ArticlePLOS global public health2024
Piloting Siyakhana: A community health worker training to reduce substance use and depression stigma in South African HIV and TB care.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa.Journal of substance use and addiction treatment · 2025Trial
- Cytopenias With HIV in the Era of Highly Active Antiretroviral Therapy: Are We Winning the Battle?Health science reports · 2026Article
- "They Call Us Amaphara (Junkies)": Intersectional Tuberculosis, Alcohol, and Drug Stigma in South Africa.Stigma and health · 2025Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Addiction science & clinical practice · 2025Article
- Community-engaged clinical governance and machine learning for optimizing tuberculosis management in rural Eastern Cape.Frontiers in public health · 2025Article
- The feasibility of respondent-driven sampling with people who use drugs in rural Western Cape, South Africa: A qualitative study.PLOS global public health · 2025Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Research square · 2024Article
- Community health worker training to reduce mental health and substance use stigma towards patients who have disengaged from HIV/TB care in South Africa: protocol for a stepped wedge hybrid type II pilot implementation trial.Implementation science communications · 2024Article
- "Global mental health (Cambridge, England) · 2024Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
South Africa has one of the highest rates of HIV/tuberculosis (TB) co-infection, and poor engagement in HIV/TB care contributes to morbidity and mortality. In South Africa, community health workers (CHWs) are tasked with re-engaging patients who have dropped out of HIV/TB care. CHWs have described substantial challenges with substance use (SU) and depression among their patients, while patients have described CHW stigma towards SU and depression as barriers to re-engagement in care. Yet, CHWs receive little-to-no training on SU or depression. Therefore, we piloted Siyakhana, a brief CHW training to reduce stigma related to SU and depression while improving skills for re-engaging these patients in HIV and/or TB care. This study evaluated the preliminary effectiveness (stigma towards SU and depression; clinical competence assessed via roleplay) and implementation (quantitative ratings of feasibility, acceptability, appropriateness, adoption; semi-structured written qualitative feedback) of Siyakhana among CHWs and supervisors (N = 17) at pre- and post-training assessments. SU stigma significantly decreased (F(1,16) = 18.94, p < 0.001, ηp2 = 0.54). Depression stigma was lower than SU stigma at both timepoints and did not significantly decrease after training. CHW clinical competency towards patients with SU/depression significantly improved (t(11) = -3.35, p = 0.007, d = 1.00). The training was rated as feasible, acceptable, appropriate, and likely to be adopted by CHWs and their supervisors. Nonjudgmental communication was commonly described as the most useful training component. Based on this pilot, the training is being refined and evaluated in a larger randomized stepped-wedge clinical trial.
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Registered trials
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