"I was in the darkness but the group brought me light": Development, relevance and feasibility of the Sondela HIV adjustment and coping intervention

Abstract

Developing interventions that address psychosocial wellbeing of people living with HIV is critical to ensure strong linkages to and retention in HIV care. This paper describes the development of Sondela, an HIV adjustment and coping intervention for heterosexual men and women living with HIV, and its relevance and feasibility in the South African context. Sondela is a six three-hour, small group-based, participatory workshop series. We followed an iterative, multi-phased process of curriculum development that involved research, theoretical frameworks and piloting. A systematic review highlighted the absence of psychosocial interventions targeting heterosexual HIV positive populations living in high HIV prevalence and resource-poor settings. Formative studies demonstrated risk and social factors associated with adjustment and coping with HIV, emphasising the need for interventions that acknowledge gendered experiences. Our pilot of Sondela demonstrated high levels of relevance and feasibility. Men appreciated the workshop “space” to openly talk about their HIV positive status and what is means for their role as partners and fathers and friends. Women valued the skills and approaches because they were relevant to “real life” situations and not just about HIV. Sondela promises to be valuable in supporting health system initiatives and psychosocial support to strengthen linkages to and retention in HIV care, and this suggests a need for rigorous evaluation of Sondela to establish evidence for its effectiveness in a general population.

Consistency of health-related quality of life among people living with HIV: Latent state-trait analysis

“…Specifically, personality indirectly changes HRQoL by influencing the process of coping with illness [ 72 ] and illness appraisal [ 73 ]. Several studies conducted among PLWH showed that coping and appraisal are crucial to the success of psychosocial interventions [ 65 , 74 , 75 ].…”

Adaptation and pre-test of a shortened Stepping Stones and Creating Futures intervention focused on HIV for young men in rural South Africa

“…Several interventions have sought to address men's gender inequitable masculinities as a pathway to improve HIV prevention and treatment outcomes [15][16][17]. Many of these interventions are based on small-group participatory approaches, drawing on Freire's [18] understanding of adult education.…”

Examining the Acceptability of a Resilience Building Intervention Among Adults Aging With HIV

“…Although time intensive (eight 2.5-hr biweekly sessions over 4 months), the program improved resilience through positive reframing, healthy activities, social support, and coping, which had positive effects on depression, anxiety, and stress. Another intervention, the Sondela program, is an HIV coping and adjustment intervention composed of six 3-hr group sessions used to enhance psychological well-being and resilience in PLWH shortly after HIV diagnosis or starting ART (Shai et al, 2017). The Sondela intervention is designed to connect PLWH to social support and address challenges that may affect coping (e.g., depression, stress, medication adherence); a pilot study of this program showed improvements in psychosocial support and bolstered linkages and retention in HIV care (Shai et al, 2017).…”

“…Another intervention, the Sondela program, is an HIV coping and adjustment intervention composed of six 3-hr group sessions used to enhance psychological well-being and resilience in PLWH shortly after HIV diagnosis or starting ART (Shai et al, 2017). The Sondela intervention is designed to connect PLWH to social support and address challenges that may affect coping (e.g., depression, stress, medication adherence); a pilot study of this program showed improvements in psychosocial support and bolstered linkages and retention in HIV care (Shai et al, 2017). Thus, resilience resources have been shown to be a malleable and promising intervention target in PLWH; however, little work has focused on interventions targeting older people living with long-term HIV to build resilience in the context of day-to-day stressors.…”