1. Firoza Haffejee1, MW Khan1, K Ports2, M Mosavel2
The use of HIV positive health care volunteers to provide information about HIV/AIDS in low socio-economic communities
Firoza Haffejee1, MW Khan1, K Ports2, M Mosavel2
1Department of Basic Medical Sciences, Durban University of Technology, South Africa
2Health and Behavior Policy unit, Virginia Commonwealth University, USA

2. Background
Epicentre of the HIV pandemic – KwaZulu-Natal, South Africa (SA)
Prevalence of HIV = 16.9%
SA – DOH has made the reduction of new infections part of its health care strategic plans
Scaling up of ARV
Reduced progression of HIV to AIDS
However
Still an increase in new infections
There is a need to increase voluntary counselling and testing (VCT)

3. Large numbers of voluntary health care workers employed
Promote VCT
Promote the uptake of ARVs
Many people are still unable to access these health services
Emergence of many voluntary health care workers
Provide educational services and emotional support

4. Aim
To explore the factors that drive a person living with HIV to provide voluntary health care services

5. Methods Quantitative and qualitative data were collected
Part of a larger study
Quantitative and qualitative data were collected
from voluntary health care workers
Study site – Kenneth Gardens
A low income community in Durban, South Africa
Ethical clearance (IREC 056/13)
Written informed consent
Interview was conducted with HIV+ health care volunteer
To protect identity – name changed
Ms Jones

6. Results / The interview
Diagnosis with HIV
± 20 years ago
By boyfriend who knew he had HIV
Unable to afford ARVs
No drug trials
New program for ARV rollout at a local tertiary hospital
Sponsored half the cost of the ARVs
Remained on the program for 2 years

7. Education Approached a professor from local Medical School
Enquired about HIV in nursing curriculum
Given permission to attend lectures at no cost
Also visited the medical wards
Enquired from patients about their illness
Enrolled for HIV short courses

8. Treatment & care in Kenneth Gardens
Numerous obstacles
Cannot access care at local hospital due to municipal zoning
Travel expenses
Elderly
Waiting time in queues = long
Patients numbers are large
Patient-practitioner interaction is suboptimal
Insufficient ARVs

9. Stigma Seen as a disgrace Gossiping Neighbourly jealousy
Affects decisions to seek care

10. Education to remove stigma
Was introduced at a meeting as “This is Ms. Jones and Ms. Jones has AIDS”
Disease is thus seen differently to other chronic conditions
People need to see someone with HIV as a person with
a chronic condition who requires compassion and care

11. Educating the community
Involved in community engagement & education
Creates awareness about HIV in surrounding schools
Open about her status
Receives a different attitude from school children & community
Reduces the stigma
Positive reaction
School children willing to ask questions and interact with her

12. Helping those living with HIV
Many live in denial
“They don’t want to hear about it, until they get sick….then they get TB and it’s too late”
Recalls carrying 2 neighbors to her cars and taking them to the hospice where they later died of AIDS

13. Other social issues Drug abuse
Role in HIV transmission through sharing of needles
Increases risky sexual behaviour
Counsellors in the community are not properly trained
Medical treatment is a last resort
Rather “pray it away”

14. Qualities required by community care givers
Positive about life
Be able to speak with conviction
Be knowledgeable
Be able to answer questions
Need to “switch off your own emotions”
Can be emotionally draining

15. Conclusion Need for more voluntary health care workers
More people living with HIV can be trained
Provide basic HIV education and support
Reduce the stigma surrounding HIV/AIDS
We hope that in the near future, funding can be provided for these health care workers

16. Acknowledgements This study was funded in part by:
Virginia Commonwealth University’s International Partnership Major Initiative Award
National research Foundation of South Africa
(NRF, Grant number 99315)