Learning through story: how peer-led support groups use storytelling to empower adolescents living with HIV in Côte d'Ivoire.

backgroundAdolescents living with HIV struggle to accept their HIV status and remain adherent to antiretroviral therapy (ART). Support groups are one way to assist adolescents overcome these barriers. This evaluation, conducted in health facilities in Abidjan, Côte d'Ivoire, explored the acceptability of peer-led support groups using a ten-topic curriculum and a 'storytelling' model in which fictional or real-life scenarios were used to make information more relatable and encourage discussion and sharing of personal experiences.

methodsIn-depth interviews were conducted to explore the acceptability of the new model among adolescents enrolled in peer-led HIV support groups, peer support group leaders, and health care workers. The study also sought to describe the experiences of peer leaders and HCWs involved in implementing the latest model. Data were collected on the percentage of adolescents who created treatment plans, and session and topic attendance, from six facilities providing peer-led support groups. Interviews were audio-recorded, transcribed, and translated. Data were approached from a constructivist perspective, and thematic analysis was used to identify themes within participants' accounts. A code list was created using a combined inductive and deductive approach. Transcripts were coded using MAXQDA v.12.

resultsA total of 45 in-depth interviews were conducted from August to September 2021. Across participant groups, peer-led support groups were perceived as highly important sources of support for adolescents living with HIV. Adolescents reported increased comfort in sharing their personal experiences and engaging with content delivered through storytelling. Participants described the development of trust and peer support within groups, while peer leaders were viewed as role models for medication adherence. Health care workers reported improved communication and relationships with their adolescent patients. Key barriers to participation included scheduling constraints and transport costs Participants attended an average of six of the ten sessions, with the highest attendance observed for sessions on safe sex and disclosure of HIV status.

conclusionPeer-led support groups provide critical support to adolescents in accepting their HIV status. The support groups helped adolescents to learn the importance of ART adherence and create a supportive environment for them to live positively with HIV.