The objective of this research is to measure the short- and mid-term effects of an empowerment program focused on serostatus disclosure management for women living with HIV (WLHIV) in Mali on the "burden of secrecy".
Serostatus disclosure is a critical issue for persons living with HIV (PLHIV). Studies identified numerous benefits associated with disclosure, but various negative consequences have also been documented. Gender inequality must be taken into account regarding the disclosure issue, in particular in Mali, where women are economically dependent and have a low decision-making power. Moreover, in Mali, since 2006, PLHIV have a legal obligation to disclose their serostatus to their spouse and sexual partner(s) " as soon as possible, or within 6 weeks " after the diagnosis. Although this law is not enforced, it highlights the sensitive nature of the serostatus disclosure issue and raise concerns among PLHIV and other stakeholders. To support women living with HIV (WLHIV), an empowerment program (Gundo-So) was implemented by ARCAD-SIDA in Mali, in collaboration with several partners. This program aims to empower WLHIV, so that they can make informed decision about disclosing or keeping their serostatus secret in their various life contexts, and that they can identify strategies to disclose or to keep the secret, as well as to manage potential negative reactions. Gundo-So ("The room of confidences") was adapted from a program established in quebec and has been implemented in Mali. The objective of this research is to measure the short- and mid-term effects of an empowerment program focused on serostatus disclosure management for women living with HIV (WLHIV) in Mali on the "burden of secrecy". The evaluation of the effects of the Gundo-So program will be helpful to assess the relevance of a national or subregional extension of the program, or even an adaptation to other target populations (e.g. heterosexual men and men who have sex with men living with HIV).
Study Type
OBSERVATIONAL
Enrollment
224
Gundo-So was adapted from a program established in quebec. It has been implemented in Mali following 3 phases: 1) cultural adaptation; 2) validation using a pre-post intervention evaluation; 3) scale-up The programm consists on 9 group meetings group spread over 9 weeks (for 8 WLHIV + 2 trained community-based leaders). Each meeting has some particular thematics with adapted tools.
CESAC de BAMAKO
Bamako, Mali
RECRUITINGUsac Cnam
Bamako, Mali
RECRUITINGUSAC commune IV
Bamako, Mali
RECRUITINGShort term evaluation of the burden associated with the disclosure issue using questionnaires
Improvement of the management of the sharing of the serological status. Empowerment in sharing the HIV status (questionnaire)
Time frame: The short term effect will be measured at the end of the intervention and compared between Group 1 and 2. Up to 6 months from the beginning of the randomization to the end of the intervention
Short term evaluation of the burden associated with the secrecy issue using questionnaires
Improvement of the management of the secret of the serological status. Empowerment in keeping secret the HIV status (questionnaire)
Time frame: The short term effect will be measured at the end of the intervention and compared between Group 1 and 2. Up to 6 months from the beginning of the randomization to the end of the intervention
Mid term evaluation of the burden associated with the disclosure issue using questionnaires
Improvement of the management of the sharing of the serological status. Empowerment in sharing the HIV status (questionnaire)
Time frame: The mid term effect will be measured 9 months after the intervention : up to 9 months after the intervention
Mid term evaluation of the burden associated with the secrecy issue using questionnaires
Improvement of the management of the secret of the serological status. Empowerment in keeping secret the HIV status (questionnaire)
Time frame: The mid term effect will be measured 9 months after the intervention : up to 9 months after the intervention
Changes in quality of life of WLHIV: questionnaire
Assess the changes in quality of life (questionnaire)
Time frame: Measured at the randomization and then immediately after the intervention
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USAC commune I
Bamako, Mali
RECRUITINGUSAC commune VI
Bamako, Mali
RECRUITINGUSAC commune V
Bamako, Mali
RECRUITINGEvolution of sexual practices and use of risk reduction strategies
Assess changes of sexual practices and risk reductions strategies (questionnaire)
Time frame: Measured at the randomization and then immediately after the intervention
Reported compliance (questionnaire)
Assess changes of reported compliance throught HIV antiretroviral treatments (questionnaire)
Time frame: Measured at the randomization and then immediately after the intervention
Biological data : HIV viral load
Access changes in HIV viral load due to the intervention (via the medical file)
Time frame: From 6 months before the intervention until the last follow up (total 2 years)
Biological data : cluster of differentiation 4 levels
Access changes in cluster of differentiation 4 levels due to the intervention (via the medical file)
Time frame: From 6 months before the intervention until the last follow up (total 2 years)
Satisfaction of the intervention: questionnaire
Assess the satisfaction of the intervention using questionnaire
Time frame: Measured immediately after the intervention