Institute of Tropical Medicine Antwerp
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HIV/AIDS competent households: interaction between a health-enabling environment and community-based treatment adherence support for people living with HIV/AIDS in South Africa

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Show simple item record Masquillier, C. Wouters, E. Mortelmans, D. Van Wyk, B. Hausler, H. Van Damme, W. 2016-06-02T13:34:26Z 2016-06-02T13:34:26Z 2016
dc.identifier.issn 1932-6203
dc.identifier.other ITG-HLA
dc.identifier.other DPH
dc.identifier.other U-HPOL
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other OAJ
dc.identifier.other Abstract
dc.identifier.other UPD62
dc.description.abstract In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household members. In this respect, a household with a high level of HIV/AIDS competence will be more receptive to treatment adherence support, as the patient is more likely to allow interaction between the CHW and the household. In contrast, in a household which exhibits limited characteristics of HIV/AIDS competence, interaction with the treatment adherence supporter may be difficult in the beginning. In such a situation, visits from the CHW threaten the hybrid identity management. If the CHW handles this situation cautiously and the patient-acting as a gate keeper-allows interaction, the CHW may be able to help the household develop towards HIV/AIDS competence. This would have a more added value compared to a household which was more HIV/AIDS competent from the outset. This study indicates that pre-existing dynamics in a patient's social environment, such as the HIV/AIDS competence of the household, should be taken into account when designing community-based treatment adherence programs in order to provide long-term quality care, treatment and support in the context of human resource shortages. en_US
dc.language English en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Health systems en_US
dc.subject Organization en_US
dc.subject Interventions en_US
dc.subject Health care delivery en_US
dc.subject Social mobilization en_US
dc.subject Community-based treatment en_US
dc.subject Households en_US
dc.subject Competence en_US
dc.subject Health workers en_US
dc.subject Acceptability en_US
dc.subject Patient's perspective en_US
dc.subject Patient-to-professional en_US
dc.subject South Africa en_US
dc.subject Africa, Southern en_US
dc.title HIV/AIDS competent households: interaction between a health-enabling environment and community-based treatment adherence support for people living with HIV/AIDS in South Africa en_US
dc.type Article-E en_US
dc.citation.issue 3 en_US
dc.citation.jtitle PLoS ONE en_US
dc.citation.volume 11 en_US
dc.citation.pages e0151379 en_US
dc.citation.jabbreviation PLoS ONE en_US

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