Implementation of a Peer HIV Community Support Worker Program in Rural Ethiopia to Promote Retention in Care.
Implementation of a Peer HIV Community Support Worker Program in Rural Ethiopia to Promote Retention in Care.
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DOI：
10.1177/2325957415614648
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发表时间：
2017-01-01
影响因子：
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通讯作者：
Shenie, Tibebe
中科院分区：
文献类型：
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作者：
Lifson, Alan R;Workneh, Sale;Shenie, Tibebe
对艾滋病毒治疗方案而言，包括在农村和资源有限的环境中，患者能否继续接受治疗是一项重大挑战。为了帮助减少埃塞俄比亚农村新接受治疗的艾滋病毒感染患者的随访损失（LTFU），将来自同一社区/村庄的13名受过培训的艾滋病毒阳性社区卫生支持工作者（CHSWs）中的1名分配给142名患者。社工提供爱滋病及健康教育、辅导/社会支援，并协助与爱滋病诊所沟通。7例死亡和3例转移，12个月保留率为94% (95% CI = 89%-97%)，项目中没有患者是LTFU。在入组至12个月期间，患者在艾滋病毒知识（增加17%）、身心生活质量（增加81%和21%）、内化污名（减少97%）和感知社会支持（增加24%）方面有显著改善（P≤0.001）。在农村和资源有限的环境中，以社区为基础的CHSW项目可以补充以设施为基础的护理，以减少LTFU并改善进入护理的艾滋病毒感染者的积极结果。
Retention in care is a major challenge for HIV treatment programs, including in rural and in resource-limited settings. To help reduce loss to follow-up (LTFU) for HIV-infected patients new to care in rural Ethiopia, 142 patients were assigned 1 of 13 trained community health support workers (CHSWs) who were HIV positive and from the same neighborhood/village. The CHSWs provided HIV and health education, counseling/social support, and facilitated communication with the HIV clinics. With 7 deaths and 3 transfers, the 12-month retention rate was 94% (95% CI = 89%-97%), and no client was LTFU in the project. Between enrollment and 12 months, clients had significant ( P ≤ .001) improvements in HIV knowledge (17% increase), physical and mental quality of life (81% and 21% increase), internalized stigma (97% decrease), and perceived social support (24% increase). In rural and resource-limited settings, community-based CHSW programs can complement facility-based care in reducing LTFU and improving positive outcomes for HIV-infected people who enter care.