Impact of using creative arts programming to support HIV treatment in adolescents and young adults in Eswatini

Abstract

Background In 2018, approximately 1.6 million adolescents (aged 10–19) were living with HIV worldwide, with the highest HIV prevalence found in Eswatini. Adolescents and young adults living with HIV are a vulnerable population due to unique psychosocial challenges that come with having a stigmatizing disease. This group struggles more than other age-groups with medication adherence and requires novel approaches to supporting treatment, including peer-group encouragement, and self-expression. Methods We piloted a theater camp for a group of adolescents and young adults enrolled at our HIV clinic in Mbabane, Eswatini, to determine the impact of having an outlet for creative expression and peer support on treatment and feelings of stigma. Pre- and post-camp surveys were administered to the participants to assess perceived stigma and impact of the camp. The results were analyzed using a Wilcoxon-signed rank test. Results Twenty individuals (ages 12–23) living with HIV participated in the camp concurrently with standard treatment. 25% showed a substantial decrease in viral load within six months of completing the camp (> 0.1 log10 change) while only 10% showed a substantial increase. Those who completed the survey felt the camp helped them with confidence, teamwork, and friendships. A comparison of pre- and post- surveys showed an overall decrease in personalized stigma. Quotes from participants reinforced these results. Conclusions Adolescents and young adults living with HIV are an important population for further program development. Our study showed creative arts programming has beneficial psychosocial effects, aids in community building, and potentially enhances the effectiveness of medical treatment. Further programs and studies should continue to investigate creative arts as an avenue for self-expression and community building among vulnerable populations.

The Relationship Between Adverse Childhood Experiences and Utilization of Different HIV Testing Strategies Among Young Men Who Have Sex with Men in Texas

“…Infusing interventions like Mpowerment [ 49 ] with strategies that have been shown to be effective in addressing trauma in people living with HIV, such as expressive writing [ 46 ] or other arts-based strategies [ 50 ], as well as with coping skills interventions could serve as potential avenue for reaching YMSM to address ACEs exposure and HIV testing [ 46 ]. Moreover, arts-based strategies have been used in other HIV-related interventions to address issues such as HIV stigma and are often delivered in a group format [ 51 , 52 ], which could be easily translated to peer-based HIV-testing and prevention interventions akin to Mpowerment. In addition, screening for exposure to ACEs in YMSM should be occurring across HIV testing settings, generally, and in community-based testing contexts, specifically, where we documented higher rates of ACEs exposure.…”

Determinants of anti-retroviral therapy adherence among adolescents living with HIV in the Kingdom of Eswatini

“…In 2015, adolescents accounted for 10% of all those in HIV treatment in the country [30]. Adolescents access care through a differential ART service delivery model which includes expert client offered by lay heath workers (LHWs) through Teen Clubs, multi-months (3 and 6 months) refills, as well as the mainstream model [31,32]. The expert client approach involves training LHWs on HIV treatment adherence, stigma and disclosure, and HIV linkage to care and communication and counselling skills [33,34].…”