Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya
<h4>Background</h4> In Kenya, harm reduction organizations have adopted evidence-based peer educator (PE) programs, where former people who inject drugs (PWID) serve as community health liaisons to engage PWID in HIV, HCV and harm reduction services. While PEs play an integral role in he...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714845/?tool=EBI |
| _version_ | 1828091771692777472 |
|---|---|
| author | Linnet N. Masese Natasha T. Ludwig-Barron Loice Mbogo Brandon L. Guthrie Helgar Musyoki David Bukusi William Sinkele Esther Gitau Carey Farquhar Aliza Monroe-Wise |
| author_facet | Linnet N. Masese Natasha T. Ludwig-Barron Loice Mbogo Brandon L. Guthrie Helgar Musyoki David Bukusi William Sinkele Esther Gitau Carey Farquhar Aliza Monroe-Wise |
| author_sort | Linnet N. Masese |
| collection | DOAJ |
| description | <h4>Background</h4> In Kenya, harm reduction organizations have adopted evidence-based peer educator (PE) programs, where former people who inject drugs (PWID) serve as community health liaisons to engage PWID in HIV, HCV and harm reduction services. While PEs play an integral role in healthcare delivery, little data exists on their roles, risks and experiences working with PWID, which may be used to inform local harm reduction policy. <h4>Methods</h4> PE’s from two harm reduction sites in Nairobi were randomly and purposively selected to participate in semi-structured in-depth interviews. Thematic analysis was conducted to characterize the expected versus actual roles that PEs employ while serving PWID, personal motivation and/or challenges and occupational health risks. Data was analyzed using Atlas.ti software. <h4>Results</h4> Twenty PEs participated in the study. On average, PEs were 37 years of age, with 3 years of service. Female representation was 30%. Expected responsibilities included locating clients, establishing rapport, educating and escorting clients to addiction care facilities. Additional roles included attending to clients outside of work hours, escorting clients to medical appointments and facilitating patient-provider discussions. Occupational health risks included harassment by police and drug dealers, needle sticks, and close proximity to drug use environments that could prompt drug relapse. Despite these challenges and risks, PEs are motivated by their personal experiences of overcoming addiction with help from harm reduction programs. <h4>Conclusions/Recommendations</h4> PEs play a vital role in HIV, HCV and harm reduction service delivery in Kenya, often exceeding their job descriptions by offering additional support to PWID. Recommendations include (1) advocating for PEs to provide patient navigation services, (2) promoting the use of post-exposure prophylaxis (PEP), (3) providing occupational mental health services to prevent drug relapse, and (4) collaborating with law enforcement to address harassment, with the ultimate goal of reducing HIV and HCV incidence among PWID. |
| first_indexed | 2024-04-11T06:19:16Z |
| format | Article |
| id | doaj.art-23d63c723c204af9a55e96b65acbee35 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T06:19:16Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-23d63c723c204af9a55e96b65acbee352022-12-22T04:40:52ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011712Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, KenyaLinnet N. MaseseNatasha T. Ludwig-BarronLoice MbogoBrandon L. GuthrieHelgar MusyokiDavid BukusiWilliam SinkeleEsther GitauCarey FarquharAliza Monroe-Wise<h4>Background</h4> In Kenya, harm reduction organizations have adopted evidence-based peer educator (PE) programs, where former people who inject drugs (PWID) serve as community health liaisons to engage PWID in HIV, HCV and harm reduction services. While PEs play an integral role in healthcare delivery, little data exists on their roles, risks and experiences working with PWID, which may be used to inform local harm reduction policy. <h4>Methods</h4> PE’s from two harm reduction sites in Nairobi were randomly and purposively selected to participate in semi-structured in-depth interviews. Thematic analysis was conducted to characterize the expected versus actual roles that PEs employ while serving PWID, personal motivation and/or challenges and occupational health risks. Data was analyzed using Atlas.ti software. <h4>Results</h4> Twenty PEs participated in the study. On average, PEs were 37 years of age, with 3 years of service. Female representation was 30%. Expected responsibilities included locating clients, establishing rapport, educating and escorting clients to addiction care facilities. Additional roles included attending to clients outside of work hours, escorting clients to medical appointments and facilitating patient-provider discussions. Occupational health risks included harassment by police and drug dealers, needle sticks, and close proximity to drug use environments that could prompt drug relapse. Despite these challenges and risks, PEs are motivated by their personal experiences of overcoming addiction with help from harm reduction programs. <h4>Conclusions/Recommendations</h4> PEs play a vital role in HIV, HCV and harm reduction service delivery in Kenya, often exceeding their job descriptions by offering additional support to PWID. Recommendations include (1) advocating for PEs to provide patient navigation services, (2) promoting the use of post-exposure prophylaxis (PEP), (3) providing occupational mental health services to prevent drug relapse, and (4) collaborating with law enforcement to address harassment, with the ultimate goal of reducing HIV and HCV incidence among PWID.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714845/?tool=EBI |
| spellingShingle | Linnet N. Masese Natasha T. Ludwig-Barron Loice Mbogo Brandon L. Guthrie Helgar Musyoki David Bukusi William Sinkele Esther Gitau Carey Farquhar Aliza Monroe-Wise Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya PLoS ONE |
| title | Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya |
| title_full | Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya |
| title_fullStr | Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya |
| title_full_unstemmed | Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya |
| title_short | Occupational roles and risks of community-embedded peer educators providing HIV, hepatitis C and harm reduction services to persons who inject drugs in Nairobi, Kenya |
| title_sort | occupational roles and risks of community embedded peer educators providing hiv hepatitis c and harm reduction services to persons who inject drugs in nairobi kenya |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714845/?tool=EBI |
| work_keys_str_mv | AT linnetnmasese occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT natashatludwigbarron occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT loicembogo occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT brandonlguthrie occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT helgarmusyoki occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT davidbukusi occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT williamsinkele occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT esthergitau occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT careyfarquhar occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya AT alizamonroewise occupationalrolesandrisksofcommunityembeddedpeereducatorsprovidinghivhepatitiscandharmreductionservicestopersonswhoinjectdrugsinnairobikenya |