A growth curve model to assess the effectiveness of a community-based intervention for the empowerment of Malian females in the decision to disclose (or not) their HIV status (ANRS-12373 Gundo-So) - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Conference Poster Year : 2023

A growth curve model to assess the effectiveness of a community-based intervention for the empowerment of Malian females in the decision to disclose (or not) their HIV status (ANRS-12373 Gundo-So)

Abstract

BACKGROUND: In Mali, women living with HIV (WLHIV) who disclose their positive status are often confronted with stigma, violence, economic pressure, and social exclusion, including from family. We aimed to evaluate the effectiveness of an intervention for the empowerment of WLHIV on the decision to disclose or not their HIV-positive status, and associated factors. METHODS: ANRS-12373/Gundo-So (Chamber of Secrets in Bambara) was implemented in 6 community-based clinics in Mali in 2019/2020. The intervention consisted of 9 weekly sessions of peer-support for strengthening the capacity of WLHIV to manage the consequences concerning (non)disclosure of their HIV-positive status. Individual and psychosocial characteristics were collected at enrolment, pre- /post-intervention, then quarterly over 9 months. Effectiveness was evaluated using a scale measuring the psychological burden related to the sero-status secret from 0 (none) to 5 (very high). A growth curve model using Poisson distribution was estimated to investigate changes before(=0) and after the intervention(=1). Random-effects allowed controlling for unobserved/unobservable characteristics. This technique accounts for missing data and unequally spaced time points. RESULTS: Among 240 WLHIV enrolled, 222 (92.5%) and 146 (60.8%) responded to the pre-/post-intervention questionnaires respectively. Then, 139 (58.0%) continued follow-up at M3, and 136 (56.6%) at both M6 and M9. Analyses were carried out over the 1019 observations. At baseline, median age[IQR] was 33[28-39] years, 76.7% of participants did not have any education level/low-level. The psychological burden of sero-status secret was self-evaluated =1 by 50% of participants, whereas it was =4 for 23%. Estimations without confounders showed that the psychological burden decreased on average by 42% after the intervention (IRR:0.58, 95%CI[0.46-0.61]). Including covariates showed that the psychological burden decreases with age (IRR:0.98, 95%CI[0.97-0.99]), easy ARV uptake (IRR:0.81, 95%CI[0.68-0.97]), and absence of loneliness (IRR:0.83, 95%CI[0.71-0.96]). The intervention effectiveness persisted after including covariates. The psychological burden decreased of 44% after the intervention (IRR:0.56, 95%CI[0.48-0.65]). CONCLUSIONS: Our results have demonstrated that the Gundo-So intervention was effective for the empowerment of Malian WLHIV to reduce the psychological burden of HIV disclosure-related issues. Social and behavioral interventions adopting a community-based approach can effectively promote health outcomes among people confronted to sociocultural hostile environments such as Mali.
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Dates and versions

inserm-04315577 , version 1 (30-11-2023)

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  • HAL Id : inserm-04315577 , version 1

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L Sagaon-Teyssier, B Coulibaly, L Riegel, V Villes, D Traoré, et al.. A growth curve model to assess the effectiveness of a community-based intervention for the empowerment of Malian females in the decision to disclose (or not) their HIV status (ANRS-12373 Gundo-So). Conférence IAS 2023 : Tour d'horizon des travaux de l'agence présenté, Jul 2023, Brisbane, Australia. ⟨inserm-04315577⟩
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