Lessons learned from peer-led support groups for HIV-positive adolescents using a storytelling model in Côte d’Ivoire

Abstract

Background Adolescents living with HIV struggle to accept their HIV status and remain adherent to antiretroviral therapy (ART). Support groups are one method of assisting adolescents to overcome these barriers. This evaluation, conducted in health facilities in Abidjan, Côte d’Ivoire, explored the acceptability of peer-led support groups using a ten-topic curriculum and a ‘storytelling’ model as a means of sharing information. Methods In-depth interviews were conducted with adolescents enrolled in peer-led HIV support groups, peer support group leaders, and health care workers. Data were collected on the percentage of adolescents that created treatment plans, and session and topic attendance, from six facilities providing peer-led support groups. Interviews were audio-recorded, transcribed, and translated. Data were analyzed using thematic analysis. A code list was created using a combined inductive and deductive approach. Transcripts were coded using MAXQDA v.12. Results A total of 45 in-depth interviews were conducted from August-September 2021. Participants reported that peer-led support groups are a critical lifeline for many adolescents. In the peer-led model, adolescents reported feeling more comfortable sharing their personal challenges and being able to better relate to the information through storytelling. Participants discussed the support and trust fostered in their group, both during and after the meetings. Peer-leaders set examples of medication adherence and the support group created a friendly motivated environment focused on staying healthy and maintaining low HIV viral loads. HCWs discussed improved communication and relationships with their adolescent patients. Challenges, such as scheduling, and transport costs affected adolescents’ ability to attend support groups. Most participants attended an average of six of ten sessions. The most attended sessions covered the topics of “Safe sex” and “Sharing HIV status.” Conclusion Peer-led support groups provide critical support to adolescents in accepting their HIV status. The support groups helped adolescents to learn the importance of ART adherence and create a supportive environment for them to live positively with HIV.