Community Health Worker Training to Reduce Depression and Substance Use Stigma in TB/HIV Care in South Africa

Summary

Poor engagement in care contributes to HIV- and TB-related morbidity and mortality in South Africa (SA). Community health workers (CHWs) are frontline lay health workers who work to re-engage patients who are lost to follow-up (LTFU) in HIV/TB care. Patients with depression and substance use (SU) have a greater likelihood of being LTFU in HIV/TB care, and there is evidence that CHWs may exhibit stigma towards these patients. When CHWs have negative attitudes towards these patients, on average they spend less time with these patients, are less likely to implement evidence-based practices, and deliver less patient-centered care. Therefore, this purpose of this study is to examine the implementation and preliminary effectiveness of a brief training ("Siyakhana"). The purpose of this training is to provide CHWs with psychoeducation, skills, and support around working with HIV/TB patients with depression/SU. The investigators will assess the training's implementation and changes in CHWs' stigma towards HIV/TB patients with depression/SU.

Conditions

• Substance-Related Disorders
• Mental Disorder
• Social Stigma
• Depression
• Treatment Adherence and Compliance
• Health Care Utilization
• Attitude of Health Personnel
• Hiv
• Tuberculosis
• Mental Health Disorder
• Community Health Workers
• Health Care Delivery

Interventions

BEHAVIORAL

Siyakhana CHW Training

Please see arm description.

Sponsors & Collaborators

• Medical Research Council, South Africa

  collaborator OTHER

• National Institute of Mental Health (NIMH)

  collaborator NIH

• University of Maryland, College Park

  lead OTHER

Principal Investigators

• Jessica F Magidson, PhD · University of Maryland

• Bronwyn J Myers, PhD · Medical Research Council, South Africa

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-06-08

Primary Completion

2023-08-01

Completion

2023-08-01

Countries

• South Africa

Study Locations