‘I think my future will be better than my past’: Examining support group influence on the mental health of HIV-infected Rwandan women

Abstract

Urgent need exists for improved psychological services among HIV-infected women in post-genocide Rwanda. Psychological problems associated with trauma and sexual violence (i.e. depression, PTSD) place women at increased risk for sexual risk behaviour, low health-seeking behaviour, delay of antiretroviral therapy (ART) and reduced ART-adherence. We explored experiences of HIV-infected Rwandan women attending psychosocial support groups and their narratives about how participation affected their mental health and HIV treatment. Focus group discussions examined why participants attended support groups, whether participants perceived support groups as beneficial to their psychological well-being, influenced ART-adherence, and other influences on health behaviours and attitudes. Rwandan women (aged 18-65) were randomly selected from 10 health clinic-facilitated support groups for HIV-infected trauma survivors in Kigali. Results identified positive psychological and physical changes as well as behaviour changes in relationships with men, which participants attributed to support group attendance. Data showed significant improvement in mental health, ART-adherence and HIV-serostatus disclosure resulting from group attendance. Participants acknowledged limitations of support groups with respect to addressing poverty and hunger. Implementing psychosocial support groups may leverage clinical outcomes and rejuvenate the well-being of HIV-infected women with interpersonal trauma and/or PTSD and depressive symptoms, particularly those from post-conflict countries.

The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

“…The finding that PLHIV support group participation is associated with ART adherence is consistent with previous findings which indicate that generally, support from peers, family members or health workers increased ART adherence [23]- [25]. The novel finding from this study is that social support from PLHIV peers, through a PLHIV support group mechanism, has value in terms of ART adherence.…”

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

“…Eighteen studies (20.7%) used focus group discussions (FDGs) [19,23–25,28,50,53,61,68,73,74,76,77,82,94,98,167,169], 16 used both IDIs and FDGs (18.4%) [18,30,31,38,44,52,64,72,75,79,83,86,92,93,99,170], one used free attitude interviews (FAIs) and FGDs (1.1%) [80], one used group sessions without more detail [168], one used IDIs and life history and illness narratives [48] and one used digital stories [91]. …”

Twenty Years Post‐genocide: The Creation of Mental Health Competence among Rwandan Survivors Through Community‐based Healing Workshops

“…One study found that community‐based support augmented perceived physical and mental health, quality of life and perceived social support among HIV patients (Thomson, Rich, Kaigamba, Socci, Hakizamungu, Bagiruwigize & Franke, ). Another study on HIV‐infected, traumatised Rwandan women showed that the attendance of psychosocial support groups led to a significant improvement in mental health (Walstrom, Operario, Zlotnick, Mutimura, Benekigeri & Cohen, ). Further, a psychosocial intervention presented by Staub () investigated the benefits of promoting healing and reconciliation in small groups and through radio programmes.…”