Siyakhana Peer: Evaluating a Peer Recovery Coach Model to Reduce Substance Use Stigma in South African HIV Care

Summary

Alcohol and other drug use is common among people living with HIV in South Africa and is associated with worse engagement in HIV care. There is evidence that healthcare workers in this setting, including community health workers who play a central role in re-engaging patients back into HIV care, exhibit stigmatizing behaviors towards HIV patients who use substances. In general, healthcare worker stigma towards alcohol and other drug use is associated with poorer treatment of patients who use substances, and in this setting, healthcare worker stigma towards alcohol and other drug use has been associated with worse patient engagement in HIV care. In the United States, peer recovery coaches (PRCs), who are trained individuals with lived substance use recovery experience, have helped patients who use substances engage in healthcare. Theoretically, integrating a PRC onto a healthcare team also increases healthcare worker contact with a person with substance use experience, which may be associated with lower stigma. Yet, a PRC model has not yet been tested in South African HIV care. Therefore, the purpose of this study is to develop and pilot a PRC model integrated into community-based primary care teams providing HIV services in South Africa. The study aims to compare a healthcare team with a PRC to a team without a PRC. The investigators will primarily assess the implementation of this PRC model and rates of patient re-engagement in care.

Conditions

• Substance-Related Disorders
• Substance Use
• Substance Use Disorders
• Stigma, Social
• Stigmatization
• Attitude of Health Personnel
• Treatment Adherence
• Treatment Adherence and Compliance
• Health Care Seeking Behavior
• HIV
• Mental Health Recovery
• Delivery of Health Care
• Global Health
• South Africa
• Health Personnel Attitude
• Health Personnel
• Community Health Workers
• Substance Use Recovery

Interventions

BEHAVIORAL

Siyakhana - P

A trained peer recovery coach (PRC) will be integrated onto the healthcare worker team randomized to Siyakhana - P. The PRC on this team will work with eligible and consenting patients who are seen by members of this healthcare team.

Sponsors & Collaborators

• Medical Research Council, South Africa

  collaborator OTHER

• National Institute on Drug Abuse (NIDA)

  collaborator NIH

• University of Maryland, College Park

  lead OTHER

Principal Investigators

• Jessica F Magidson, PhD · University of Maryland, College Park

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

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-02-22

Primary Completion

2024-01-29

Completion

2024-08-29

Countries

• South Africa

Study Locations