Water and Sanitation Management Considerations for HIV Programs

Background: People living with HIV/AIDS (PLWHA) need access to safe drinking water to swallow their medications and to prevent water borne diseases that weaken their immune system. Identifying effective water management and sanitation options to integrate into HIV/AIDS programs is challenging. Hygiene Improvement Project partnered with home-based care (HBC) programs in Ethiopia to design and execute rapid research to identify safe water, sanitation and hygiene behaviors that PLWHA and households could implement. This presentation describes the adapted Trials of Improved Practices methods, findings, and implications for HIV/AIDS programs and demonstrates how this research framework can be adapted and used in program implementation.

Methods: Over seven weeks, researchers made four visits to each of 62 PLWHA households in urban/rural Ethiopia to understand better water management and sanitation practices and contexts, negotiate options for improving these practices, and follow-up with participants to identify constraints and motivations for adopting these options. Men and women from 19 to 71 years participated. Each behavior was coded to analyze the qualitative information gathered.

Results and conclusions: The research results identified simple water treatment and storage practices and hand washing and sanitation behaviors that were both effective and feasible for PLWHA households. Ethiopian HBC workers in Amhara and Oromia regions were trained in these “small doable actions” and are training PLWHA households to implement each set of actions. The research framework and tools for addressing information/ programming gaps during program implementation will be shared.