Factors Affecting Caregivers' Participation in Support Groups for People Living with HIV in Tanzania

Overview

Journal Front Public Health

Specialty Public Health

Date 2023 Oct 2

PMID 37780441

Authors

Levina Kikoyo

Amon Exavery

John Charles

Akwila Temu

Asheri Barankena

Amal Ally

Remmy Mseya

Tumainiel Mbwambo

Rose Fovo

Aidan Tarimo

Godfrey Martin Mubyazi

Marianna Balampama

Erica Kuhlik

Tom Ventimiglia

Elizabeth Lema

Affiliations

Soon will be listed here.

Abstract

Introduction: Support groups for people living with HIV (PLHIV) are essential for increasing adherence, retention, addressing their psychosocial needs and improving patient literacy. However, factors that influence participation of caregivers living with HIV (LHIV) in these groups are scarcely documented, particularly for those caring for orphans and vulnerable children (OVC).

Methods: This study used baseline data collected between 1st October 2021 and 30th September 2022 from the PEPFAR/USAID-funded Adolescents and Children HIV Incidence Reduction, Empowerment and Virus Elimination (ACHIEVE) project in Tanzania to investigate factors that affect participation of caregivers LHIV in support groups for PLHIV. A total of 74,249 HIV-positive OVC caregivers who were already receiving antiretroviral therapy (ART) and had a confirmed care and treatment centre identification number were included in the analysis. Factors affecting group participation were identified through multilevel analysis using multivariable mixed-effects logistic regression.

Results: Results showed that 84.2% of the caregivers were participants in the support groups for PLHIV. Their mean age was 36 years, and the majority (82.1%) were female. Multivariable analysis revealed that participation in the groups was more likely among caregivers living in urban areas (aOR = 1.39 [1.24, 1.55]), with primary education (aOR = 1.17 [1.07, 1.28]), and without disabilities (aOR = 0.62 [0.47, 0.82]). However, participation was less likely among widowed (aOR = 0.91 [0.84, 0.999]), single or unmarried (aOR = 0.86 [0.78, 0.95]), and those with secondary education or higher levels than never attended (aOR = 0.69 [0.60, 0.80]), moderate hunger (aOR = 0.86 [0.79, 0.93]), and those aged 30 years or older (< 0.001).

Discussion: A sizeable proportion (15.8%) of the caregivers were not in support groups for PLHIV, ranging from 12.3% among those in households with severe hunger to 29.7% among disabled ones. The study highlights the need for tailored interventions to increase participation in support groups for PLHIV, particularly for caregivers who are disabled, live in rural areas, are older, widowed, and/or unmarried, and those in poor households.

References

Charles J, Exavery A, Barankena A, Kuhlik E, Mubyazi G, Abdul R . Determinants of undisclosed HIV status to a community-based HIV program: findings from caregivers of orphans and vulnerable children in Tanzania. AIDS Res Ther. 2020; 17(1):42. PMC: 7364533. DOI: 10.1186/s12981-020-00299-8. View

Hill W, Weinert C, Cudney S . Influence of a computer intervention on the psychological status of chronically ill rural women: preliminary results. Nurs Res. 2006; 55(1):34-42. PMC: 1484522. DOI: 10.1097/00006199-200601000-00005. View

Heymann J, Earle A, Rajaraman D, Miller C, Bogen K . Extended family caring for children orphaned by AIDS: balancing essential work and caregiving in a high HIV prevalence nations. AIDS Care. 2007; 19(3):337-45. DOI: 10.1080/09540120600763225. View

Hanass-Hancock J . Disability and HIV/AIDS - a systematic review of literature on Africa. J Int AIDS Soc. 2009; 12:34. PMC: 2788347. DOI: 10.1186/1758-2652-12-34. View

Williams A, Friedland G . Adherence, compliance, and HAART. AIDS Clin Care. 1997; 9(7):51-4, 58. View

Charles J, Exavery A, Ally A, Mseya R, Mbwambo T, Barankena A . Rates and Determinants of Retention on ART Among Orphans and Vulnerable Children Living With HIV in Tanzania. Front Public Health. 2022; 10:934412. PMC: 9366305. DOI: 10.3389/fpubh.2022.934412. View

Audi C, Jahanpour O, Antelman G, Guay L, Rutaihwa M, Van de Ven R . Facilitators and barriers to antiretroviral therapy adherence among HIV-positive adolescents living in Tanzania. BMC Public Health. 2021; 21(1):2274. PMC: 8670050. DOI: 10.1186/s12889-021-12323-1. View

Thielman N, Ostermann J, Whetten K, Whetten R, ODonnell K . Correlates of poor health among orphans and abandoned children in less wealthy countries: the importance of caregiver health. PLoS One. 2012; 7(6):e38109. PMC: 3374817. DOI: 10.1371/journal.pone.0038109. View

Exavery A, Charles J, Barankena A, Kuhlik E, Mubyazi G, Kyaruzi C . Accelerating caregivers' HIV status disclosure to community-based lay social welfare volunteers in Tanzania. AIDS Res Ther. 2021; 18(1):9. PMC: 8015201. DOI: 10.1186/s12981-021-00332-4. View

10.

Hosseinzadeh H, Hossain S, Bazargan-Hejazi S . Perceived stigma and social risk of HIV testing and disclosure among Iranian-Australians living in the Sydney metropolitan area. Sex Health. 2012; 9(2):171-7. DOI: 10.1071/SH10111. View

11.

Sibeudu F, Uzochukwu B, Onwujekwe O . Rural-urban comparison of routine immunization utilization and its determinants in communities in Anambra States, Nigeria. SAGE Open Med. 2019; 7:2050312118823893. PMC: 6348577. DOI: 10.1177/2050312118823893. View

12.

Mazambara F, Chagwena D, Mudzviti T, Sithole S, Monera-Penduka T, Maponga C . Utility of HIV support groups in advancing implementation research in resource-limited settings: experiences from an urban-setting HIV support group in Zimbabwe. AIDS Res Ther. 2022; 19(1):7. PMC: 8843025. DOI: 10.1186/s12981-022-00431-w. View

13.

Tomori C, Kennedy C, Brahmbhatt H, Wagman J, Mbwambo J, Likindikoki S . Barriers and facilitators of retention in HIV care and treatment services in Iringa, Tanzania: the importance of socioeconomic and sociocultural factors. AIDS Care. 2013; 26(7):907-13. DOI: 10.1080/09540121.2013.861574. View

14.

Pellowski J, Kalichman S, Matthews K, Adler N . A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Am Psychol. 2013; 68(4):197-209. PMC: 3700367. DOI: 10.1037/a0032694. View

15.

Corrigan P, Watson A . Understanding the impact of stigma on people with mental illness. World Psychiatry. 2006; 1(1):16-20. PMC: 1489832. View

16.

Swenor B . Including disability in all health equity efforts: an urgent call to action. Lancet Public Health. 2021; 6(6):e359-e360. PMC: 8964271. DOI: 10.1016/S2468-2667(21)00115-8. View

17.

Wang Y, Kinsler J, Kiwuwa-Muyingo S . Factors associated with HIV testing among youth in Tanzania based on the 2016-2017 Tanzania HIV Impact Survey (THIS). PLOS Glob Public Health. 2023; 2(11). PMC: 9799957. DOI: 10.1371/journal.pgph.0000536. View

18.

Exavery A, Charles J, Kuhlik E, Barankena A, Ally A, Mbwambo T . Correlates of Uptake of Antiretroviral Therapy in HIV-Positive Orphans and Vulnerable Children Aged 0-14 Years in Tanzania. HIV AIDS (Auckl). 2020; 12:233-241. PMC: 7367717. DOI: 10.2147/HIV.S259074. View

19.

Ostermann J, Reddy E, Shorter M, Muiruri C, Mtalo A, Itemba D . Who tests, who doesn't, and why? Uptake of mobile HIV counseling and testing in the Kilimanjaro Region of Tanzania. PLoS One. 2011; 6(1):e16488. PMC: 3031571. DOI: 10.1371/journal.pone.0016488. View

20.

Miller C, Gruskin S, Subramanian S, Rajaraman D, Heymann S . Orphan care in Botswana's working households: growing responsibilities in the absence of adequate support. Am J Public Health. 2006; 96(8):1429-35. PMC: 1522103. DOI: 10.2105/AJPH.2005.072280. View