Exploring the Effectiveness of HIV-Positive Community Health Workers
UNAIDS estimates that more than 76 million people around the world have been infected with HIV. Numbers reported by the World Health Organization at the end of 2016 indicate there are about 36.7 million people living with HIV, and 1.2 million of them live in the U.S. as reported by the Centers for Disease Control and Prevention (CDC).
“More people are living with HIV because of the new treatments available for those who can tolerate the medicine,” says Richard Jiménez, DrPH, a faculty member in Walden’s Master of Public Health (MPH) and PhD in Public Health programs with more than 30 years of experience working in HIV prevention and education. “While overall the prevalence of HIV infection has stabilized over the last few years, incidence has increased in U.S. populations like African Americans and Latinos and young people who may not have access to HIV education. That’s why there is a great need for community health workers to help educate these at-risk populations.”
Dr. Jiménez is a member of Walden University’s Center for Social Change inaugural class of Social Change Fellows along with Dr. Faith Foreman, contributing faculty member in the School of Health Sciences, and Dr. Phronie Jackson, a PhD in Public Health graduate. Together, they are conducting a study that examines the experiences of HIV-positive community health workers who serve HIV-positive clients in the Washington, DC, area. Their study, Wounded Healers: HIV + Community Health Workers as Agents of Social Change, aims to understand why HIV-positive health workers choose to work with HIV-positive people.
“Psychologist Carl Jung developed the ‘wounded healer’ theory, positing that many psychotherapists enter the profession because they themselves have experienced psychological trauma and this experience makes them more effective therapists because they themselves have walked the walk. Caregiving as a wounded healer is also a therapeutic experience for the therapist,” he explains. “Wounded healer theory has been studied and applied extensively in the nursing profession, especially among oncology nurses. Many nurses who are cancer survivors—wounded healers—are drawn to oncology nursing because they believe they can be more effective caregivers because they, too, have walked the walk that their patients are walking.”
Dr. Jiménez and team aim to apply this general theory to HIV-positive community health workers. Community health workers populate a rapidly growing sector of the healthcare workforce. They are used in a variety of health settings and other professions and are often respected and recognized as leaders in the community where they live. As such, they are well positioned to deliver important health education and disease prevention messages. However, there is no standard system for training.
Data collection for the study is based in Washington, DC, because of Dr. Jackson’s credibility and reputation as a community HIV prevention worker and his access to the study population. The fellows are currently recruiting and gathering data for their qualitative study, in which they hope to interview 15 community health workers about their experiences. “We want to learn their process for making the decision to become a community health worker serving those who are HIV positive, and what they see are the advantages to them and to their clients. We think there is a synergistic relationship where not only are community health workers providing a service and mentorship but they, too, benefit from the experience and process. Once we know, then we can develop a curriculum to create training programs that produce a better public health workforce,” says Dr. Jiménez.
Dr. Jiménez and Dr. Jackson have worked together before, when he was on her dissertation committee: “We formed a great partnership, which is why it’s been very easy to translate the doctoral committee experience into a post-graduate research opportunity wherein we are learning together. This fellowship program is also an excellent way for Walden to support research activity among the faculty and continue to develop researchers that will make us better educators.”
His advice for future Social Change Fellow applicants is to follow your instinct on what interests you and what you really want to explore. “Look at the potential positive social change impact of not only the research but also the potential student–faculty partnership and the good work that can come of it.”