Community Capacity Building for HIV and Addiction Service Integration: An Intervention Trial in Vietnam

Li Li,Tuan Anh Nguyen,Chunqing Lin,Loc Quang Pham,Tuan Anh Le,Diep Bich Nguyen,Li-Jung Liang

doi:10.1007/s10461-021-03363-0

Abstract

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.

Highlights

Due to the high burden of HIV and substance use comorbidities, researchers and physicians are increasingly examining primary care-based approaches to address the comprehensive health needs of HIV-affected populations and populations who use drugs [1,2,3]
Community health systems are in the perfect position to coordinate community resources, provide culturally appropriate HIV and addiction prevention, and ensure convenient linkage to care [4, 5]
This paper presents the intervention outcomes among community health workers (CHW), focusing on their collaborations with other health agencies to deliver health services

Summary

Introduction

Community health systems are in the perfect position to coordinate community resources, provide culturally appropriate HIV and addiction prevention, and ensure convenient linkage to care [4, 5]. Literature has documented the efficacy of community-based HIV and substance use services in reduced risky behaviors, expanded service coverage, increased patient retention and adherence, and improved health outcomes [6, 7]. The World Health Organization published an operation manual to guide the expansion of HIV testing and prevention, the delivery of accessible treatment, and the provision of sustained patient-oriented care in the community [9]. Communitybased health systems are often resource-constrained, and the providers there are not adequately equipped with knowledge and skills; they lack the confidence to render HIV/ addiction services [12, 13]. Systematic capacity-building interventions to enhance community health providers’ confidence and capacity in administering HIV and drug-related clinic tasks are currently underdeveloped

Methods

Results

Conclusion