Abstract
Support groups for people living with the Human Immunodeficiency Virus (HIV) have continued to evolve since their emergence over two decades ago. In addition to providing HIV education and fostering psychosocial support, recent efforts have shifted the focus to socio-economic activities and retention in care. The sense of urgency to adopt new treatment and prevention strategies in sub-Saharan Africa necessitates greater engagement of established HIV care programs, especially among researchers seeking to conduct implementation research, promote prevention strategies and optimize treatment as prevention. To maximize the utility of support groups in doing so, efforts to create an organized, collaborative framework should be considered. This paper aims to describe the process of refocusing an adult HIV peer-support group and illustrate how a structured program was strengthened to sustain implementation research in resource-limited settings, while promoting patient recruitment and retention. A multidisciplinary team of scientists supporting an HIV peer-support group spearheaded the implementation process that authored the successes, challenges and lessons documented over eight years. Psychosocial support, nutrition care and support, adherence education and income generating projects were the main interventions employed. The initiative resulted in seven peer-reviewed publications, submission of 23 scientific abstracts, scientific dissemination at 12 international conferences. Eleven research studies and 16 income generating projects were successfully conducted over eight years. More than 900 patients participated in peer-support group activities every month and 400 were engaged in income generating activities. This multidisciplinary structured program was valuable in the retention and recruitment of patients for implementation research and benefits extended to psychosocial support, microeconomic projects, and improved nutrition. The support group contributed to strengthening implementation research through providing a platform for identification of research priorities, patient recruitment and retention in studies and dissemination of research findings.
Highlights
An estimated 37.7 million people are living with Human Immunodeficiency Virus (HIV) globally [32]
Support groups are widely accepted as an essential part of HIV care in sub-Saharan Africa and are effective in helping People Living with HIV (PLHIV) manage stress, neutralize stigma and practice new behaviors [9]
This paper describes how support groups for PLHIV can be useful in supporting implementation research in resource-limited settings, based on a model HIV support group at the country’s largest referral hospital in Harare, Zimbabwe
Summary
An estimated 37.7 million people are living with Human Immunodeficiency Virus (HIV) globally [32]. Sub-Saharan Africa has two thirds of the global population of People Living with HIV (PLHIV) [32]. Support groups are widely accepted as an essential part of HIV care in sub-Saharan Africa and are effective in helping PLHIV manage stress, neutralize stigma and practice new behaviors [9]. Numerous studies have documented the usefulness of support groups in HIV patient care and support [1] While their role has evolved to provide support in a variety of areas, including lifeskills training, performing arts, peer to peer counselling, adherence support and income generating activities [29], there is scarce literature on their usefulness in implementation research. Zimbabwe is among the initial countries to institute formal community-based HIV support systems in sub Saharan Africa during a period when stigma and prejudice were rife [28]. Nutrition interventions are a pivotal source of support in PLHIV on antiretroviral therapy (ART) in resource limited settings [16]
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