Disclosure, Empowerment, HIV/AIDS, HIV Seropositivity
Conditions
Keywords
WLHIV, empowerment, disclosure, Mali
Brief summary
The objective of this research is to measure the short- and mid-term effects of an empowerment program focused on serostatus disclosure management for women living with HIV (WLHIV) in Mali on the burden of secrecy.
Detailed description
Serostatus disclosure is a critical issue for persons living with HIV (PLHIV). Studies identified numerous benefits associated with disclosure, but various negative consequences have also been documented. Gender inequality must be taken into account regarding the disclosure issue, in particular in Mali, where women are economically dependent and have a low decision-making power. Moreover, in Mali, since 2006, PLHIV have a legal obligation to disclose their serostatus to their spouse and sexual partner(s) as soon as possible, or within 6 weeks after the diagnosis. Although this law is not enforced, it highlights the sensitive nature of the serostatus disclosure issue and raise concerns among PLHIV and other stakeholders. To support women living with HIV (WLHIV), an empowerment program (Gundo-So) was implemented by ARCAD-SIDA in Mali, in collaboration with several partners. This program aims to empower WLHIV, so that they can make informed decision about disclosing or keeping their serostatus secret in their various life contexts, and that they can identify strategies to disclose or to keep the secret, as well as to manage potential negative reactions. Gundo-So (The room of confidences) was adapted from a program established in quebec and has been implemented in Mali. The objective of this research is to measure the short- and mid-term effects of an empowerment program focused on serostatus disclosure management for women living with HIV (WLHIV) in Mali on the burden of secrecy. The evaluation of the effects of the Gundo-So program will be helpful to assess the relevance of a national or subregional extension of the program, or even an adaptation to other target populations (e.g. heterosexual men and men who have sex with men living with HIV).
Interventions
BEHAVIORALGundo So
Gundo-So was adapted from a program established in quebec. It has been implemented in Mali following 3 phases: 1) cultural adaptation; 2) validation using a pre-post intervention evaluation; 3) scale-up The programm consists on 9 group meetings group spread over 9 weeks (for 8 WLHIV + 2 trained community-based leaders). Each meeting has some particular thematics with adapted tools.
Sponsors
Fondation de France
Aix Marseille Université
Université du Québec a Montréal
Centre Population et Développement (CEPED), Paris, France
ARCAD-SIDA MALI
Groupe de Recherche en Psychologie Sociale (GRePS), Bron, France
Coalition Plus, France
ANRS, Emerging Infectious Diseases
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* women living with HIV * living in Bamako area (Mali) * over 18 years old * knowing their serological status for more than 6 months and less than 5 years * being available to participate in the 9 weekly sessions lasting about 2 hours each.
Exclusion criteria
* having already participated in Gundo-So
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Short term evaluation of the burden associated with the disclosure issue using questionnaires | The short term effect will be measured at the end of the intervention and compared between Group 1 and 2. Up to 6 months from the beginning of the randomization to the end of the intervention | Improvement of the management of the sharing of the serological status. Empowerment in sharing the HIV status (questionnaire) |
| Short term evaluation of the burden associated with the secrecy issue using questionnaires | The short term effect will be measured at the end of the intervention and compared between Group 1 and 2. Up to 6 months from the beginning of the randomization to the end of the intervention | Improvement of the management of the secret of the serological status. Empowerment in keeping secret the HIV status (questionnaire) |
| Mid term evaluation of the burden associated with the disclosure issue using questionnaires | The mid term effect will be measured 9 months after the intervention : up to 9 months after the intervention | Improvement of the management of the sharing of the serological status. Empowerment in sharing the HIV status (questionnaire) |
| Mid term evaluation of the burden associated with the secrecy issue using questionnaires | The mid term effect will be measured 9 months after the intervention : up to 9 months after the intervention | Improvement of the management of the secret of the serological status. Empowerment in keeping secret the HIV status (questionnaire) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biological data : cluster of differentiation 4 levels | From 6 months before the intervention until the last follow up (total 2 years) | Access changes in cluster of differentiation 4 levels due to the intervention (via the medical file) |
| Changes in quality of life of WLHIV: questionnaire | Measured at the randomization and then immediately after the intervention | Assess the changes in quality of life (questionnaire) |
| Satisfaction of the intervention: questionnaire | Measured immediately after the intervention | Assess the satisfaction of the intervention using questionnaire |
| Evolution of sexual practices and use of risk reduction strategies | Measured at the randomization and then immediately after the intervention | Assess changes of sexual practices and risk reductions strategies (questionnaire) |
| Reported compliance (questionnaire) | Measured at the randomization and then immediately after the intervention | Assess changes of reported compliance throught HIV antiretroviral treatments (questionnaire) |
| Biological data : HIV viral load | From 6 months before the intervention until the last follow up (total 2 years) | Access changes in HIV viral load due to the intervention (via the medical file) |
Countries
Mali
Contacts
Primary ContactLucas Riegel
Backup ContactMarie Préau, Pr
Outcome results
None listed