title: Spirituality, social capital and service: factors promoting resilience among Expert Patients living with HIV in Ethiopia.
abstract: People living with HIV (PLHIV) in Ethiopia and other developing nations face numerous challenges to their health and well-being, including poverty, limited healthcare infrastructure and high levels of societal stigma. Despite these challenges, resilient trajectories have been observed even within such resource-limited settings. In Ethiopia, such resilience is exemplified by the 'Expert Patients (EPTs)', HIV-positive lay health workers who function as adherence counsellors, health educators, outreach workers and community advocates. We conducted a multi-method qualitative study with 20 EPTs in Addis Ababa, Ethiopia in order to understand pathways to resilience in this selected population. Participants described three key mechanisms of resilient coping: (1) the use of spirituality and faith-based practices to manage psychological difficulties associated with living with HIV; (2) utilisation of social capital from family and community networks as a buffer against the psychological and economic consequences of societal stigma; and (3) serving others as a mechanism for finding optimism and purpose in life. Interventions designed to facilitate and/or augment these social processes in the wider community may be promising strategies for improving health among PLHIV in Ethiopia and other resource-limited settings.
authors: a Hubert Department of Global Health , Rollins School of Public Health of Emory University , Atlanta , GA , USA.
authors: Sophia Ahmed
authors: SA
authors: Hussen
authors: Mulugeta
authors: M
authors: Tsegaye
authors: Meron Gurji
authors: MG
authors: Argaw
authors: Karen
authors: K
authors: Andes
authors: Danielle
authors: D
authors: Gilliard
authors: Carlos
authors: C
authors: del Rio
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000458:organization & administration / Q000523:psychology*; D005002:Ethiopia; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods / Q000458:organization & administration; D010781:Photography; D036301:Qualitative Research; D055500:Resilience, Psychological; D057545:Social Stigma; D012944:Social Support; D029181:Spirituality; D000078329:Workforce