An assessment of home based care among regular service clients with HIV in Guyana
K. Boryc1, M. Anastario1, K. Gordon-Boyle2, S. Singh3, M. Steilen1, B. Cicatelli1
1Cicatelli Associates Inc., New York, United States, 2Management Sciences for Health - GHARP II, Georgetown, Guyana, 3National AIDS Programme Secretariat, Georgetown, Guyana
Background: Beginning in 2005, PEPFAR and USAID established a home-based care (HBC) program in collaboration with the Guyana National AIDS Programme Secretariat (NAPS) to improve the quality of lives of people living with HIV (PLHIV) in Guyana. As part of this endeavor, we assessed the experiences of PLHIV living in region 4 of Guyana who received regular visits from HBC program volunteers and/or nurse providers.
Methods: We collected data from a random sample of PLHIV HBC clients from Region 4 in Guyana, and examined results from respondents reporting regular HBC visits (n=40) (defined as ≥2 visits monthly). A questionnaire was verbally administered with respondents to collect information on their HBC needs and their experience with the HBC program, including questions in the following domains: demographics; services received; quality of service delivery; and mental health and substance abuse.
Results: The services most commonly received by respondents included nutritional assessment and counseling (95%), emotional support (90%), HIV-related prevention education/counseling (87.5%), support for disclosure of HIV status (80%), and personal and household hygiene education (80%). Respondents reported further need for referrals and linkages for children (52.5%), income-generating opportunities (42.5%), and linkages to food support (40%). Forty-five percent of respondents screened positive for probable depression, and 22.5% of respondents screened positive for being at risk for a drinking problem. Respondents reported an improvement in self-assessed general health following the HBC program (t=3.7, df=39, p< 0.001). When asked how participating in the HBC program had changed their life, 92.5% of respondents reported positively or very positively.
Conclusions: While a substantial portion of needs were addressed among those receiving regular services in the HBC program, outstanding needs included mental health, and referrals and linkages for children, income-generating opportunities, and food support. These data have implications for future HBC programming in Guyana.
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