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"I was in the darkness but the group brought me light": Development, relevance and feasibility of the Sondela HIV adjustment and coping intervention

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      Abstract

      Developing interventions that address psychosocial wellbeing of people living with HIV is critical to ensure strong linkages to and retention in HIV care. This paper describes the development of Sondela, an HIV adjustment and coping intervention for heterosexual men and women living with HIV, and its relevance and feasibility in the South African context. Sondela is a six three-hour, small group-based, participatory workshop series. We followed an iterative, multi-phased process of curriculum development that involved research, theoretical frameworks and piloting. A systematic review highlighted the absence of psychosocial interventions targeting heterosexual HIV positive populations living in high HIV prevalence and resource-poor settings. Formative studies demonstrated risk and social factors associated with adjustment and coping with HIV, emphasising the need for interventions that acknowledge gendered experiences. Our pilot of Sondela demonstrated high levels of relevance and feasibility. Men appreciated the workshop “space” to openly talk about their HIV positive status and what is means for their role as partners and fathers and friends. Women valued the skills and approaches because they were relevant to “real life” situations and not just about HIV. Sondela promises to be valuable in supporting health system initiatives and psychosocial support to strengthen linkages to and retention in HIV care, and this suggests a need for rigorous evaluation of Sondela to establish evidence for its effectiveness in a general population.

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        Psychosocial resilience and protective mechanisms.

        The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: reduction of risk impact, reduction of negative chain reactions, establishment and maintenance of self-esteem and self-efficacy, and opening up of opportunities. The mechanisms operating at key turning points in people's lives must be given special attention.
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          Social Foundation for thought and action: a social cognitive theory

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            Author and article information

            Affiliations
            [1 ]Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa
            [2 ]School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
            [3 ]School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
            [4 ]School of Public Health, University of Western Cape, Bellville, South Africa
            [5 ]School of Health and Rehabilitative Sciences, Faculty of Health, University of Cape Town, Cape Town, South Africa
            Stellenbosch University, SOUTH AFRICA
            Author notes

            Competing Interests: The authors have declared that no competing interests exist.

            • Conceptualization: NS YS IVDH NA RJ.

            • Data curation: NS YS IVDH.

            • Formal analysis: NS YS IVDH NA RJ.

            • Funding acquisition: YS IVDH NA RJ.

            • Investigation: NS YS IVDH.

            • Methodology: NS YS IVDH NA RJ.

            • Project administration: NS YS IVDH.

            • Resources: NS YS IVDH.

            • Supervision: NS YS IVDH.

            • Validation: NS YS IVDH NA RJ.

            • Visualization: NS YS IVDH NA RJ.

            • Writing – original draft: NS YS IVDH.

            • Writing – review & editing: NS YS IVDH NA RJ.

            Contributors
            Role: Editor
            Journal
            PLoS One
            PLoS ONE
            plos
            plosone
            PLoS ONE
            Public Library of Science (San Francisco, CA USA )
            1932-6203
            1 June 2017
            2017
            : 12
            : 6
            28570597
            5453489
            10.1371/journal.pone.0178135
            PONE-D-16-48089
            (Editor)
            © 2017 Shai et al

            This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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            Figures: 3, Tables: 1, Pages: 19
            Product
            Funding
            Funded by: South African Medical Research Council
            Award Recipient :
            Funded by: CDC
            Award Recipient :
            This paper was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention, under the terms of Cooperative Agreement Number 5U2GPS001137-4.
            Categories
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            Biology and Life Sciences
            Microbiology
            Medical Microbiology
            Microbial Pathogens
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            Immunodeficiency Viruses
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