Int
ern
at
i
onal
Journ
al of
P
u
bli
c Hea
lt
h S
c
ie
nce (IJPH
S)
Vo
l.
6
,
No.
3
,
S
eptem
ber
201
7
, pp.
25
1
~
25
6
IS
S
N:
22
52
-
8806,
DOI: 10
.11
591/
ij
phs
.
v6
i
3.
9
292
251
Journ
al h
om
e
page
:
https:
//
ww
w.i
aesco
re
.c
om
/j
our
nals/
ind
ex.
php/IJP
H
S
Developi
ng Prim
ary Liais
on Psych
iatr
i
c Se
rv
i
ces fo
r HIV/
AIDS
Patients
in Com
mu
nity
Ah
s
an
Ahsan
,
Re
tn
o L
est
ari
Depa
rt
m
ent
o
f
N
ursing
,
Unive
rsit
y
of
Brawi
jay
a
,
I
ndonesia
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
J
un
10, 2
017
Re
vised A
ug 12, 2
017
Accepte
d Aug
27, 201
7
In
Indone
sia,
th
e
num
ber
of
HI
V/AID
S
pat
ie
nt
s
has
grown
at
signifi
ca
n
t
le
ve
l.
HIV
ca
n
be
a
source
of
m
aj
or
stress
wh
ic
h
c
an
lead
to
cha
nges
i
n
m
ent
al
he
al
th
,
such
as
per
sisten
t
sadne
ss
,
feeli
n
g
empt
y
and
an
xie
t
y
.
Th
e
abi
lit
y
of
liaison
officer
cou
ld
h
e
lp
patien
ts
red
uc
e
th
ei
r
ps
y
ch
ia
tr
i
c
probl
ems
and
at
th
e
sam
e
ti
m
e
it
ca
n
gre
at
l
y
aff
ect
patie
nts'
risks
for
trans
m
ission
of
HIV
to
othe
rs
.
T
his
stud
y
a
imed
to
an
aly
z
e
the
e
f
fec
t
of
d
eve
lop
i
ng
primar
y
l
ia
ison
ps
y
chiatr
ic
s
erv
ices
for
HIV
/AIDS
pat
ients
on
the
abi
liti
es
of
hea
lt
h
ca
re
workers
to
provide
tr
ea
tm
ent
s.
Th
is
stud
y
used
a
quasi
e
xper
imental
design
with
on
e
group
pre
t
est
-
po
stte
st
which
incl
uded
64
he
al
th
c
a
re
workers
age
d
bet
we
en
20
and
50
y
e
ars
from
the
Co
m
m
u
nity
-
Int
egr
ated
Hea
lt
h
Car
e
in
Ea
st
J
ava
.
Th
e
inclusion
cr
it
er
ia
wer
e
nurses
a
nd
ph
y
si
ci
an
in
Com
m
unit
y
-
Inte
gra
te
d
H
ea
l
t
h
Care
.
The
resp
ondent
s
were
as
sess
ed
using
the
Abili
ties
of
Hea
lt
h
Ca
re
W
orke
rs
Chec
kli
st
pre
-
tr
eatm
ent
and
post
-
treatment
.
Th
e
outc
om
es
were
ana
l
y
z
ed
using
t
he
W
il
coxon
sig
ned
ran
k
t
est.
T
her
e
was
a
signifi
c
ant
in
creased
in
th
e
abilit
i
es
of
health
ca
re
work
ers
to
provid
e
ps
y
chiatr
ic
servi
ce
s
aft
er
tr
eatm
ent
(p<
0.
05).
Th
e
li
ai
son
ps
y
ch
ia
t
ric
services
were
conside
r
ed
to
be
eff
ec
t
ive
in
inc
rea
sing
t
he
abi
liti
es
of
hea
l
th
ca
re
workers i
n
impr
oving
th
e
tr
eatm
ent
of
HIV
/AIDS
.
Ke
yw
or
d:
Com
m
un
it
y
HIV/A
IDS
Lia
ison
Psychia
tric
servic
es
Copyright
©
201
7
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Ah
sa
n,
Dep
a
rtm
ent o
f
Nursin
g
,
Un
i
ver
sit
y o
f B
raw
ijaya
,
Jl. V
et
era
n
-
Ma
la
ng
,
Ja
wa
Tim
ur,
I
ndonesi
a
,
65145
.
Em
a
il
:
ahsan
@
ya
hoo.
c
o.
id
1.
INTROD
U
CTION
In
I
ndonesi
a,
t
he
num
ber
of
Hu
m
an
Im
m
u
node
fici
ency
Vir
us
(
HIV
)
/
A
cqu
i
red
Im
m
un
e
De
fici
ency
Syndro
m
e
(
AIDS
)
patie
nts
ha
s
grown
at
sign
i
ficant
le
vel.
It
is
est
i
m
at
ed
that
aro
un
d
690,0
00
patie
nt
s
li
vin
g
with
H
IV
/
AID
S.
Lo
w
treat
m
ent,
la
ck
of
ac
cur
at
e
healt
h
knowle
dge
ab
ou
t
H
I
V/AIDS
and
the
at
ti
tu
de
of
so
ci
et
y t
o unde
rstan
d
thei
r pro
blem
s ar
e the
m
ai
n
reasons
for t
he
s
pread
of HI
V
in
In
done
sia
[
1].
HIV
ca
n
be
a
source
of
m
ajor
st
ress
w
hi
ch
can
le
ad
to
c
hanges
in
m
ental
healt
h.
Em
otion
al
pro
blem
s
are
the
m
os
t
com
m
on
m
ental
disorde
rs
am
ong
H
IV
patie
nts,
s
uc
h
as
de
pr
e
ssio
n,
pe
rsiste
nt
sa
dn
e
ss,
feeli
ng
em
pty
and
a
nxie
t
y.
The
pre
valence o
f
de
pr
essi
on
a
re
do
ub
le
d
am
ong
HIV
patie
nts
tha
n
ot
her
s
exu
al
ly
trasm
it
ther
disease.
Pr
e
vious
stud
ie
s
al
so
e
xp
l
or
e
d
that
H
IV
af
fects
co
gnit
ive
functi
on
s
and
oth
e
r
m
ental
disorde
rs
s
uc
h as psyc
ho
sis
. T
hey s
how
m
or
e
f
eel
in
gs
of an
ger,
gu
il
t an
d h
ave m
or
e s
uicidal
th
oughts [
2
]
,
[
3].
Ther
e
hav
e
be
en
e
xpla
natio
ns
ab
out
the
li
nk
be
twee
n
H
IV
an
d
m
ental
il
lness.
C
omm
on
facto
rs
wh
ic
h
ca
n
be
fou
nd
are
soc
ia
l
pr
e
disposi
ti
on
f
act
ors
s
uc
h
as
so
ci
al
s
ti
g
m
a,
ho
m
el
e
ssn
ess
,
pover
t
y
and
su
bst
ance
m
isuse
[4
]
.
So
ci
a
l
sti
gm
a
is
still
the
m
a
in
re
aso
n
w
hy
HIV
patie
nts
are
afr
ai
d
to
see
healt
h
prof
e
ssio
nals
t
o
see
k
t
reatm
e
nt.
St
ud
ie
s
s
howed
that
HIV/
AIDS
sti
ll
thriv
e
in
our
c
ultu
res
beca
us
e
pe
op
le
fail
to g
et
help
[5].
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
6
, No
.
3
,
Septem
ber
20
1
7
:
25
1
–
25
6
252
The
abili
ty
of
li
ai
so
n
officer
in
pr
im
ary
care
cou
l
d
hel
p
pa
ti
ents
reduce
their
ps
yc
hiatri
c
prob
le
m
s
and
at
the
sam
e
tim
e
can
gr
eat
ly
aff
ect
patien
ts'
risks
fo
r
t
ran
sm
issi
on
of
HI
V
to
oth
er
s
.
In
ge
ne
ral,
pa
ti
ents
consult
to
heal
th
care
w
orke
r
s
in
pr
im
ary
care
pla
nned
to
e
xp
la
in
their
fe
el
ing
s.
H
ow
e
ve
r,
c
omm
on
ly
healt
h
care
w
orkers
f
ocus
pr
im
aril
y
on
the
ph
ysi
c
al
sy
m
pto
m
s
a
nd
patie
nts
m
a
y
exp
res
s
their
distress
in
dire
ct
ly
.
It
happe
ned
a
s
pa
ti
ents
hav
e
di
ff
ic
ulti
es
to
e
xpress
directl
y.
Ther
e
f
or
e,
buil
ding
a
go
od
re
la
ti
on
sh
i
p
bet
ween
healt
h prof
e
ssion
al
s
and
patie
nts is
ver
y i
m
po
rta
nt [6].
Lia
ison
ps
yc
hi
at
ry
serv
ic
es
in
pr
im
ary
care
br
id
ge
the
ga
p
betwee
n
m
e
ntal
and
physi
cal
healt
h.
It
was
dev
el
op
e
d
to
pro
vid
e
a
r
ang
e
of
patie
nt
care,
s
uc
h
as
assessm
ents,
evaluati
on,
outp
at
ie
nt
con
s
ultat
ion
s
et
c.
The
b
e
ne
fit
of
de
vel
opin
g
li
ai
son
ps
yc
hiatri
c
se
rv
ic
es
is
a
c
ollaborat
ive
e
ffor
t
betwee
n
healt
h
prof
e
ssio
nals,
patie
nts
an
d
al
l
syst
e
m
to
wo
rk
to
gethe
r
to
su
pp
or
t
m
ental
healt
h
co
nd
it
ion
am
on
g
HIV
/AIDS
patie
nts [7].
Coll
aborati
ve
pro
gr
am
facil
i
t
at
es
m
ental
he
al
th
interve
ntion
to
patie
nts
by
m
anag
in
g
HIV
cases
i
n
colla
borati
on
with
healt
h
pro
fessio
nals
(
ph
ysi
ci
ans
a
nd
nur
ses)
,
an
d
pro
ve
d
to
be
ef
fecti
ve
f
or
the
m
anag
em
ent
of
m
ental
health
issue
s
in
pr
i
m
ary
care
[
8].
In
a
ddit
ion
,
pri
m
ary
l
ia
ison
ps
yc
hiatri
c
se
r
vic
es
reduce
d
m
ental
il
lness
up
to
3
m
on
ths,
as
well
as
inc
reas
ing
sat
is
facti
on
a
nd
ad
heren
ce
to
m
edicat
i
on
up
t
o
12 m
on
ths,
p
a
r
ti
cularly
a
m
ong depresse
d pa
ti
ents [
9].
Ther
e
f
or
e,
t
his
stud
y
ai
m
ed
to
analy
ze
the
eff
ect
of
de
velop
i
ng
pri
m
ary
li
ai
so
n
psy
chia
tric
serv
ic
es
for
HIV/A
ID
S
patie
nts
on
t
he
abili
ti
es
of
hea
lt
h
care
wor
kers
to
prov
i
de
tre
atm
ents,
both
ph
ysi
cal
a
nd
m
ental
healt
h
c
onditi
on
.
2.
RESEA
R
CH MET
HO
D
The
c
oncept
ua
l
fr
am
ewo
r
k
of
this
st
ud
y
ex
pl
ai
ned
in
detai
ls
in
Fig
ur
e
1.
Li
ai
so
n
ps
yc
hiatr
ic
ser
vices
wh
ic
h
base
d
in
pri
m
ary
care
prov
i
ded
c
onsu
lt
at
io
n,
ed
uc
at
ion
,
s
up
e
rv
i
sion,
suppo
rt
and
researc
h.
Durin
g
consulta
ti
on
se
ssion,
healt
h
c
are
w
orke
rs
de
li
ver
ed
m
ental
healt
h
inter
ve
nt
ion
as
w
el
l
as
ph
ysi
cal
healt
h
[
9].
Lia
ison
se
rv
ic
es
us
e
d
a
colla
borati
ve
ca
re,
wh
e
re
by
al
l
healt
h
prof
e
ssio
na
ls
work
t
og
et
her
with
nurse
s
an
d
do
ct
or
s
to disc
us
se
d HIV cas
es.
Figure
1. The
c
on
ce
ptu
al
fram
ewor
k
of
li
ai
son
ps
yc
hiatri
c s
erv
ic
es i
n pr
im
ary care
This
pilot
stu
dy
us
ed
a
quasi
exp
e
rim
ental
desig
n
with
one
gro
up
pr
et
e
st
-
postt
est
to
analy
ze
the
eff
ect
of
dev
el
op
i
ng
pri
m
ary
li
ai
so
n
ps
yc
hia
tric
serv
ic
es
for
H
IV
/
AIDS
pa
ti
ents
on
t
he
a
bili
ti
es
of
healt
h
care
workers
t
o
pro
vid
e
treat
m
ents
am
on
g
64
he
al
th
care
w
ork
ers
in
a
C
ommun
it
y
-
I
nteg
rate
d
Healt
h
Ca
re
in
E
ast
Java
.
T
o
m
ini
m
iz
e
the
co
nfoun
ding
facto
r
s,
the
re
searc
he
rs
restrict
ed
r
esp
onde
nts
int
o
se
ve
ral
incl
us
io
n
crit
eria
:
[1
]
nurses
a
nd
physi
ci
an
in
C
omm
un
it
y
-
I
nteg
rate
d
Healt
h
Ca
re
,
[2
]
ha
ve
ne
ve
r
ha
d
t
he
pro
gram
of
li
ai
so
n
psy
chia
tric
serv
ic
es
,
[
3]
will
ing
a
nd
able
to
par
ti
ci
pate
in
al
l
ses
sion
s
a
nd
[
4]
m
ini
m
u
m
of
3
ye
ars
exp
e
rience
of
handlin
g HIV
patie
nts
.
Pu
r
posive
sam
pling
us
e
d
for
recr
uiti
ng
res
pondents
w
hich
c
on
sist
s
of
6
physi
ci
ans
an
d
58
nurs
e
s
from
three
c
om
m
un
it
y
-
integrated
healt
h
c
enter
(
P
uskes
m
a
s
)
in
E
ast
Java
.
T
he
r
es
earche
rs
a
sk
e
d
healt
h
Lia
ison
ps
yc
hiatri
c
serv
ic
es
co
m
m
un
it
y
base
d
Con
s
ultat
ion
Ed
ucati
on
Super
visio
n
Suppor
t
Re
search
Cl
inic
Orga
nizat
ion
Syst
e
m
Pr
ofessi
on
al
Ph
ysi
cal
h
eal
th
Me
ntal healt
h
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N:
22
52
-
8806
Develo
ping Pri
ma
ry
Liais
on
Psychiatri
c
Ser
vi
ces for
HI
V/
AIDS P
atients
in Co
mmu
nity
(
Ahsan)
253
prof
e
ssio
nals
wh
et
her
they
agr
ee
d
to
par
ti
ci
pate
in
the
stud
y.
Co
ns
e
nt
was
sig
ned
by
healt
h
pro
fess
ion
al
s
after
eac
h res
ponde
nts
had ex
planati
ons a
bo
ut
the
stu
dy
pu
rpose.
Con
se
nt
was
sign
e
d
after
e
ach
par
ti
ci
pa
nt
had
ex
plana
ti
on
s
ab
ou
t
th
e
stud
y
pur
pose
.
Ethic
al
appr
ov
al
was
gaine
d
f
r
om
t
he
Healt
h
Re
s
earch
Ethic
s
Com
m
un
it
y,
Faculty
of
Publ
ic
Healt
h
Airlangga
Un
i
ver
sit
y,
A
pri
l
201
6
(No:
153
-
KPK
)
.
Wri
tt
en
app
r
oval
from
the
sit
e
was
al
so
obta
i
ned
.
The
respo
nd
e
nts
wer
e
assesse
d
us
in
g
i
ns
tr
um
ent
the
A
bili
ti
es
of
Healt
h
Ca
re
Worker
s
Chec
klist
pre
-
treat
m
ent
and
po
st
-
treatm
ent
.
Scal
e
us
e
d
i
n
the
r
esearch
wa
s
th
e
co
nf
i
den
ce
s
cal
e
that
the
re
li
abili
ty
coef
fici
ent
al
pha
(α
)
=
0.
9
so
it
ca
n be sai
d
that t
he
it
em
is q
uite
valid a
nd r
el
ia
ble.
Data
wer
e
coll
ect
ed
betwee
n
Novem
ber
2016
-
Ma
rch,
201
7.
This
pro
gr
am
was
held
in
com
m
un
it
y
-
integrate
d
heal
th
center
(
Pu
s
kesm
as)
wh
ic
h
was
locat
ed
in
East
Java.
T
her
e
wer
e
f
our
session
s
of
tr
ai
ni
ng
wh
ic
h was sc
he
du
le
d
twic
e
in
a m
on
th
,
a
s e
xpla
ined
b
el
ow:
a.
First
sessio
n
:
Assessi
ng
m
ental
healt
h
probl
e
m
s
a
m
on
g
HIV
patie
nts.
In
t
his
sessi
on
,
the
res
ponde
nts
wer
e
trai
ned
t
o
identify
both
ph
ysi
cal
an
d
m
ental
healt
h
iss
ues
that
c
ommon
ly
ha
ppene
d
as
co
ns
eq
ue
nc
es
of
diag
nose
d
with
H
I
V.
Als
o,
th
ey
ha
d
op
portu
niti
es
to
express
a
ny
di
ff
ic
ulti
es
relat
e
d
to
m
ental
he
al
th
assessm
ent.
b.
Seco
nd
sessio
n:
Ca
rin
g
f
or
HIV
patie
nts.
In
t
his
sessi
on,
res
ponde
nts
wer
e
t
raine
d
t
o
ca
re
f
or
H
I
V
patie
nts, w
hich
inclu
des p
hysic
al
an
d m
ental
h
eal
th ca
re
c.
Thi
r
d
sessio
n:
Pr
ovidi
ng
se
ver
al
rela
xatio
n
thera
pies
du
rin
g
co
ns
ultat
ion.
I
n
this
session,
there
w
ere
sever
al
ps
yc
hoso
ci
al
inter
ve
ntion
s
to red
uce
m
ental
h
eal
th i
ssu
es i
n HIV
pa
ti
ents.
d.
Four
t
h
sessio
n:
Pati
ent
and
fa
m
ilies
m
anag
e
m
ent.
In
this
session,
res
pond
e
nts
pract
ic
ed
to
exp
l
or
e
the
bur
den of treat
m
ent in HI
V p
at
ie
nts.
Durin
g
the
pr
ogram
of
li
ai
s
on
ps
yc
hiatri
c
serv
ic
es,
bo
t
h
ph
ysi
ci
an
a
nd
nurses
w
orke
d
toge
ther
t
o
colla
borate
in
the
treatm
ent.
All
healt
h
care
wo
r
ke
rs
ha
ve
exp
e
rience
d
in
handling
HIV
patie
nts
before
and
kn
e
w
ab
out
the
cha
racteri
sti
cs
patie
nts.
Ther
e
f
or
e,
m
at
ching
t
his
process
co
uld
i
ncr
ease
t
he
pro
gr
am
ou
tc
om
es.
Col
la
borati
ve
scr
eenin
g
in
a
te
a
m
can
fu
rth
er
increase
th
e
ou
tc
om
es
of
HIV
inter
ve
ntion.
Coll
aborati
ve
work
i
ng
requir
es
healt
h
pro
fe
ssion
al
s
to
s
up
port
i
m
pr
ovem
ents
in
both
th
e
m
ental
and
physi
cal
healt
h
of
t
he
people
they
w
ork
with
[
10]
.
To
e
nhance
the
delive
ry
of
healt
h
care
,
a
m
ult
idisci
plinary
com
m
un
it
y t
ea
m
has
to d
e
vel
op the
pro
gr
am
of
li
ai
so
n p
syc
hiatri
c ser
vices
in prim
ary ca
r
e.
In
data
analy
sis,
m
ean
and
sta
nd
a
rd
de
viati
on
wa
s
ob
ta
i
ned
us
in
g
SP
SS
ve
rsion
20
.
W
il
co
xo
n
Sign
e
d
Ra
nks
Test
was
us
e
d
to
fi
nd
if
a
ny
sig
nifica
nt
diff
e
re
nce
of
the
a
bili
ti
es
of
healt
h
pr
of
es
sion
al
s
betwee
n
the
pr
e an
d post
trai
ni
ng
sco
re.
3.
RESU
LT
S
3.1.
Charac
teristic
s of resp
onde
nt
s
The
Ta
ble
1
is
based
on
the
a
ge
of
the
res
pond
e
nts.
T
he
m
ajorit
y
of
res
ponde
nts
wer
e
a
ged
ov
e
r
30
ye
ars
as
m
any
as
35
(54.7%
)
people.
Ba
sed
on
age
,
fem
al
e
res
pondents
a
s
m
any
as
49
(
76.6%)
pe
op
le
,
w
hile
a
m
ino
rity
of
r
esp
onde
nts
w
e
re
m
al
e
as
m
an
y
as
15
(
23.4%
)
people.
As
m
any
as
60.
9%
r
esp
onde
nts
re
porte
d
le
ng
th
of
w
ork was m
or
e tha
n 5 years
.
Table
1
. C
har
a
ct
erist
ic
s o
f
Re
sp
on
de
nts
Ch
arac
teristics
n
%
Ag
e (
y
ears
)
20
-
30
29
4
5
.3
31
-
50
35
5
4
.7
Gen
d
er
Fe
m
ale
49
7
6
.6
Male
15
2
3
.4
Leng
th
of
work
< 5 y
e
ars
25
3
9
.1
> 5 y
e
ars
39
6
0
.9
Total
64
100
3.2.
Bi
va
ri
ate
analysis
The
stu
dy
ai
m
ed
t
o
a
naly
ze
the
e
ff
ect
of
pr
i
m
ary
li
ai
so
n
psy
chiat
ric
ser
vi
ces
f
or
H
I
V/AIDS
patie
nts
on
t
he
a
bili
ti
es
of
healt
h
ca
re
wor
ker
s
t
o
pr
ov
i
de
treat
m
ents.
The
i
ns
tr
um
ent
was
sc
ored
by
t
he
rese
arch
e
rs.
The
res
ults
of
the
pre
a
nd
post
trai
ning
of
pri
m
ary
li
a
ison
ps
yc
hiatri
c
s
e
r
vices
f
or
HIV/AIDS
patie
nts
on
t
he
abili
ti
es o
f hea
lt
h
care
w
orkers t
o pro
vid
e t
re
atm
ents sco
res
are s
how
n
in
T
able 2.
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
6
, No
.
3
,
Septem
ber
20
1
7
:
25
1
–
25
6
254
Table
2
. Pret
es
t and P
os
tt
est
S
cor
es
of t
he Abi
li
t
ie
s o
f Heal
t
h
Ca
re
Work
e
r
s
The abi
lities o
f
health
car
e
work
ers
n
Mean ±
SD
Co
g
n
itiv
e abilities
64
Pretest
6
2
.56
±6
.8
4
2
Po
sttes
t
7
6
.25
±4
.7
3
0
Af
f
ectiv
e abilities
Pretest
6
3
.86
±4
.1
7
3
Po
sttes
t
7
8
.64
±4
.5
9
1
Psycho
m
o
to
r
ab
ilit
ies
Pretest
5
9
.59
±5
.2
9
8
Po
sttes
t
7
6
.12
±4
.6
8
5
W
il
c
oxon
Si
gned
Ra
nks
Te
st
sh
owe
d
sig
nifi
cant
val
ue
of
<
0.05
(
p=0.00
0).
It
can
be
c
on
cl
ud
e
d
that
there
is
sig
nifi
cance
di
ff
e
rence
betwee
n
pre
te
st
and
postt
e
st
scor
e
afte
r
tr
ai
nin
g
of
pri
m
ary
li
ai
so
n
ps
y
chiat
ric
serv
ic
es
for H
I
V/AIDS
p
at
ie
nt
s on
the
ab
il
it
i
es of
healt
h
ca
r
e wor
kers to
pr
ov
i
de
treat
m
ents
.
4.
DISCU
SSI
ON
Pr
im
ary
care
s
erv
es
as
t
he
c
orne
rstone
t
o
bu
il
d
co
nnect
ion
betwee
n
m
ental
an
d
ph
ysi
cal
healt
h.
The
colla
borati
ve
c
are
ca
n
prov
i
de
suppo
rt
to
H
IV
patie
nts
with
c
o
-
m
or
bi
d
physi
cal
an
d
m
e
ntal
healt
h
pro
blem
s
in
pr
im
ary
care,
al
so
ef
fecti
ve
for
treat
m
ent
of
depressi
on
al
ong
with
HIV
disease
[10]
.
A
bout
60.
5%
HIV
patie
nts
ha
d
de
pr
essi
on,
21.5%
ha
d
ps
yc
hos
is
and
7.1%
AIDS
r
el
at
ed
de
m
entia
.
M
ental
healt
h
iss
ue
s
in
H
I
V
patie
nts
hav
e
a
m
ajo
r
ef
fect
on the
ad
he
ren
c
e to treatm
ent
and pr
ognosis
of the
HIV
[
11]
.
P
syc
hoso
ci
al
inter
ven
ti
on
de
li
ver
s
to
pr
ov
i
de
com
pr
ehe
nsi
ve
treat
m
ent
for
HIV/A
I
D
S
patie
nts
.
Psychosocia
l
thera
py
can
he
lp
HIV
patie
nt
s
to
acce
pt
th
ei
r
co
nd
it
io
ns
,
i
m
pr
ove
co
pin
g
m
echan
ism
s
an
d
abili
ty
to
coo
per
at
e
with
he
al
th
care
te
a
m
[12].
Diag
nos
ed
with
a
ch
r
on
ic
a
nd
sti
gm
at
iz
ing
disease
al
so
influ
e
nce
patie
nts’
psy
ch
olog
ic
al
well
-
being
.
They
nee
d
to
hav
e
a
posit
iv
e
cop
in
g
strat
e
gies,
ade
quat
e
so
ci
al
su
pp
or
ts
a
nd
pe
op
le
t
o
s
har
e
their
feeli
ng
s
[
13
]
.
I
n
this
st
udy,
healt
h
care
wor
ker
s
we
re
pr
e
pa
red
a
s
he
al
th
agen
ts
to
im
prov
e
their
ab
il
it
ie
s to pro
vid
e t
r
eatm
ents inclu
ding m
ental
h
e
al
th stat
us
.
Pr
e
vious
stu
dies
showe
d
the
eff
ect
ive
ness
of
de
velo
ping
li
ai
so
n
ps
yc
hiatr
ic
serv
ic
es
in
pri
m
ary
care
that
there
we
re
91
.
2%
of
phy
sic
ia
n
sta
te
d
posit
ive
eff
ect
s
for
pri
m
ary
care
m
anag
em
ent
wh
e
n
gi
ving
s
upport
and
58.9
%
no
t
ed
posit
ive
effe
ct
s
fo
r
patie
nt
ou
tc
om
e
s
[1
4]
.
Lia
ison
in
pri
m
ary
care
is
a
sp
eci
fic
strat
eg
y
to
pro
vid
e
m
ental
healt
h
care
t
o
H
IV
patie
nt
s
in
the
pri
m
a
ry
care
set
ti
ng
.
Lia
ison
ps
yc
hiatri
c
act
ivit
i
es
al
so
adv
a
nce
d
the
syst
e
m
in
pr
i
m
ary
care
whic
h
inclu
des
coor
din
at
io
n,
c
omm
un
ic
at
ion
and
inte
gr
at
ion
of
serv
ic
es
.
T
he
ro
le
of
the
he
al
th
care
te
am
is
i
m
po
rta
nt
f
or
t
he
i
ntegr
at
i
on
of
HIV
ca
r
e
in
the
com
m
un
it
y
thr
ough
co
ordi
nated
ca
re
inc
orp
or
at
in
g
al
l
healt
h
do
m
ai
ns
[15]
.
F
ur
t
herm
or
e,
there
we
re
co
ns
ist
ent
be
nef
it
s
of
inte
gr
at
io
n
from
the
healt
h
care
w
orke
r
s’
pe
rsp
ect
iv
e
that
it
streng
th
en
orga
nizat
io
nal
syst
e
m
and
their
sta
ff
relat
io
ns
hi
ps
,
colla
bo
rati
ve
te
am
wo
rk
a
nd
m
otivati
on
a
l
to
m
anag
e
the
cases.
Both
physi
ci
an
an
d
nurse
s
work care
f
ully
to
assess
HIV
patie
nts a
nd int
egr
at
e t
he
ca
re
serv
ic
e
[
16
]
.
C
on
s
ultat
ion
li
ai
so
n
in
pr
im
ary
care
is
a
he
al
th
care
deliv
ery
m
od
el
in
c
omm
u
nity
wh
ic
h
com
bin
ed
bo
t
h
ph
ysi
cal
and
m
ental
healt
h
care.
T
his
li
ai
so
n
ser
vices
inclu
de
pro
vid
in
g
healt
h
edu
cat
io
n,
assi
sti
ng
i
n
pro
blem
so
lving
a
nd
oth
e
r
st
r
at
egies
to
im
pr
ov
e
m
ental
healt
h
sta
tus.
P
re
vi
ou
s
stu
dy
sho
wed
that
li
ai
son
care
serv
ic
es e
nha
nc
e
m
ental
h
eal
t
h
sta
tus
f
or
a
bo
ut
thre
e m
on
th
s; and ad
he
rence
to treatm
ent
for
a
bout
12
m
on
ths
in
patie
nts
w
it
h
m
ental
h
eal
th iss
ues
, m
ai
nly depresse
d
pa
ti
ents [
17]
.
Re
sp
on
den
ts
s
ta
te
d
that
the
t
rainin
g
increa
s
ed
their
knowl
edg
e
a
bout
HIV
treat
m
ent.
They
sta
t
ed
that
the
assess
m
ent
was
easi
er
an
d
sim
ple
t
o
be
us
ed
.
Stu
dies
showe
d
th
at
si
m
ple
screening
to
ols
ha
ve
to
be
dev
el
op
e
d
in
orde
r
to
help
th
e
m
to
reco
gniz
e
m
ental
health
issues
in
H
I
V
-
i
nf
ect
ed
patie
nts.
A
dd
it
io
na
ll
y,
i
t
al
lowed
res
pond
e
nts
to
bu
i
ld
stron
ge
r
re
la
ti
on
sh
i
ps
wi
th
HIV
patie
nts
[18].
Re
s
pondents
e
xpr
essed
diff
ic
ulti
es
to
eng
a
ge
relat
ion
sh
i
ps
with
H
IV
patie
nts
as
m
os
t
of
t
hem
felt
gu
il
ty
an
d
af
raid
a
bout
so
ci
al
sti
gm
a
if
they
descr
i
bed
thei
r
co
ndit
ion
s.
H
ow
e
ve
r,
healt
h
pro
fessio
nals
kn
e
w
t
hat
they
ha
ve
t
o
im
pr
ove
t
heir
com
m
un
ic
at
ion
.
S
ocial
sti
gm
a
is
instea
d
a
com
plex
sit
uation
w
hic
h
can
ne
gativel
y
i
m
pact
the
a
bili
ty
of
people
li
ving
HIV/A
IDS.
T
he
refor
e
,
it
need
s
a
pu
blic
he
al
th
po
li
cy
to
conq
uer
th
e
soc
ia
l
sti
g
m
a
rel
at
ed
to
HIV/A
IDS [1
9]
.
HIV
pa
t
ie
nts
exp
e
rience
d
st
igm
a
su
ch
as
feeli
ng
a
sh
am
ed,
b
la
m
ing
sel
f
beca
us
e
of
bein
g
H
I
V
-
po
sit
ive
,
feeli
ng
discrim
inate
d
by
so
ci
et
ie
s,
hav
in
g
los
s
of
ed
ucati
on
or
e
m
plo
ym
ent,
feeli
ng
isolat
ed
fr
om
fam
i
ly
m
e
m
be
rs
an
d
fr
ie
nds
.
Lia
ison
ps
yc
hi
at
ric
serv
ic
es
in
pr
im
ary
care
prom
ote
resp
ect
of
hum
an
righ
ts.
Me
ntal
healt
h
interve
ntio
n
in
pri
m
ary
car
e
cou
l
d
m
ini
m
iz
e
the
sti
gma
and
disc
rim
inati
on
[
20
]
.
It
al
so
pro
vid
es
go
od
ou
tc
om
es
bo
t
h
f
or
the
patie
nts
an
d
healt
h
care
orga
nizat
ion
.
I
nteg
rati
ng
m
ental
health
int
o
pr
im
ar
y
care
is
based
on
e
vide
nce
that
m
ent
al
healt
h
issue
s
are
over
-
re
presented
in
c
omm
un
it
y.
To
facil
it
at
e
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N:
22
52
-
8806
Develo
ping Pri
ma
ry
Liais
on
Psychiatri
c
Ser
vi
ces for
HI
V/
AIDS P
atients
in Co
mmu
nity
(
Ahsan)
255
bette
r
outc
om
es,
pri
m
ary
care
has
been
at
te
m
pt
ing
to
m
eet
the
nee
ds
of
H
IV
patie
nts
re
ga
rd
i
ng
m
ental
healt
h
treatm
ent
by
pr
ovidi
ng
he
al
th
care
serv
ic
es
in
sub
rural
are
as.
Howe
ver,
it
need
s
furthe
r
trai
nin
g
pr
ogr
a
m
t
o
increase t
he
a
bi
li
t
ie
s o
f heal
th
care
w
orker
s
a
bout m
ental
h
e
al
th treatm
ent.
Re
sp
on
den
ts
s
howe
d
im
pr
ove
m
ents
in
psy
cho
m
oto
r
abili
ti
es
to
giv
e
psy
cho
s
ocial
int
erv
e
ntio
n
i
n
HIV
patie
nts.
Seve
r
al
stu
dies
inv
est
igate
d
t
he
be
ne
fits
of
ps
yc
hos
ocial
thera
pies
that
it
i
m
pr
oved
t
he
well
-
bein
g
sta
tus
as
well
as
e
m
oti
on
al
dist
ress
a
m
on
g
HIV/A
I
DS
patie
nts
[21].
Psych
osoci
al
interven
ti
on
s
include
su
pp
or
ti
ng
t
he
abili
ty
to
c
ope
with
t
he
i
ll
ness,
s
ocial
sti
gm
a
and
in
te
racti
on
with
their
fam
ilie
s
an
d
su
r
rou
nd
i
ngs.
Fu
rt
her,
it
ha
s
the
po
te
ntial
to
ha
ve
a
posit
ive
eff
ect
on
m
ental
healt
h
sta
tus
an
d
trea
t
m
en
t
adh
e
re
nce.
P
re
vious
stu
dy
showe
d
that
H
I
V
patie
nts
ha
ve
sp
eci
fic
issues
s
uch
as
re
la
ti
on
sh
i
p
pro
blem
s
,
h
eal
th
disease
con
t
ro
l,
dru
g/a
lc
ohol
us
e
a
nd
m
oo
d
cha
nge
s
,
em
otion
al
di
stress,
s
ocial
s
ti
g
m
a,
gr
ie
vi
ng
an
d
e
m
plo
ym
ent stat
us
[2
2].
5.
CONCL
US
I
O
N
HIV
ca
n
be
a
source
of
m
a
j
or
stres
s
w
hic
h
ca
n
le
ad
t
o
changes
i
n
e
m
otion
al
pro
blem
s
su
ch
as
depressi
on,
pe
rsiste
nt
sa
dne
s
s,
feeli
ng
em
pty
and
an
xiety
.
Com
m
on
fac
tors
w
hich
can
be
f
ound
a
re
so
ci
al
pr
e
disposit
io
n
factors
s
uch
a
s
so
ci
al
sti
gm
a,
hom
el
essnes
s,
pove
rty
an
d
s
ubsta
nce
m
isuse.
The
abi
li
ty
of
li
ai
so
n
officer
in
pr
im
ary
care
cou
ld
help
pa
ti
ents
red
uce
t
heir
ps
yc
hiatri
c
pr
oble
m
s
and
at
the
sa
m
e
t
i
m
e
can
gr
eat
ly
af
fect p
at
ie
nts'
r
isks fo
r
tra
ns
m
issi
on
of HIV
to othe
rs.
ACKN
OWLE
DGE
MENTS
We
w
ould
li
ke
to
ex
pr
ess
our
s
pecial
tha
nk
s
t
o
al
l
of
t
he
res
ponde
nts
for
pa
rtic
ipa
ti
ng
in
this
pro
gr
am
.
W
e
al
so
receive
d
s
upport
f
ro
m
C
omm
un
it
y
-
In
te
gr
at
e
d
Healt
h
Ce
nter
in
East
Java
an
d
Sc
hool
of
Nursin
g,
Fac
ulty
o
f
Me
dicine,
Unive
rsity
o
f
Brawijaya
,
to
c
onduct
this
res
earch
.
REFERE
NCE
S
[1]
UN
AID
S,
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HIV
and
AID
S E
stim
at
es,
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Ja
y
ara
j
an
an
d
P.
S.
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HIV
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ea
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rist
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Com
par
ison
w
it
h
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infe
c
ted
Pati
ent
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from
the
Gene
ral
Popu
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i
nfe
cted
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l
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a
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at
m
ent
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gra
ti
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vent
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Morbid
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one
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The
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ved
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per
ie
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ce
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an
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om
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outh
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a
:
A
Phenom
enol
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Inquir
y
,
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ernati
onal Journal of
Heal
th
S
ci
en
c
es
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ss
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y
a
l
Col
le
g
e
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f
Ps
y
chiatr
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“
The
Man
age
m
en
t
o
f
Pa
ti
en
ts
wit
h
Ph
y
sic
al
and
P
s
y
chol
og
ical
Pro
ble
m
s
in
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a
r
y
Care
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A Practica
l
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,
”
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e
R
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P.
Aitke
n
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l.
,
“
An
Evi
d
enc
e
Base
for
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Ps
y
chiatr
y
–
Guidanc
e
,
”
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te
gi
c
Cl
ini
ca
l
N
et
work
for
Me
nt
al
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h,
Dement
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a
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cal
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outh
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N.
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al
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“
Faci
li
t
at
ing
P
rofe
ss
iona
l
Liais
on
in
Coll
abor
a
t
ive
Care
for
De
pre
ss
ion
in
UK
Prim
ar
y
Care;
A
Quali
t
at
iv
e
Stud
y
U
ti
li
sing
Nor
m
al
isat
ion
Proce
ss
The
or
y
,
”
BM
C
Family
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ct
i
ce
,
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,
pp
.
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8,
2014
.
[9]
A.
J.
Mi
tc
he
ll,
“
I
s L
iaison Ps
y
ch
i
at
r
y
Eff
e
ct
iv
e in P
rimar
y
C
are
?
,
”
BJ
Psy
ch Adv
anc
es
,
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–
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2016
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[10]
C.
Na
y
lo
r,
et
al
.
,
“
Bringi
ng
Toge
the
r
Ph
y
si
cal
a
nd
Menta
l
Hea
lth:
A
New
Frontie
r
for
Inte
gra
t
ed
Care
,
”
London
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The
King’s Fun
d,
2016
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[11]
S.
Ro
y
,
et
a
l.
,
“
Patt
ern
s
of
Ps
y
c
hia
tric
Co
-
Morb
idi
ties
In
Pat
ie
n
ts
of
HIV
/AIDS
on
Anti
R
et
rov
ira
l
Treat
m
ent,
”
IOSR
Journal
of D
ent
al
and
Me
d
i
cal
S
ci
en
ce
s (
IOSR
-
JDMS)
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v
ol
/
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ss
ue:
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(
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)
,
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57
-
61,
2017
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[12]
J.
S.
McDani
el
,
et
al
.
,
“
Prac
ti
c
e
Guidel
in
e
For
T
he
Treat
m
ent
of
Pa
ti
ent
s
W
it
h
HIV
/AIDS
,
”
Ame
rican
Psyc
h
iat
ri
c
Associat
ion
,
201
0.
[13]
V
.
D
.
He
ij
den
,
e
t
al
.
,
“
Ps
y
chosoc
ial
group
int
e
rv
ent
ions
to
impro
ve
ps
y
chol
og
ic
a
l
well
-
b
ei
ng
in
a
dult
s
li
v
ing
with
HIV
,
”
Cochrane
Database
of
Sys
te
mati
c
R
evie
ws
,
i
ss
ue
3
,
2017
.
[14]
N.
Younes,
et
a
l
.
,
“
Long
Te
rm
GP
Opinions
and
Involve
m
ent
After
a
Consultation
-
liaison
Int
er
vent
ion
f
or
Men
ta
l
Hea
lt
h
Problems
,
”
BMC Famil
y
Pract
i
ce
,
vol
.
9
,
pp.
41
,
2008
.
[15]
L.
W
il
kes,
et
al
.
,
“
The
Role
of
the
Gene
ral
Prac
tice
Liaison
Nurs
e
as
Inte
gra
te
d
Ca
re
Coordina
tor
:
A Del
phi
stud
y
,
”
Cli
nic
a
l
Nurs
ing
Studies
,
v
ol
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ss
ue:
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(
3
)
,
2016
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[16]
S.
M.
Topp
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et
al.
,
“
Inte
gr
at
in
g
HIV
Tre
a
tment
with
Prim
ar
y
C
are
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ent
Servi
ce
s:
Opportunit
i
es
an
d
Chal
le
ng
es
Fro
m
A Sca
le
d
-
Up
Model
in
Z
ambia
,
”
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th
Po
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347
–
357,
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[17]
D.
Gill
ie
s,
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t
al
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,
“
Consulta
ti
on
li
ai
son
in
primar
y
ca
re
for
pe
ople
withmental
disorder
s
(Revi
ew),
”
Cochrane
Database
of
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yst
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Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
6
, No
.
3
,
Septem
ber
20
1
7
:
25
1
–
25
6
256
[18]
M.
Duff
y
,
e
t
al
.
,
“
Inte
gr
at
ing
Menta
l
Hea
lt
h
and
HIV
Servic
es
in
Zi
m
babwe
an
Com
m
unit
ie
s:
A
Nurs
e
and
Com
m
unit
y
-
le
d
Approac
h
to
R
e
ac
h
th
e
Mos
t
V
ulne
rab
le
,
”
Journal
Of
The
Associat
ion
Of
Nurs
es
In
Ai
ds
Care
,
v
ol
/i
ss
ue:
28
(
2
)
,
pp.
186
-
198
,
20
17.
[19]
R.
A.
Burgess
,
“
Supporting
Me
nta
l
Hea
lt
h
in
South
Afric
an
HIV
-
Affec
te
d
Co
m
m
unit
ie
s:
Prim
ar
y
Hea
l
th
Ca
re
Profess
iona
ls’
Understa
ndings
an
d
Responses,”
Healt
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Policy and Planni
ng
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vol
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2015.
[20]
P.
Bower,
“
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s
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wee
n
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ar
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C
are
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Sp
ec
i
al
ist
Servi
ce
s
in
The
Mana
ge
m
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of
Comm
o
n
Menta
l
Hea
l
th
P
roble
m
s,”
Cl
inic
al
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h
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try
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issue:
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(
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)
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[21]
J.
P.
Herna
nd
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M.
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wan,
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choso
ci
a
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Int
erv
ention
for
W
om
en
wit
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:
A
Crit
ical
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”
Re
search
on
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[22]
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et
al
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,
“
Prom
oti
ng
a
Com
bina
ti
on
Approac
h
to
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iatric
HIV
Ps
y
cho
socia
l
Support,
”
AIDS
,
vol/
issue:
27(2)
,
pp
.
S147
-
S157,
2013.
BIOG
R
AP
H
I
ES
OF
A
UTH
ORS
Ahs
an
is
a
le
cturer
in
School
of
Nurs
ing,
Facul
t
y
of
Medicin
e,
Univer
si
t
y
of
Brawij
a
y
a
.
H
is
spec
ialt
y
is
in
n
ursing
m
ana
gement
.
H
e
r
ec
e
ived
h
is
ba
che
lor
of
nursing
in
N
ursing
Facult
y
,
Univer
sit
y
of
Pa
ja
j
ara
n
.
H
is
m
aste
r
of
health
sc
ience
was achie
v
e
d
from
Univer
sity
of
Air
la
ngga
.
His
doct
ora
l
pro
gra
m
ac
hi
eve
d
f
rom
Univer
sit
y
of
Airla
ngg
a.
C
urre
ntly
,
he
is
a
hea
d
of
Schoo
l
of
Nurs
ing,
Fa
cu
lty
of
Medi
ci
ne
,
Univer
sit
y
of
Br
awij
a
y
a
.
Ret
no
Le
st
ari
is
a
lectur
er
in
Sch
ool
of
Nurs
ing,
Facul
t
y
of
Med
i
ci
ne
,
Univer
sit
y
of
Brawij
a
y
a
.
Her
spec
i
al
t
y
is
in
m
ental
h
ea
l
th
nursing.
She
recei
ved
her
b
ac
he
lor
of
nursi
ng
in
Nurs
ing
Facul
t
y
,
Univer
s
ity
of
Indone
si
a.
Her
m
aste
r
of
nursing
was
ac
hieved
from
Monash
Univer
sit
y
,
Aus
tra
li
a
.
She
a
lso
provide
s
m
ent
al
h
ea
l
th
coun
sell
ing
in
comm
unity
integra
te
d
vil
la
g
e
in
Ea
s
t
Java
.
Evaluation Warning : The document was created with Spire.PDF for Python.