Number of people living with or affected by HIV provided with spiritual or psychosocial support services

How to use this indicator

This indicator tracks the psychosocial support services provided to people living with or affected by HIV. Psychosocial support deals with the ongoing psychological and social problems faced by people living with and affected by HIV. HIV has a serious impact on the lives of people living with the virus and their families. Previous research has shown that people living with HIV tend to suffer from fatigue, pain, fever, headache, and mental health issues. Acquiring HIV can result in stigma and discrimination against those who live with the virus and their families, and can lead to decline in socioeconomic status, employment, income, housing, healthcare, and mobility. Psychological support can help these individuals cope more effectively with their situation and enhance their quality of life. Support services such as mental health, case management, and counseling services have been associated with improved CD4 counts in patients receiving antiretroviral therapy (ART). This support has also been shown to affect the level of stress and the severity of mental problems that can develop as a result of diagnosis.

It has been shown that community health workers can provide psychosocial and psychological interventions as part of primary and secondary prevention of mental, neurological, and substance use disorders in low-resource settings. Interventions involving community health workers in promotion of health among people living with HIV have historically focused on reducing depression or stigma associated with HIV and promoting quality of life, social support, and self-efficacy. The efforts of community health workers to address psychosocial outcomes of people living with HIV have demonstrated positive changes in improving quality of life and self-efficacy in some contexts. Community workers are ideally positioned to provide psychosocial support, because of they often have the highest level of interaction with people living with HIV and, therefore, the greatest chances of understanding their needs.

Data from this indicator can assist programs in tracking any efforts to improve the mental health of those living with and affected by the virus, help them to develop coping strategies, improve their adherence to treatment, build resilience among children and guardians, and prevent further HIV transmission. World Health Organization guidelines include psychosocial support as an essential component of HIV care and management.

Numerator

Number of adults and children living with or affected by HIV who have been provided with spiritual or psychosocial support services during the reporting period

Note: number of households is alternative language for this indicator, especially for vulnerable children programs, but tracking the number of individuals is recommended because each household member will require individual care planning based on individual-level needs for case management.

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

Community workers can ask project beneficiaries whether they have participated in or are receiving psychosocial or spiritual support services during the reporting period, regardless of source, to determine whether they should be counted towards this indicator. Psychosocial support provided by community workers themselves, or by community-based organizations, can be tracked directly by the community worker.

Psychosocial or spiritual support services can include participation in self-help groups; peer counseling related to fears, hopes, meaning, and guilt; succession planning; and preparing for and coping with the process of dying. Counseling on HIV care and treatment adherence (ART pickup clubs and support groups) should also be included when counting individuals for this indicator.

Community workers can be trained to develop competency to provide psychosocial support and positive parenting at the household level and during outreach activities, as well as to targeted groups, but should receive sensitivity training on how to interact with and protect people living with, vulnerable to, or affected by HIV. They can be trained on how to recognize signs of distress and use supportive listening techniques, provide education about stress reduction, and make a referral to a specialist as needed, if a specialist is available. A training curriculum for health providers and community workers should be mandated at the national level. Counseling should be provided to caregivers and their children to prevent separation of children from families suffering from the vulnerabilities caused by HIV. This counseling should cover parenting skills and best practices for childcare. 

Beneficiaries should not be included in counseling if they are not old enough to understand counseling messages or if messaging conflicts with what is approved by their caregiver; counseling should be age appropriate and should only be provided following consent of the caregiver. Counseling should also be tailored to the individual’s target population, and messaging should account for that population’s vulnerabilities.

Data source

These data are often tracked using quarterly report forms, community-level care-and-support-service forms, beneficiary support forms, monthly registration forms, adult counseling session forms, behavior-change communication activity forms, and vulnerable children monthly registration forms.

Disaggregation

  • Age (5–9 years, 10–14 years, and 15–17 years for children; 18–24 years, 25–49 years, and 50+ years for adults)
  • Sex
  • Pregnancy/lactation status
  • Key population type (sex workers, men who have sex with men, people who inject drugs, transgender people)
  • Service delivery modality

Data quality considerations

This indicator does not track the quality or the intensity of the psychosocial support provided. It is essential for community workers and community-based organizations providing support to be adequately trained in line with national guidance if deployed by programs to provide this type of support. Supportive supervision and coaching of community workers should ensure that they are providing quality and appropriate counseling. This indicator includes individuals who have received one counseling session as well as those who received numerous sessions throughout the reporting period. Programs may consider also tracking individual participation rates in counseling, to ensure that beneficiaries are provided with comprehensive psychosocial support.

Reporting frequency

Community workers should collect this information regularly, but they should monitor progress monthly with support from their supervisors. The indicator should be reported on a quarterly basis.

Data element

HIV-related psychosocial support

Category

Vulnerable Children, Key Populations, Home-Based Care, HIV Prevention 

References

World Health Organization. (2006). Psychosocial support. Retrieved from http://www.who.int/hiv/topics/psychosocial/support/en/

The Global Fund. (2017). HIV indicators. Retrieved from https://www.theglobalfund.org/en/monitoring-evaluation/framework/

MEASURE Evaluation (2016). Community-Based Information Systems in the Global Context: A review of the literature. Retrieved from https://www.measureevaluation.org/resources/publications/wp-16-161

Sarfo, B., Vanderpuye, N. A., Addison, A., & Nyasulu, P. (2017). HIV case management support service is associated with improved CD4 counts of patients receiving care at the antiretroviral clinic of Pantang Hospital, Ghana. AIDS Research and Treatment, 4697473. http://doi.org/10.1155/2017/4697473

Han, H., Kim, K., Murphy, J., Cudjoe, J., Wilson, P., Sharps, P., & Farley, J. (2018). Community health worker interventions to promote psychosocial outcomes among people living with HIV—A systematic review. PLoS ONE 13(4):e0194928. https://doi.org/10.1371/journal.pone.0194928

Walker, P., McGrath, M., & Schafer, A. (n.d.). CHWs and mental health: Equipping community health workers with essential skills for addressing mental health and violence in the home. CHWCentral. Retrieved from http://www.chwcentral.org/blog/chws-and-mental-health-equipping-community-health-workers-essential-skills-addressing-mental

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