A model for revitalising caregiver social support competencies : the value of support group participation on behavioural outcomes of people living with HIV in Nigeria

Abstract

The discovery that anti-retroviral therapy (ART) is important for human immunodeficiency syndrome (HIV) prevention has increased interest in factors that influence adherence to HIV treatment. Studies have shown that non-adherence to ART results in drug resistance, morbidity and person-to-person HIV transmission. For persons defaulting on or living risky sexual lives, becoming adherent is a life-saving behavioural change, both for themselves and for their sexual partners. HIV/AIDS programmes are trying different innovations to enhance behavioural outcomes of people living with HIV (PLHIV). This study sought to determine the value of support group participation and based on the findings, to develop an evidence-based model for revitalising caregiver social support competencies. The study was conducted in two phases. In the first phase, a cross-sectional descriptive design was used to compare PLHIV who participate in support group activities with those who do not, in terms of their behavioural outcomes. Multistage probability sampling was used to select study respondents. Data was collected using a selfadministered questionnaire from 1,676 respondents between February and May 2014. Data was analysed using STATA. Data analysis shows that 47% of respondents had once (ever) participated in support group activities while 53% had never. PLHIV who participated in support group activities differed from those who did not in terms of HIV-related stigma (p=<0.001), positive HIV status disclosure (p=0.005), ART adherence (p=0.021), and sexual risk behaviours (p=0.045). PLHIV who participated in support group activities were more likely to have less internal HIV-related stigma, disclose their positive HIV status, adhere to ART and live less risky sexual lives. The two study groups were not different in terms of perceived social support (p=0.28) and external stigma (p=0.250). More PLHIV obtained social support from health workers (66%) and family members (36%) than from PLHIV support groups (16%). The researcher concludes that participating in support group activities positively impacts on behavioural outcomes of PLHIV, but PLHIV support groups are not the only sources of social support. In the second phase, a model for revitalising PLHIV caregiver social support competencies was developed as a recommendation for assuring PLHIV access to holistic care and support.