Understanding participation in a hospital-based HIV support group in Limpopo Province, South Africa

Factors associated with health-related quality of life among people living with HIV in South Korea: Tobit regression analysis

This study investigated health-related quality of life and identified factors affecting it among people with the HIV in South Korea. A total of 243 people living with HIV participated in this cross-sectional survey. Data were collected from five hospitals between November 2021 and August 2022 using structured online questionnaires. Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, Spearman's rho analysis, and Tobit regression analysis because a significant ceiling effect was observed for the dependent variable. The mean score for the health-related quality of life was 75.74 ± 16.48. The significant factors that positively influence the health-related quality of life were "employment" (B = 4.57, p = .035), "not participating in the self-help group" (B = 6.10, p = .004), "higher self-efficacy for managing symptoms" (B = 1.32, p = .036), "higher self-efficacy for getting support/help" (B = 0.95, p = .035), and "higher self-efficacy for managing fatigue" (B = 2.80, p < .001) in the Tobit regression analysis. The results suggest that interventions to increase self-efficacy should involve developing programs and policies for people living with HIV. There is a need for efforts to provide healthcare services linked to employment support, as well as to establish a social environment in which they can work without stigma. Further, self-help groups could be utilized as intervention channels.

Use of self-help groups by people living with HIV in Central America

Self-help groups (SHGs) for people living with HIV (PLHIV) are organizations created by the community to provide individuals with security, affection, improved self-esteem, and a sense of belonging. However, SHGs have also been used by the government to help implement HIV control policies. This study aimed to identify the characteristics associated with the use of SHGs by PLHIV and the routes and displacement patterns adopted by users. An analytical cross-sectional study was conducted based on data collected in six Central American countries during 2012. Using a list of SHGs, a random sampling was conducted in two stages. Firstly, the SHGs were selected. Then, the selected SHGs were visited and every third user who attended the SHG was surveyed. Logistic regression models were used to identify the characteristics associated with the use of SHGs and with attending the nearest SHGs. A spatial analysis was performed to identify the routes followed by users to reach the SHGs from their home communities. We found that the characteristics significantly associated with higher odds of SHG usage were country of residence and schooling level. The average and median distances traveled by users to attend SHGs were 20 and 5 kilometers, respectively. PLHIV do not use the SHGs closest to their locality, perhaps for fear of stigma and discrimination. We recommend that research on this topic use a mixed qualitative-quantitative methodology to better understand utilization decisions, user expectations, and the degree to which these are being met.

Sustaining peer support groups: Insights from women living with HIV in rural Kenya

OBJECTIVE

As HIV transitions to a chronic disease, measures that foster continued health are critical. Peer support groups can help in reducing stigma and ensuring wellbeing for those living with HIV. The purpose of our study was to gain an understanding of the ways in which women living with HIV in rural areas sustain peer support groups.

DESIGN AND SAMPLE

For this descriptive qualitative study, 20 women living with HIV participated in the study. Women were randomly divided into two peer support groups of ten women each; the groups met over a 12-month period. monthly for the first two months and then every three months for the remainder of the year.

RESULTS

Discussion themes indicated women found ways to sustain the groups by using them as a platform for engaging in income generation; starting and participating in table banking; addressing food security; and finding financial and moral support. Problem-solving challenges of sustaining peer support groups was also a major theme.

CONCLUSION

As people live longer with HIV, long-term peer support will be needed to maintain wellbeing. Community-based peer support groups can be sustained by engaging women in common income-generation activities.

Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia

This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination).

Support groups for HIV-positive people in South Africa: who joins, who does not, and why?

Psychosocial health care for persons living with HIV/AIDS (PLWHA) is inadequate. Support groups for PLWHA could offer arenas where psychosocial issues are addressed, yet more knowledge is needed about those who join and those who do not join such groups. In this study, conducted in Limpopo province, South Africa, 49 PLWHA were asked about their motivations for joining a support group, while 22 PLWHA were asked about their reasons for not joining a support group. The most prevalent motivations for joining were to get information (59%) and social support (53%). The main reasons for not having joined were lack of knowledge (32%) and understanding (19%) about the support group and time constraints (19%). Physical symptoms and mental health were measured using the Stages of HIV Related Physical Symptoms & 20-item Symptom Checklist for HIV Infection and the General Health Questionnaire-28 (GHQ-28). Physical symptoms ranged from 0 to 17 with an average of 6. Mental distress was high, with 55% of members and 46% of non-members scoring above threshold levels. Support group members tended to be female, younger, to have tested due to pregnancy or out of concern, and to have grants as their sources of income. Non-members had tested due to illness, reported considerably more pain and were more likely to have no income. PLWHA experienced high mental, physical and social distress which must be addressed. Attention to gender differences is called for. While all members joined the support group to gain information and learn to cope, women were more likely to join to get support and deal with stress, while men joined to stay active and educate others. Support groups could be important links in the chain of comprehensive HIV health service delivery, given that they manage to recruit and meet the needs of PLWHA.

When families fail: shifting expectations of care among people living with HIV in Nairobi, Kenya

The availability of free antiretroviral treatment in public health facilities since 2004 has contributed to the increasing biomedicalization of AIDS care in Kenya. This has been accompanied by a reduction of funding for community-based care and support organizations since the 2008 global economic crisis and a consequent donor divestment from HIV projects in Africa. This paper explores the ways that HIV interventions, including support groups, home-based care and antiretroviral treatments have shaped expectations regarding relations of care in the low-income area of Kibera in Nairobi, Kenya, over the last decade. Findings are based on 20 months of ethnographic research conducted in Nairobi between January 2011 and August 2013. By focusing on three eras of HIV treatment – pre-treatment, treatment scale-up, and post-crisis – the authors illustrate how family and community-based care have changed with shifts in funding. Many support groups that previously provided HIV care in Kibera, where the state is largely absent and family networks are thin, have been forced to cut services. Large-scale HIV treatment programmes may allow the urban poor in Nairobi to survive, but they are unlikely to thrive. Many care needs continue to go unmet in the age of treatment, and many economically marginal people who had found work in care-oriented community-based organizations now find themselves jobless or engaged in work not related to HIV.