Background Support groups for people living with HIV (PLHIV) are integrated into Human Immunodeficiency Virus (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, and ongoing HIV transmission, as well as their cost effectiveness. Results Of 1809 citations identified, 20 met inclusion criteria. One reported on mortality, seven on morbidity, five on retention in care, seven on quality of life, and seven 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 quality of life. Due to study limitations, the overall quality of evidence was rated as fair for mortality, morbidity, retention in care, and quality of life, 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 quality of life of PLHIV. Support groups improve disclosure with potential prevention benefits but the impact on ongoing transmission is uncertain. It is unclear if this intervention is cost-effective given the paucity of studies in this area.

Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.