HIV/AIDS

Guidelines for Occupational Safety and Health, Including HIV in the Health Services Sector

These guidelines target all health workers at the different levels of the health care delivery system and apply to both the formal and informal workplaces within the health sector. This document covers the basic principles that are required to ensure workplace safety and health including hazard identification, risk management, prevention and management of exposures and incidents. [from foreword]

Balanced Counseling Strategy Plus: a Toolkit for Family Planning Service Providers Working in High HIV/STI Prevalence Settings

This toolkit is an interactive, client-friendly approach for improving counseling on family planning and prevention, detection, and treatment of sexually transmitted infections (STIs) including HIV. It includes a training of trainers guide that supervisors and others can use to train health care facility directors and service providers on how to use the BCS+ for counseling family planning clients. [from publisher]

Role of Reproductive Health Providers in Preventing HIV

This brief discusses the important role of reproductive health providers in reducing the incidence of new HIV infections over the coming years through an increased focus on outreach to young people and men. [adapted from introduction]

Evaluation of Uptake and Attitude to Voluntary Counseling and Testing among Health Care Professional Students in Kilimanjaro Region, Tanzania

Voluntary counseling and testing (VCT) is a cornerstone for successful implementation of prevention, care and support services among HIV negative and positive individuals. VCT is also perceived to be an effective strategy in risk reduction among sexually active young people. This study aimed to assess the acceptability of VCT and its actual uptake among young health care professional students. [adapted from abstract]

Nurse-Driven, Community-Supported HIV/AIDS Treatment at the Primary Health Care Level in Rural Lesotho

A joint pilot program was launched at the primary health care level in Lesotho through which nurses were trained and empowered to assume high levels of clinical responsibility for HIV care, including ART. This nurse-driven, community-supported model of care has proven to be successful in delivering quality HIV/AIDS and TB services integrated into existing primary health care structures for a population living in remote, rural areas. [from summary]

Use of Task-Shifting to Rapidly Scale-Up HIV Treatment Services: Experiences from Lusaka, Zambia

This report describes field experiences with task shifting in Lusaka, Zambia, where a large public-sector ART program has enrolled over 71,000 HIV-infected adults and children across 19 program sites. It advocates a comprehensive, three-pronged approach to task-shifting that comprises training, on-site clinical mentoring, and continuous quality assurance. A structured approach is important so that clinical care is not compromised when clinical duties are initially shifted to less specialized health professionals. [from introduction]

Reducing the Burden of HIV and AIDS Care on Women and Girls

Public health systems in most developing countries do not have the capacity to provide necessary care and support to people living with HIV & AIDS. Out of necessity, many turn to family, neighbours and friends for care, the majority of whom are female. This policy brief outlines why women and girls carry the burden of HIV & AIDS care, describes the impact on them and makes policy and program recommendations to help reduce this burden. [adapted from abstract]

Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages: a Generic Guide

The objective of this adaptable tool is to assess HIV and sexual and reproductive health (SRH) bi-directional linkages at the policy, systems and service-delivery levels. It is intended also to identify gaps, and ultimately contribute to the development of country-specific action plans to forge and strengthen these linkages. It includes assement tools for evaluating staffing, human resources and capacity development (p.32) as well as a checklist for evaluating health workers’ capacity to perform SRH and HIV functions (p.82). [adapted from author]

Tracking Working Status of HIV/AIDS-Trained Service Providers by Means of a Training Information Monitoring System in Ethiopia

Ethiopia does not have a sufficient health care workforce to meet the population’s demand for services and the burden of disease. The objective of this project was to assess the usefulness and feasibility of collecting key participant and training information for monitoring and planning of HIV/AIDS services. This paper describes a project that uses training data to follow up with providers after training to assess whether they are still working in HIV/AIDS-related services. [adapted from introduction]

Training Health Care Workers to Promote HIV Services for Patients with Tuberculosis in the Democratic Republic of Congo

This study involves the development and evaluation of training materials for provider-initiated HIV counseling and testing, HIV prevention and integrated primary HIV care and support for use by health care workers involved in the care of patients with TB at the primary health care clinic level in the Democratic Republic of Congo. [adapted from abstract]

Community Health Workers for ART in Sub-Saharan Africa: Learning from Experience - Capitalizing on New Opportunities

Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery sites. This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. [from abstract]

Developing Hope in Life: Mothers' Support Groups for Living Positively in Ethiopia

The Mothers’ Support Group empowers mothers and mother-to-be to access peer-based support and make linkages to services such as family planning, infant-feeding, counseling, nutriotional guidance, antiretroviral therapy, prevention of mother-to-child transmission and health institutional delivery. [from author]

Existing Capacity to Manage Pharmaceuticals and Related Commodities in East Africa: an Assessment with Specific Reference to Antiretroviral Therapy

East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity.

Private-for-Profit HIV/AIDS Care in Uganda: an Assessment

The goal of the assessment was to review the quality of HIV care, antiretroviral treatment and tuberculosis services provided in private-for-profits in Uganda in order to generate appropriate recommendations and inform the development of a strategy to improve the quality of those services. [from author]

Antiretroviral Treatment and the Health Workforce in South Africa: How Have ART Workers Been Affected by Scaling Up?

The objective of this study was to investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. [from summary]

Reducing HIV Stigma and Gender Based Violence: Toolkit for Health Care Providers in India

The toolkit is a collection of participatory educational exercises for educating health care providers on the issues of stigma and gender-based violence. It was developed for and with health care providers in Andhra Pradesh, India. The goal is to facilitate open discussion on HIV stigma and gender violence, and on what health workers can do to promote a change in attitude and practice. [from publisher]

What Impact Do Global Health Initiatives Have on Human Resources for Antiretroviral Treatment Roll-Out? A Qualitative Policy Analysis of Implementation Processes in Zambia

Zambia, like many of the countries heavily affected by HIV and AIDS in southern Africa, also faces a shortage of human resources for health. The country receives significant amounts of funding from GHIs for the large-scale provision of antiretroviral treatment through the public and private sector. This paper examines the impact of GHIs on human resources for ART roll-out in Zambia, at national level, in one province and two districts. [from abstract]

Effectiveness of a Training-of-Trainers Model in a HIV Counseling and Testing Program in the Caribbean Region

This study evaluates the effectiveness and sustainability of a voluntary counseling and testing training program based on a training-of-trainers model. [adapted from abstract]

How Nurses in Cape Town Clinics Experience the HIV Epidemic

Nurses and managers interviewed in Cape Town primary care facilities share their insights, experiences and how they cope with the impact of the HIV/AIDS epidemic. [from introduction]

What Impact do Global Health Initiatives Have on Human Resources for Antiretroviral Treatment Roll-Out? A Qualitative Policy Analysis of Implementation Processes in Zambia

This paper examines the impact of Global Health Initiatives on human resources for antiretroviral treatment roll-out in Zambia at a national level, in one province and two districts. [adapted from abstract]

Patients Consulting Traditional Health Practitioners in the Context of HIV/AIDS in Urban Areas in Kwazulu-Natal, South Africa

This paper describes the results of a study to assess patients consulting full-time traditional health practitioners (THP) and the THPs' practices after they had been trained on HIV/Sexually Transmitted Infections prevention and care. [adapted from abstract]

Traditional Healers and Nurses: a Qualitative Study on Their Role on Sexually Transmitted Infections Including HIV and AIDS in Kwazulu-Natal, South Africa

This study investigated the role of traditional healers in sexually transmitted infections including HIV/AIDS as well as a collaboration between the traditional and biomedical health care systems as seen by nurses and traditional healers. Qualitative analyses are presented on themes including attitude and respect; collaboration between traditional healers and nurses; control and regulation of traditional health practices; and the training needs of healers and nurses. [adapted from abstract]

Participation of Traditional Birth Attendants in Prevention of Mother-to-Child Transmission of HIV Services in Two Rural Districts in Zimbabwe: a Feasibility Study

Prevention of Mother-to-Child Transmission of HIV is among the key HIV prevention strategies in Zimbabwe. The main objective of this study was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs) in family and child health services through their participation in PMTCT programmes in Zimbabwe. [from abstract]

HIV/AIDS-Related Stigma, Fear, and Discriminitatory Practices among Healthcare Providers in Rwanda

The purposes of this study were to quantify stigma among Rwandan healthcare providers toward patients with HIV/AIDS; to assess healthcare provider fears and perceived risks for HIV while providing services to patients with HIV/AIDS; to quantify practices in hospitals and health centers and among health providers that discriminate against HIV-positive patients; and to evaluate the relationship between provider stigma, provider fears, and perceived risks with discrimination against HIV-positive patients in health facilities and among healthcare providers. [from summary]

Stigmatization and Discrimination of HIV-Positve People by Providers of General Medical Services in Ukraine

HPI conducted a survey in Ukraine to test indicators and questions regarding HIV/AIDS-related stigma and discrimination at the facility/provider level. This research examined HIV/AIDS-related stigma and discrimination by providers of general medical services in three regions in Ukraine. [from summary]

HIV/AIDS Services through the Workplace: a Survey in Four Sub-Saharan African Countries

This study cuts across countries and quantifies the range of service provision types and mechanisms used by sub-Saharan companies that are diverse in terms of size, industry, and national origin. The study results systematically quantify which services are actually being offered, and how companies actually finance those services. The study also explores some motivators for offering workplace services and assesses why certain services and financing mechanisms are used predominantly by large companies. [from summary]

Increasing Access to Contraception for Clients with HIV: a Toolkit

The toolkit was developed to facilitate improved access to appropriate and effective contraception for clients with HIV, especially through the strategic integration of family planning with HIV prevention, care, and treatment services.

Barriers to HIV Care and Treatment by Doctors: a Review of the Literature

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

HIV Care for Health Workers: Perceptions and Needs

The HIV pandemic does not spare health workers. In many countries, HIV prevalence among health care providers is equal to or higher than national averages, and in some areas, morbidity and mortality account for over 60% of health worker vacancies, compared to the 23% accounted for by the more commonly acknowledged impact of out-migration. The resulting attrition of health workers has a severe impact on the health resource capacity of developing nations and leaves critical efforts such as the rollout of antiretroviral therapy largely insurmountable. [from introduction]

Feasibility, Acceptability, Effect and Cost of Integrating Counseling and Testing for HIV within Family Planning Services in Kenya

This document summarizes a project to design, implement and compare two models of integrating CT for HIV within FP services in 23 health facilities in Kenya in terms of their feasibility, acceptability, cost and effect on the voluntary use of CT, as well as the quality of FP services. [adapted from summary]