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.

Keywords:

• Ethiopia
• peer educators
• HIV/AIDS
• resilience
• social capital

Acknowledgements

We would like to first thank the 20 brave and exceptional individuals who work as EPTs at ALERT for their enthusiastic and thoughtful participation in this study. We would next like to thank our two interviewers, Ms Helen Asres and Mr Bizuneh Alemu, for conducting thorough and thought-provoking interviews with all of our participants. We would also like to acknowledge the high quality transcription and translation work of Mr Alemu Hailu and his colleagues at KAB Center for Data Collection and Analysis.

Funding

This work was supported by NIH/FIC ‘Emory-Ethiopia Global Interdisciplinary Partnership’ [grant #1R24TW008825].

Notes

1. In the interest of protecting participant confidentiality, all names used here are pseudonyms.

Additional information

Funding

Funding: This work was supported by NIH/FIC ‘Emory-Ethiopia Global Interdisciplinary Partnership’ [grant #1R24TW008825].