The Impact of Structured Support Groups for Pregnant South African Women Recently Diagnosed HIV Positive

Abstract

The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p < 0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t = 2.68, p < 0.05) and lower levels of avoidant coping (t = −2.02, p < 0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t = 2.11, p < 0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time.

KEYWORDS:

• HIV/AIDS
• mental health
• pregnancy
• psychosocial
• social support

Notes

ⁱTime since HIV diagnosis measured in weeks;

ⁱⁱPer capita income measured in South African Rand (ZAR);

ⁱⁱⁱSocio-economic score measuring standard of living;

^ivPower score measured the level of power the subject holds within her home, to make decisions related to sex, finances, food, health, and children;

^vOther languages included English, Afrikaans, Xhosa, Sotho, Venda, Tsonga, Ndebele, Seswati, and Shona.

1. The Serithi Project (NIH R24HD43558) is a longitudinal study aimed at developing an understanding of the experiences of women who test HIV-positive at antenatal clinics in townships in Tshwane, South Africa.

2. The housing score included five items, namely whether the house was built from bricks or cement, whether there was running water within the home, whether there was a flushing toilet, whether the dwelling had electricity and whether a refrigerator was owned A score of 1 was assigned for affirmative answers. The total score was out of 5.

3. A power score was calculated, which estimates the level of power the woman holds within her home, to make decisions related to sex, finances, food, health decisions, and children. A score of 1 was assigned if the women made the decision, or it was made jointly with her and someone else. The total score was out of 6.

4. The authors examined correlations between stage of pregnancy and the various psychosocial scores for the women participating in the groups, but found no significant differences.