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Feasibility and impact of a
psychosocial support group program for HIV-affected youth and their parents/
caregivers in Haiti - implications for HIV services in resource-poor settings
Presented by Eddy Eustache (Haiti).
J. Mukherjee1,2,3, E. Eustache4, C. Oswald1, P. Surkan5, E. Louis4, F. Scanlan1, S. Hook1, A. Casey1, M. Smith Fawzi1,2,3
1Partners In Health, Boston, United States, 2Harvard Medical School, Department of Global Health and Social Medicine, Boston, United States, 3Brigham and Women's Hospital, Division of Global Health Equity, Boston, United States, 4Zanmi Lasante Sociomedical Complex, Cange, Haiti, 5John Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, United States
Background: A family-centered psychosocial support
group model (Project TALC - Teens and Adults Learning to Communicate) that has
demonstrated effectiveness in the U.S. was adapted for use in central Haiti
with HIV-affected youth and their caregivers. The goal of the study was to
examine the feasibility of implementing the twenty-session program in this
setting and to assess the possible effect on psychological distress and
psychosocial functioning among the youth and their caregivers.
Methods: Families
determined to be 'high risk' according to data from a baseline survey were included
in the intervention. For 168 youth
who received services at baseline, 130 caregivers participated. Prevalence of
psychological symptoms and degree of psychosocial functioning were assessed
pre- and post-intervention.
Results: Caregivers
demonstrated significant reductions in depressive symptoms, including thoughts
of suicide (27% vs. 8%; p=0.0002), feeling sad (74% to 47%; p< 0.0001), and
feeling hopeless about the future (57% to 35%, p =0.01) comparing pre- versus
post-intervention estimates. Youth affected by HIV also demonstrated
significant reductions in somatic and depressive symptoms (Figure 1).
Prevalence of poor psychosocial functioning related to symptoms among youth
declined from 51% to 16% (p< 0.0001).
Conclusions:
The TALC psychosocial support program demonstrated feasibility in central
Haiti, a very resource-poor setting. Preliminary results suggest that youth
affected by HIV/AIDS and their caregivers have high levels of psychological
distress that can be addressed through a family-centered psychosocial support
group intervention with the goals of enhancing coping skills, improving social
support and strengthening relationships of HIV-affected youth and their
caregivers.
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