Efficacy of a Social SelfValue Empowerment Interv

Authors: Dharma Nand Bhatta Tippawan Liabsuetrakul

Publish Date: 2016/09/09

Volume: 21, Issue: 6, Pages: 1620-1631

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Abstract

We developed a comprehensive and culturally applicable empowerment intervention social selfvalue package with an aim to assess its efficacy in order to improve the quality of life QoL of HIV infected people receiving antiretroviral treatment Participants were randomly allocated to receive either six weekly intervention sessions or standard care Nonlinear mixedeffects models were performed to compare changes in empowerment scores over time Between September and November 2014 1447 individuals were screened of whom 132 were randomly assigned to either the intervention or control group The mean scores of empowerment social support and quality of life increased and stigma scores were reduced in the intervention group at 3 and 6months An intervention effect on social support stigma and QoL was significantly increased by time and group with low and high empowerment No adverse events were reported The empowerment intervention was efficacious in improving QoL of HIV infected peopleHemos desarrollado un fortalecimiento completo y cultural applicable a la intervención social del paquete del valor propio con la intención de evaluar su eficacia para mejorar la calidad de vida de las personas infectadas por el VIH que están recibiendo ART A los participantes se les adjudicó aleatoriamente la asignación de seis dosis semanales o los cuidados estandar El resultado de los efectos se presentó para comparar los cambios en los valores del fortalecimiento a lo largo del tiempo Entre septiembre y noviembre de 2014 1447 individuos fueron moritonizados de los cuales 132 fueron aleatoriamente asignados para cada intervención o grupo de control La media del valor del fortalecimiento apoyo social y calidad de vida incrementaron y los valores del estigma fueron reducidos en la intervención grupal entre 3 y 6 meses Los efectos de una intervención al apoyo social estigma y calidad de vida se incrementaron significativamente en ese periodo y el grupo con un bajo y alto fortalecimiento No hubo efectos secundarios notificados La intervención en el fortalecimiento fue satisfactoria en la mejora de la calidad de vida de la gente infectada por el VIHEpidemiological studies have highlighted decreases in HIV incidence and increased deaths related to HIV/AIDS 1 2 3 4 5 However the prevalence of HIV has remained extensive and epidemic contained enormous heterogeneity 4 Decreasing trends of epidemics and increased life expectancy of people infected with HIV have been reported but risky sexual behaviors have promoted the transmission of HIV among general populations and reinfections and coinfections among HIV infected people 3 6 Disease burdens are reported to be more common among HIV infected populations compared to general populations altering their quality of life QoL 7 8 9 The life expectancy among people living with HIV after they have initiated suitable antiretroviral treatment ART or combined antiretroviral treatment is reported to be similar to the general population 10 11Availability of the ART among HIV infected people is very low and combined with psychological distress might lead to the development of anxiety low QoL and increased stigma 4 12 The effect of ART on QoL was found to be reasonable among HIV infected people 13 14 15 Further their quality of life is influenced by health status economic factors and psychological status 16 The mechanism of how immunological and virological response influences quality of life among HIV infected people has not been comprehensively studied and therefore the effect of HIV status on QoL is unclear Albeit much less has been identified about the QoL of HIV infected people in comparison with other people despite considerable progress in medical prospective 16 17 Moreover the effect of treatment on HIV might be affected by several factors which would help to increase stigma reduce QoL and social support and disempowerment of HIV infected people 18 19 20 21Social taboos and stigma are universal sociocultural barriers for HIV control and prevention 22 23 Empowerment and social support could be helpful assets among HIV infected people to enhance their QoL reduce stigma and improve adherence to ART in resource poor settings 24 25 A practical and integrated program is needed for empowerment of HIV infected people 26 27 Empowerment would be best approached to reduce HIV risk associated problems with cost effective interventions 28 29 30 However HIV related empowerment based programs are sparse and it has been necessary to strengthen and implement them with usual ART and other programs with political and social transforms 26 31 32 33Different organizations have set the goal to achieve zero discrimination transmission and stigma but the interventions are too sparse to cover these goals 2 34 35 In addition the ‘909090’ target has been set by UNAIDS by the year 2020 36 Therefore extensive socially and culturally accepted costeffective interventions are needed which enhance QoL and social support and eliminate stigma among HIV infected people in resource poor settings 15 37 38 39 40 Unfortunately most of the interventions were established in developed countries and few from developing countries There is thus an urgent need to develop a culturally sensitive intervention for use in developing countries An empowerment intervention program we have developed designed to improve QoL of HIV infected people was developed on the foundation of the diffusion model of innovations 41 and followed different theories to connect empowerment framework that assumed to change behavior selfesteem social support discrimination stigma and QoL 6 42 43 44 45 46 47 48 49 50 51 52 The aim of this study was to assess the efficacy of a social selfvalue empowerment intervention package to improve QoL of HIV infected people receiving ART Furthermore we assessed the effect of this intervention to enhance social support and reduce stigma

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