Preliminary results from Hlanganani (Coming Together): A structured support group for HIV-infected adolescents piloted in Cape Town, South Africa

Abstract

HIV positive adolescents require unique physical and emotional care as they navigate not only developmental challenges but also HIV-related issues including stigma, prevention, and maintaining long-term HIV health. The Hlanganani Program was created to address these issues and engage adolescents in care using a dynamic, 3-session cognitive behavioral support group facilitated by laypersons. Youth 16 to 24years old, diagnosed within the previous 12months, were invited to attend three sessions in clinics or other community spaces. Topics included: 1.) Coping and support; 2.) HIV health (including CD4 counts and ARVs); and 3.) HIV prevention. The program was developed and evaluated for feasibility, acceptability and improvements in participants' knowledge, attitudes and behavior. Impact on linkage to care was measured using participant clinic folders from two local youth clinics and was defined as attending at least one ART clinic visit if eligible (CD4 <200cells/mm3). 109 participants were enrolled, and follow-up assessments were matched among those retained for 3 sessions (n=65 compared). Self-reported safe sex practices demonstrated improvement with the proportion of participants affirming condom use at last sex rising from 71% to 83% at follow-up (p=.049). Linkage to care was met by 100% of all ART eligible participants (n=13), compared to 58% in the comparison group (n=31). Hlanganani demonstrated that it would be feasible and acceptable to recruit HIV positive adolescents into a support group setting, with measurable improvements in short-term behavioral outcomes including safe sex and linkage to ART care. Results from this pilot show promise that a structured support group for newly diagnosed HIV+ youth could be effective as an entry point for long-term HIV wellness and care.