Establishing support groups for HIV-infected women: Using experiences to develop guiding principles for project implementation

Abstract

HIV-infected women need support to deal with their diagnosis as well as with the stigma attached to HIV. As part of their practical training, Master's-level psychology students negotiated with the staff of four clinics in townships in Tshwane, South Africa, to establish support groups for HIV+ women and offered to assist them in facilitating the groups. This study aimed to understand why the implementation of groups was successful in one clinic and not other clinics. The student reports on their experiences and interaction with clinic staff and clients were used as sources of data. Using qualitative data analysis, different dynamics and factors that could affect project implementation were identified in each clinic. The socio-ecological and systems theories were used to understand implementation processes and obstacles in implementation. The metaphor of building a bridge over a gorge was used to describe the different phases in and obstacles to the implementation of the intervention. Valuable lessons were learnt, resulting in the development of guiding principles for the implementation of support groups in community settings. Keywords: Support groups, HIV+ women, project implementation strategies, change in systems, socio-ecological theory. RésuméLes femmes séropositives ont besoin du soutien afin de faire face à leur diagnostique ainsi qu'avec la stigmatisation liée au VIH.Faisant partie du programme pratique de formation, les étudiants de maîtrise en psychologie ont négocié avec le personnel de quatre cliniques des townships (quartiers pour les Noirs) à Tshwane en Afrique du Sud. Le but fut d' établir des groupes de soutien pour des femmes séropositives. Ces étudiants ont également offert leur aide en animant les groupes. Le but de cette étude est de comprendre pourquoi l' exécution de groupes fut un succès dans une seule clinique et pas dans les autres. Les rapports des étudiants sur leurs expériences et leurs interactions avec le personnel et les malades ont été utilisés comme sources de données. En utilisant l'analyse qualitative des données, les dynamiques et les facteurs différents qui pourraient affecter l' exécution du projet furent identifiés dans chacune des cliniques. Les théories de systèmes socio-écologiques ont été utilisées afin de comprendre le processus de l' exécution ainsi que les obstacles à celle-ci. On a fait référence à la métaphore de bâtir un pont au dessus d'une gorge pour décrire les différentes phases du processus d' exécution et les obstacles face à l' exécution de l'intervention. On a appris des leçons importantes qui ont, par la suite, favorisé l'aménagement des principes directeurs des groupes de soutien dans un milieu communautaire.Mots clés : Groupes de soutien, femmes séropositives, stratégies de l' exécution d'un projet, changement de systèmes, théorie socio-écologique. Establishing support groups for HIV-infected women: Using experiences to develop guiding principles for project implementation Maretha J Visser, Jonathan P Mundell Maretha Visser is a counselling ...

Factors Associated with Attendance and Non-Attendance of Support Groups among HIV Positive Adults Attending an Antiretroviral Community Clinic at Ekurhuleni District, South Africa

“…In this study, unemployed participants also cited time as a barrier; their home schedule and health status did not allow them to attend support groups. Time was found to be a barrier to attending support group meetings in previous studies [6,[16][17][18].…”

“…The interaction with other HIV positive people is an essential component in the success of support groups and creates a sense of belonging among mutually empathetic members [5,6]. Participation in support groups also offers benefits of improved adherence to medication, decreased risk behavior for reinfection such as safer sex practices, condom use, and HIV status disclosure [9,10].…”

“…There is evidence of poor participation in support groups by PLWHI from qualitative and quantitative data. Several studies have shown that HIV positive men are particularly reluctant to attend support groups and that in most mixed gender HIV support groups, women outnumber men [5,6,11,12]. The poor participation of men in support groups might be attributed to the poor involvement of men in HIV prevention, care, and support programmes [11,13].…”

“…Support groups enhance the quality of life, decrease social isolation, create a sense of belonging, offer a forum of peer support, and offer an opportunity to learn from others who are facing similar challenges [1,5]. Furthermore, they provide PLWHI with a safe environment to talk about the disease, neutralize stigma, and allow members to practice new behaviors [2,[6][7][8].…”

Adapting Positive Prevention Interventions for International Settings: Applying U.S. Evidence to Epidemics in Developing Countries

“…Another study found that groups can provide individuals with a nonstigmatizing atmosphere in which to gain information, share experiences, and learn from one another (Visser & Mundell, 2008). Support groups can help to renew hope, contribute to social reintegration, and help people feel they are taking control of their lives (Visser & Mundell, 2008).…”