Numerous studies have focused on the effectiveness of community health worker (CHW) programs in producing positive health behaviors and health outcomes for the clients CHWs serve; however, there has been a gap in the literature regarding how the health of HIV + CHWs is impacted by their jobs. A phenomenological design was used to gain insight into the lived experiences of HIV+ CHWs (HIVCHW) who provided services to HIV positive clients. Fifteen HIVCHW were recruited using criteria and snowball techniques. Data were collected via audio recorded personal interviews regarding respondents' perceptions of their work and how it impacted their own health and wellbeing. The data were organized by hand creating charts with pen and paper. Lazarus's theory of stress and coping was used to understand the data and aided in the analysis. The key findings indicated that while the majority of participants had an overall positive perception of the experience of being HIVCHWs, they also indicated that being a CHW impacted their health and well-being. Stress and stressful situations were among the impacts most often referenced by the study participants. The study is socially significant because it may offer the workforce of HIVCHWs empowerment to self-advocate for tools such as stress and time management training and mentors to support healthy work-life balance. In addition, this study may help to prevent or reduce rates of adverse health outcomes such as pain and burnout that HIVCHWs reported experiencing.

A quantitative approach was used to investigate the stigmatization of HIV positive clients in the Leribe District of Lesotho. The study population included 5200 HIV positive patients who enrolled for ARV in government clinics. A randomly selected sample of 520 clients responded through a questionnaire and interviews. The statistical package (STATA version 9) was used to analyze data. The objectives of the study were to explore the type and level of stigmatization of HIV-positive clients and to describe ways in which health workers in the PHC can reduce the stigmatization of HIV-positive clients at the clinics. The findings revealed that types of stigmatization included separation, isolation, labeling and discrimination. Ways to reduce the stigma within a community based primary health care facility included educating people living with HIV on how to protect themselves from multiple infection, providing effective counselling to clients and families maintaining confidentiality, and using change strategies to change attitudes of health care providers. The integration of HIV-related activities is a strong recommendation and the importance of the consistent availability of ARV treatment was emphasized. / Public Health / M.A. (Public Health)

A quantitative approach was used to investigate the stigmatization of HIV positive clients in the Leribe District of Lesotho. The study population included 5200 HIV positive patients who enrolled for ARV in government clinics. A randomly selected sample of 520 clients responded through a questionnaire and interviews. The statistical package (STATA version 9) was used to analyze data. The objectives of the study were to explore the type and level of stigmatization of HIV-positive clients and to describe ways in which health workers in the PHC can reduce the stigmatization of HIV-positive clients at the clinics. The findings revealed that types of stigmatization included separation, isolation, labeling and discrimination. Ways to reduce the stigma within a community based primary health care facility included educating people living with HIV on how to protect themselves from multiple infection, providing effective counselling to clients and families maintaining confidentiality, and using change strategies to change attitudes of health care providers. The integration of HIV-related activities is a strong recommendation and the importance of the consistent availability of ARV treatment was emphasized. / Public Health / M.A. (Public Health)

Introduction: HIV referral and linkage system in many countries in general and in Ethiopia in particular was poorly characterised by low linkage rate. The purpose of this study was to analyses factors associated with poor referral and linkage system and develop strategies to improve the system. Methods: A sequential mixed method approach using exploratory descriptive study design was employed. The study was conducted in Addis Ababa, Ethiopia and it was conducted in two phases. Phase I involved data collection and analysis as evidence for the development of strategies while phase II was the development of strategies. For phase I, data were collected in steps 1 and 2 using individual interviews and focus group discussions respectively. The study participants were programme owners and partners who were supporting facilities during the data collection period in step 1 and health care providers in step 2. A total of 4 individual interviews and 3 FGDs were conducted with purposively selected participants. Data were analysed using computer assisted software called OpenCode version 4.2. Results: The findings revealed five themes namely, issues of referral and linkage practice, ensuring linkage through communication, issues of health care, issues of health care system and issues of partnerships and Health Bureau. Many gaps that affected the referral system were identified and in phase II, nine strategies were developed to strengthen the referral and linkage system. Conclusion:The results of this study highlighted weaknesses in the referral and linkage system of the HIV positive clients from counselling and testing services to chronic care and proposed strategies to strengthen those weaknesses. Measures to operationalise those strategies are also proposed. The successful implementation of the proposed strategies depends on the support of the ministry of health and regional bureau in terms of resources and the readiness of the health care providers to adhere to the proposed measures. Intervention research is needed to test the effectiveness of the proposed strategies. / Health Studies / D. Litt. et Phil. (Health Studies)