title: Psychosocial support intervention for HIV-affected families in Haiti: implications for programs and policies for orphans and vulnerable children.
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.
authors.affiliation: Partners In Health, Boston, MA, USA. mksfawzi@msn.com
authors.forename: Mary C
authors.initials: MC
authors.lastname: Smith Fawzi
authors.forename: Eddy
authors.initials: E
authors.lastname: Eustache
authors.forename: Catherine
authors.initials: C
authors.lastname: Oswald
authors.forename: Ermaze
authors.initials: E
authors.lastname: Louis
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.forename: Fiona
authors.initials: F
authors.lastname: Scanlan
authors.forename: Sarah
authors.initials: S
authors.lastname: Hook
authors.forename: Anna
authors.initials: A
authors.lastname: Mancuso
authors.forename: Joia S
authors.initials: JS
authors.lastname: Mukherjee
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D017028:Caregivers / Q000523:psychology*; D002648:Child; D054540:Child, Orphaned; D002908:Chronic Disease; D003863:Depression / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D005190:Family / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006205:Haiti; D006801:Humans; D016014:Linear Models; D008297:Male; D015337:Multicenter Studies as Topic; D012657:Self-Help Groups / Q000458:organization & administration / Q000639:trends; D057545:Social Stigma; D012944:Social Support