'I think my future will be better than my past': Examining support group influence on the mental health of HIV-infected Rwandan women

• Published in: Global public health Vol. 8; no. 1; pp. 90 - 105
• Main Authors: Walstrom, Paige, Operario, Don, Zlotnick, Caron, Mutimura, Eugene, Benekigeri, Chantal, Cohen, Mardge H.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.01.2013; Taylor & Francis Ltd
• Subjects: Adherence; Adhesion; Adolescent; Adult; Aged; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral drugs; Antiretroviral therapy; ART adherence; Attendance; Attitudes; Behavior change; Behavior modification; Benefits; Clinical outcomes; Depression; Female; Focus Groups; Genocide; Genocide - psychology; Genocide - statistics & numerical data; Health behavior; Help seeking behavior; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - etiology; HIV Infections - psychology; Human immunodeficiency virus; Humans; Hunger; Interpersonal conflicts; Leverage; Medical service; Medical treatment; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Men; Mental depression; Mental disorders; Mental Health; Mental health services; Middle Aged; Narratives; Participation; Post traumatic stress disorder; post-conflict; Post-conflict societies; Posttraumatic stress disorder; Poverty; Psychological distress; Psychological problems; Psychological services; Psychological trauma; Psychosocial factors; Psychosocial support; Risk; Risk behavior; Rwanda; Rwanda - epidemiology; Self Disclosure; Self-Help Groups; Sex crimes; Sex Offenses - psychology; Sex Offenses - statistics & numerical data; Sexual behavior; Social influence; Social Stigma; Social support; support group; Support groups; Survivors - psychology; Trauma; Treatment outcomes; Victims; Violence; Warfare; Well being; Women; Womens health; Young Adult; Rwanda
• ISSN: 1744-1692; 1744-1706
• DOI: 10.1080/17441692.2012.699539

Urgent need exists for improved psychological services among HIV-infected women in post-genocide Rwanda. Psychological problems associated with trauma and sexual violence (i.e., depression, posttraumatic stress disorder [PTSD]) place women at increased risk for sexual risk behaviour, low health-seeking behaviour, delay of antiretroviral therapy (ART) and reduced ART adherence. We explored experiences of HIV-infected Rwandan women attending psychosocial support groups and their narratives about how participation affected their mental health and HIV treatment. Focus group discussions examined participants' reasons for support group attendance, perceived psychological benefit of support groups, influence on ART adherence, and other influences on health behaviors and attitudes. Rwandan women (aged 18-65) were randomly selected from 10 health clinic-facilitated support groups for HIV-infected trauma survivors in Kigali. Results identified positive psychological and physical changes as well as behaviour changes in relationships with men, which participants attributed to support group attendance. Data showed significant improvement in mental health, ART adherence and HIV serostatus disclosure resulting from group attendance. Participants acknowledged limitations of support groups with respect to addressing poverty and hunger. Implementing psychosocial support groups may leverage clinical outcomes and rejuvenate the well-being of HIV-infected women with interpersonal trauma and/or PTSD and depressive symptoms, particularly those from post-conflict countries.