to treatment and facilitators to treatment. ASHAs claimed that their knowledge about mental illness improved because of the HOPE study, though some gaps remained in their understanding of mental illness etiology and treatment. Overall, ASHA workers viewed the HOPE study as a necessary and effective intervention, and requested that it continue and expand.Conclusions: ASHA workers are important in establishing and maintaining relationships with patients that encourage attendance and participation, and the efforts of ASHAs often help in mitigating common barriers to treatment. Our results show that the beliefs and knowledge of ASHA workers can be changed in regards to mental illness, and ASHAs can become effective advocates for patients. The perspectives of ASHA workers need to be understood in order to understand the complexities of a rural health system that relies on their work, and most effectively help patients.

show abstract

“…The PM has over a decade of experience with international projects in this role and she has coauthored a number of studies with the research team. 36,42,47 The SSIG, used to guide the discussion, included openended questions related to nutritional issues and ongoing barriers to ART. In particular, the SSIG focused on topics such as health services sought, access to care, and HIV/AIDS program resources needed.…”

Section: Methodsmentioning

confidence: 99%

“…In a qualitative study conducted among WLHA who participated in the AL study in Nellore, Andhra Pradesh, depressed mood and anxiety were experienced prior to their participation. 47 Further, participants reported how the program was helpful in managing mental health symptoms and the role of ASHA and staff in providing support with mental health symptoms. 47 Data also revealed the importance of tangible support, need for social support, and their experience of having difficulty accessing ART.…”

Section: Introductionmentioning

confidence: 99%

Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study

Salem

Bustos

Shalita

et al. 2018

J Int Assoc Provid AIDS Care

Self Cite

View full text Add to dashboard Cite

Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.

show abstract

Women living with AIDS in rural Southern India: Perspectives on mental health and lay health care worker support

Cited by 12 publications

References 38 publications

Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India

Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India

Perceptions of Asha Workers in the Hope Collaborative Care Mental Health Intervention in Rural South India: A Qualitative Analysis

Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study

Contact Info

Product

Resources

About