title: Impact of support groups for people living with HIV on clinical outcomes: a systematic review of the literature.
abstract: BACKGROUND
  Support groups for people living with HIV are integrated into HIV care and treatment programs as a modality for increasing patient literacy and as an intervention to address the psychosocial needs of patients. However, the impact of support groups on key health outcomes has not been fully determined.
  
  
  METHODS
  We searched electronic databases from January 1995 through May 2014 and reviewed relevant literature on the impact of support groups on mortality, morbidity, retention in HIV care, quality of life (QOL), and ongoing HIV transmission, as well as their cost-effectiveness.
  
  
  RESULTS
  Of 1809 citations identified, 20 met the inclusion criteria. One reported on mortality, 7 on morbidity, 5 on retention in care, 7 on QOL, and 7 on ongoing HIV transmission. Eighteen (90%) of the articles reported largely positive results on the impact of support group interventions on key outcomes. Support groups were associated with reduced mortality and morbidity, increased retention in care, and improved QOL. Because of study limitations, the overall quality of evidence was rated as fair for mortality, morbidity, retention in care, and QOL, and poor for HIV transmission.
  
  
  CONCLUSIONS
  Implementing support groups as an intervention is expected to have a high impact on morbidity and retention in care and a moderate impact on mortality and QOL of people living with HIV. Support groups improve disclosure with potential prevention benefits but the impact on ongoing transmission is uncertain. It is unclear whether this intervention is cost-effective given the paucity of studies in this area.
authors.affiliation: *Division of Global AIDS, Centers for Disease Control and Prevention (CDC), Atlanta, GA; and †Technical Leadership and Research Division Office of HIV and AIDS Global Health Bureau United State Agency for International Development, Washington DC, ‡Strategic Planning, Evaluation and Research Division Office of HIV and AIDS Global Health Bureau United State Agency for International Development, Washington DC.
authors.forename: Moses H
authors.initials: MH
authors.lastname: Bateganya
authors.forename: Ugo
authors.initials: U
authors.lastname: Amanyeiwe
authors.forename: Uchechi
authors.initials: U
authors.lastname: Roxo
authors.forename: Maxia
authors.initials: M
authors.lastname: Dong
mesh_terms: D003362:Cost-Benefit Analysis; D003906:Developing Countries; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D062489:Health Impact Assessment; D006295:Health Resources; D006801:Humans; D009017:Morbidity; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012657:Self-Help Groups