we are the change: self-stigma and hiv in zimbabwe deirdre ní cheallaigh
TRANSCRIPT
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We are the change:Self-stigma and HIV in ZimbabweDeirdre Ní Cheallaigh
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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
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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
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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
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The MethodologyIBSR: The Work of Byron Katie
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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
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Fears around disclosure
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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
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Measurements:Quality of Life (QoL), CES-D, Internalised AIDS Stigma Scale (IASS)
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Quantitative results – 3 months
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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
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RESULTS - FEARS AROUND DISCLOSURE
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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.
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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
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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)
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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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