Semel Institute for Neuroscience and Human Behavior-Center for Community Health, University of California, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
AIDS Behav. 2022 Jan;26(1):123-131. doi: 10.1007/s10461-021-03363-0. Epub 2021 Jul 6.
Scientific findings and policy guidelines recommend integrating HIV and drug addiction prevention and care into community-based settings. Systematic capacity-building efforts are warranted to provide technical support for community health workers and improve their confidence in the integrated service provision. An intervention trial was conducted between 2018 and 2019 with 120 community health workers (CHW) from 60 communes in Vietnam's four provinces. The 60 intervention CHW received in-person training to enhance their HIV/addiction-related service knowledge and skills. Online support groups were established between trained CHW and local HIV and addiction specialists. The intervention outcomes were assessed using mixed-effects regression models with the data collected at baseline and every 3 months for 1 year. Adjusted analyses showed that intervention CHW reported a significant increase in the interaction with other treatment providers than the control group at 6 months and remained at the 12-month follow-up. The difference in the improvement of confidence in HIV/addiction-related service delivery between the intervention and control groups was significant at 6-month but became insignificant at the 12-month. Male CHW were more confident in providing services than female CHW at baseline, and gender differences in the changing patterns were observed over time. This capacity-building intervention demonstrated promising outcomes on CHW inter-agency collaborations and confidence in service delivery. Gender divides in healthcare professionals should be attended to in future studies.
科学发现和政策指南建议将艾滋病毒和药物滥用预防和护理纳入社区环境。有必要进行系统的能力建设工作,为社区卫生工作者提供技术支持,提高他们提供综合服务的信心。2018 年至 2019 年,在越南四个省的 60 个公社进行了一项干预试验,共有 120 名社区卫生工作者(CHW)参加。60 名干预性 CHW 接受了面对面培训,以增强他们与艾滋病毒/药物滥用相关的服务知识和技能。在接受培训的 CHW 和当地艾滋病毒和药物滥用专家之间建立了在线支持小组。使用混合效应回归模型评估干预结果,基线数据和 1 年内每 3 个月收集一次。调整分析表明,与对照组相比,干预组 CHW 在 6 个月时与其他治疗提供者的互动显著增加,并在 12 个月的随访中保持不变。干预组和对照组在提供艾滋病毒/药物滥用相关服务方面的信心改善方面的差异在 6 个月时显著,但在 12 个月时不再显著。男性 CHW 在提供服务方面比女性 CHW 更有信心,并且随着时间的推移观察到性别差异在变化模式方面的变化。这项能力建设干预措施在 CHW 机构间合作和服务提供信心方面取得了有希望的结果。未来的研究应该关注医疗保健专业人员中的性别差距。