We are the change:Self-stigma and HIV in ZimbabweDeirdre Ní Cheallaigh

Vision and Goal

VisionA Zimbabwean community of men and women living with HIV free of self-stigma

GoalTo empower and equip men and women living with HIV to tackle their self-stigma

Programme Model

Phase I 2012-2013

• Research• Programme

design and delivery

• Local adaptation,

• Advocacy

Phase II2014

• Building Capacity for local facilitators

• Localising facilitators programme

• Advocacy

Phase III2015-2016

• Research • Local

Programme delivery

• Zimbabwean Facilitators supported

• Advocacy

Phase I

• Formative research into core beliefs on self-stigma and HIV Published March 2015 http://www.smw.ch/content/smw-2015-14113/

• Two local HIV positive women attended the School in Germany, 2013• Research tools to measure impact developed and

ethics approval secured, 2013• Self-stigma and HIV course designed • 12-week self-stigma and HIV course with two groups of 12 participants,

September-November 2013• Curriculum revised based on delivery• Research data analysed and will be published

The MethodologyIBSR: The Work of Byron Katie

Course themes

• Session 0 Introduction to the Course• Session 1 Introduction to The Work• Session 2 What others think about me because I have HIV• Session 3 How HIV limits me• Section 4 HIV treatment• Session 5 My HIV story• Session 6 Me, My Body and HIV• Session 7 My sex life since HIV• Session 8 Shame and guilt• Session 9 Fears of disclosing my HIV status• Session 10 Death• Session 11 God and a friendly universe• Session 12 Who I truly am

Fears around disclosure

PARTICIPANTS

• 23 Participants• Group A : 11 Women• Group B : 6 Men, 6 Women• Aged 25 to 54, half aged 41 or under• Most (65%) had completed form 4 education• Few working at baseline (5 women, 2 men)• 11 women and 4 men married/living with stable partner• All had children, most (17) had 2 to 4 children• 21 were Shona, all were Christian

Measurements:Quality of Life (QoL), CES-D, Internalised AIDS Stigma Scale (IASS)

Quantitative results – 3 months

FEARS AROUND DISCLOSURE

All of the time

A lot of the time

Someof the time

A little of the time

None of the time

In the past 4 weeks, I haven't been able to live the way I'd like to because I'm so worried about my healthIn the past 4 weeks, I've been worried about my CD4 count In the past 4 weeks, I've been worried about my viral load In the past 4 weeks, I've been worried about when I'm going to die

RESULTS - FEARS AROUND DISCLOSURE

RESULTS - FEARS AROUND DISCLOSURE

• Fears around disclosure improved significantly following the intervention (P=0·023 comparing both follow-ups with baseline).

• There was no significant change between the 1-month and 3-month scores (P=0·329).

• So the improvement was immediate, but was maintained at 3 months

• The proportion who expressed no fears about disclosure rose from 35% at baseline to 61% at three-month follow-up.

GENERAL SUMMARY

• Most measures improved immediately• More significantly, measures that improved maintained

improvement at three months• And some measures were improved at three months but not

at one month• No measure got worse

These themes emerged during pre-course focus group discussions of the question:

“When you were first diagnosed with HIV, can you describe some of the feelings you had at the time? ” The size of each word roughly represents the number of times that the theme was mentioned by participants.

Emerging themes (pre course)

These themes emerged from analysis of focus group discussions of the question: “If you had to describe what you got out of this course, what would you say?”

The size of each word roughly represents the number of times that the theme was mentioned by participants.

Emerging themes (post course)

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