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Preliminary Impact of Group-Based Interventions on Stigma and the Mental Health of Caregivers of Adolescents Living with HIV in Uganda

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Abstract

This study examined the preliminary impact of group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family groups (MFG-FS) on HIV stigma, parenting stress, and the mental health of caregivers of adolescents living with HIV. We analyzed data from the Suubi4Stigma study (2020–2022), a two-year pilot randomized clinical trial for adolescents and their caregivers (N = 89 dyads), recruited from nine health clinics in Uganda. Adolescent-caregiver dyads were randomized to three intervention conditions delivered over three months, with data collected at baseline, three and six-months follow-up. We fitted mixed-effects linear regression models to test the effect of the interventions on caregiver outcomes over time. At six months, caregivers randomized to the MFG-FS condition reported lower levels of stigma by association (mean difference = -1.45, 95% CI = -2.52 – -0.38, p = 0.008), and stigma and discrimination attitudes (mean difference = -3.84, 95% CI = -4.63 – -3.05, p < 0.001), compared to Usual care condition. In addition, caregivers of adolescents randomized to the G-CBT condition reported lower levels of stigma and discrimination attitudes at three months (mean difference = -5.18, 95% CI = -9.13 – -1.22, p = 0.010), and at six months (mean difference = -6.70, 95% CI = -9.28 – -4.12, p < 0.001). Caregiver mental health and parenting stress significantly reduced over time regardless of intervention condition. Findings point to the importance of incorporating stigma reduction components within psychosocial interventions targeting adolescents and families impacted by HIV.

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Acknowledgements

We are grateful to the staff and the volunteer team at the International Center for Child Health and Development (ICHAD) in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study.

Funding

This work was supported by the National Institute of Mental Health (NIMH; Grant # R21MH121141, 2020–2022; MPIs: Proscovia Nabunya, PhD and Fred M. Ssewamala, PhD). NIMH had no role in the study design, data collection, analysis, interpretation of findings and preparing this manuscript. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH.

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Authors and Affiliations

  1. International Center for Child Health and Development (ICHAD), Brown School Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA

    Proscovia Nabunya, Samuel Kizito, Atwebembere Raymond & Vicent Ssentumbwe

  2. The Initiative on Social Work & Forced Migration, Brown School, Washington University in St. Louis, St. Louis, USA

    Mitra Naseh

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  1. Proscovia Nabunya
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Correspondence to Proscovia Nabunya.

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Nabunya, P., Kizito, S., Naseh, M. et al. Preliminary Impact of Group-Based Interventions on Stigma and the Mental Health of Caregivers of Adolescents Living with HIV in Uganda. AIDS Behav (2024). https://doi.org/10.1007/s10461-024-04353-8

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