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Psychosocial support intervention for HIV-affected families in Haiti: Implications for programs and policies for orphans and vulnerable children

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  • Smith Fawzi, Mary C.
  • Eustache, Eddy
  • Oswald, Catherine
  • Louis, Ermaze
  • Surkan, Pamela J.
  • Scanlan, Fiona
  • Hook, Sarah
  • Mancuso, Anna
  • Mukherjee, Joia S.

Abstract

Given the increased access of antiretroviral therapy (ART) throughout the developing world, what was once a terminal illness is now a chronic disease for those receiving treatment. This requires a paradigmatic shift in service provision for those affected by HIV/AIDS in low-resource settings. Although there is a need for psychosocial support interventions for HIV-affected youth and their caregivers, to date there has been limited empirical evidence on the effectiveness of curriculum-based psychosocial support groups in HIV-affected families in low-income countries. Therefore, the purpose of this study is to examine the feasibility and assess the preliminary effectiveness of a psychosocial support group intervention for HIV-affected youth and their caregivers in central Haiti. The study was conducted at six Partners In Health-affiliated sites between February 2006 and September 2008 and included quantitative as well as qualitative methods. HIV-affected youth (n = 168) and their caregivers (n = 130) completed a baseline structured questionnaire prior to participation in a psychosocial support group intervention. Ninety-five percent of families completed the intervention and a follow-up questionnaire. Psychological symptoms, psychosocial functioning, social support, and HIV-related stigma at baseline were compared with outcomes one year later. Qualitative methods were also used to assess the participants' perspectives of the intervention. Comparing pre- and post-intervention assessment, youth affected by HIV experienced decreased psychological symptoms as well as improved psychosocial functioning and social support. Caregivers (95% HIV-positive) demonstrated a significant reduction in depressive symptoms, improved social support, and decreased HIV-related stigma. Although further study is needed to assess effectiveness in a randomized controlled trial, corroborative findings from qualitative data reflected reduced psychological distress, less social isolation and greater hope for the future for families affected by HIV/AIDS following the intervention.

Suggested Citation

  • Smith Fawzi, Mary C. & Eustache, Eddy & Oswald, Catherine & Louis, Ermaze & Surkan, Pamela J. & Scanlan, Fiona & Hook, Sarah & Mancuso, Anna & Mukherjee, Joia S., 2012. "Psychosocial support intervention for HIV-affected families in Haiti: Implications for programs and policies for orphans and vulnerable children," Social Science & Medicine, Elsevier, vol. 74(10), pages 1494-1503.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:10:p:1494-1503
    DOI: 10.1016/j.socscimed.2012.01.022
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    References listed on IDEAS

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    1. Gielen, A. C. & McDonnell, K. A. & Wu, A. W. & O'Campo, P. & Faden, R., 2001. "Quality of life among women living with HIV: the importance violence, social support, and self care behaviors," Social Science & Medicine, Elsevier, vol. 52(2), pages 315-322, January.
    2. Li, L. & Lee, S.-J. & Jiraphongsa, C. & Khumtong, S. & Iamsirithaworn, S. & Thammawijaya, P. & Rotheram-Borus, M.J., 2010. "Improving the health and mental health of people living with HIV/AIDS: 12-month assessment of a behavioral intervention in Thailand," American Journal of Public Health, American Public Health Association, vol. 100(12), pages 2418-2425.
    3. repec:mpr:mprres:5077 is not listed on IDEAS
    4. Kumakech, Edward & Cantor-Graae, Elizabeth & Maling, Samuel & Bajunirwe, Francis, 2009. "Peer-group support intervention improves the psychosocial well-being of AIDS orphans: Cluster randomized trial," Social Science & Medicine, Elsevier, vol. 68(6), pages 1038-1043, March.
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    Cited by:

    1. Eddy Eustache & Margaret E Gerbasi & Mary C Smith Fawzi & J Reginald Fils-Aimé & Jennifer Severe & Giuseppe J Raviola & Rupinder Legha & Sarah Darghouth & David J Grelotti & Tatiana Thérosmé & Erma, 2017. "High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country," International Journal of Social Psychiatry, , vol. 63(3), pages 261-274, May.
    2. Shraddha Bajaria & Ramadhani Abdul & Amon Exavery & Epifania Minja & John Charles & Sally Mtenga & Elizabeth Jere & Eveline Geubbels, 2020. "Programmatic determinants of successful referral to health and social services for orphans and vulnerable children: A longitudinal study in Tanzania," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-15, September.
    3. Cook, Jonathan E. & Purdie-Vaughns, Valerie & Meyer, Ilan H. & Busch, Justin T.A., 2014. "Intervening within and across levels: A multilevel approach to stigma and public health," Social Science & Medicine, Elsevier, vol. 103(C), pages 101-109.
    4. Visser, Maretha & Thurman, Tonya R. & Spyrelis, Alexandra & Taylor, Tory M. & Nice, Johanna K. & Finestone, Michelle, 2018. "Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa," Evaluation and Program Planning, Elsevier, vol. 68(C), pages 124-134.
    5. Tulloch, Olivia & Taegtmeyer, Miriam & Ananworanich, Jintanat & Chasombat, Sanchai & Kosalaraksa, Pope & Theobald, Sally, 2015. "What can volunteer co-providers contribute to health systems? The role of people living with HIV in the Thai paediatric HIV programme," Social Science & Medicine, Elsevier, vol. 145(C), pages 184-192.
    6. Brewis, Alexandra & Wutich, Amber & Galvin, Michael & Lachaud, James, 2022. "Localizing syndemics: A comparative study of hunger, stigma, suffering, and crime exposure in three Haitian communities," Social Science & Medicine, Elsevier, vol. 295(C).

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