RESUMO
OBJECTIVE: To examine the preliminary impact of group cognitive behavioral therapy and multiple family group-based family strengthening to address HIV stigma and improve the mental health functioning of adolescents living with HIV in Uganda. STUDY DESIGN: We analyzed data from the Suubi4Stigma study, a 2-year pilot randomized clinical trial that recruited adolescents living with HIV (10-14 years) and their caregivers (n = 89 dyads), from 9 health clinics. We fitted separate three-level mixed-effects linear regression models to test the effect of the interventions on adolescent outcomes at 3 and 6 months post intervention initiation. RESULTS: The average age was 12.2 years and 56% of participants were females. Participants in the multiple family group-based family strengthening intervention reported lower levels of internalized stigma (mean difference = -0.008, 95% CI = -0.015, -0.001, P = .025) and depressive symptoms at 3 months (mean difference = -0.34, 95% CI = -0.53, -0.14, P < .001), compared with usual care. On the other hand, participants in the group cognitive behavioral therapy intervention reported lower levels of anticipated stigma at 3 months (mean difference = -0.039, 95% CI = -0.072, -0.006), P = .013) and improved self-concept at 6 months follow-up (mean difference = 0.04, 95% CI = 0.01, 0.01, P = .025). CONCLUSION: Outcome trends from this pilot study provide compelling evidence to support testing the efficacy of these group-based interventions on a larger scale. TRIAL REGISTRATION: The study is registered in the Clinical trials.gov database (Identifier #: NCT04528732).
Assuntos
Terapia Cognitivo-Comportamental , Infecções por HIV , Psicoterapia de Grupo , Estigma Social , Humanos , Feminino , Masculino , Adolescente , Uganda , Infecções por HIV/psicologia , Infecções por HIV/terapia , Criança , Projetos Piloto , Terapia Cognitivo-Comportamental/métodos , Psicoterapia de Grupo/métodos , Saúde Mental , Cooperação e Adesão ao Tratamento/psicologia , Cuidadores/psicologiaRESUMO
In recent years, calls for the scaling-up, or more broad dissemination of evidence-based HIV prevention programmes, have increased. This paper responds to the call for increasing applicable knowledge about programme dissemination by reviewing the history of a major evidence-based human immunodeficiency virus (HIV) prevention and mental health promotion programme that has been adapted successfully and pilot-tested across four settings - including two major cities, as well as in the United States, Trinidad and Tobago and South Africa - to date. This programme, entitled CHAMP (the Collaborative HIV Prevention & Adolescent Mental Health Project), is distinctive primarily for its emphasis on community collaboration and power-sharing, and also its incorporation of individual, family and community-level interventions. The history of programme development, including theoretical foundations and results across sites, is discussed with a particular emphasis on the implications of CHAMP'S dissemination thus far.