Background: Peer advocates, community-based educators, and prevention and treatment outreach workers are essential participants in the delivery of HIV interventions in the US and elsewhere. Numerous studies have described the critical elements of these workers' effectiveness: appropriate service delivery training; linguistic, cultural, and socio-economic congruency with client populations; geographic proximity; and shared histories of risk behaviors. These characteristics also frequently comprise employment requirements for many community workers. However, the proximity to prior or ongoing risk engendered by their work environments present personal and professional challenges for community health workers; these have yet to be adequately described in public health or work force literature. Methods: An administrative review of publicly contracted HIV service programs in the state of Massachusetts (USA) was conducted to assess worker-related concerns. Results: The administrative review revealed an array of previously unacknowledged risks and dilemmas experienced by community health workers in their HIV service delivery. These included substance abuse relapse, drug trade involvement, and renewed participation in risky sexual activity. Besides health and personal welfare risks, workers also faced employment problems with resulting job actions, including dismissal. Lessons Learned: Indigenous community health workers are doubly compromised in their workforce obligations. Their identities and histories of risk, requirements for their very employment, simultaneously enhance the likelihood of new or renewed health risks and put their ongoing employment in jeopardy. Public health agencies must undertake active worker education, support, and intervention services to minimize the vulnerability of these critical workforce participants. Additional support and training must be provided to community agency administrators.
Learning Objectives: Participants will be able to: identify the characteristics of effective community health workers; identify work hazards that these workers face; enumerate alternative remediation of the risks of community health workers
Keywords: Community Health Advisor, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.