"You are not alone": A process evaluation of a psychosocial intervention for PLHIV of Africa descent in Belgium

Despite the progressive transformation of HIV from a deadly disease into a chronic condition, its psychosocial impact remains significant. People living with HIV (PLHIV) still face long-term challenges to their psychological well-being, challenges mainly associated with stigma and discrimination, which in turn negatively affect different aspects of their self-management capacities such as health-seeking behaviour, adherence to treatment and harnessing and sustaining needed peer and social support. The suboptimal quality of the physical, social, and spiritual wellbeing of many remains a gap to be filled-in. There is evidence that the impact of living with HIV for people with a migrant background in Europe is stronger than that experienced by native PLHIV. For example, although people of people of African descent constitute the second largest group of PLHIV in Belgium next to men who have sex with men, they were shown to have restricted positive coping abilities and poorer adherence to HIV treatment. We developed a culturally sensitive and context specific psychosocial behavioral intervention to address the specific needs of PLHIV of Africa descent in the Flanders, Belgium. The intervention intends to positively influence determinants of health behaviour, including knowledge and health literacy, self-management, practical skills such as coping strategies, self-regulation of negative emotions, adherence to treatment and HIV disclosure skills. We hypothesized that these determinants can be improved to achieve a better health-related quality of life. A process evaluation of the intervention was conducted to elicit the facilitators and barriers regarding the implementation of the intervention. We applied mixed methods and a participatory evaluation framework: a standardized evaluation form with a 1-10 Likert scale, anonymous written evaluation and a focus group discussion with one patterner organization. Participants gave their appraisal regarding different aspects of the intervention and to what extend they had benefited from it or not. At the same time, participants gave suggestions on how the intervention can be improved in order to benefit further and better other PLHIV. A total of 47 participants were include; 37 PLHIV and 10 professionals. Results showed an overall high satisfaction of the participants with the workshop objectives and program, and good retention of the topics. It also showed that the program was highly acceptable to the group of interest and thus feasible to implement by the partner organization, despite the extensive program. This presentation targets people with chronic illness, community-based chronic illness healthcare professionals, and other psychosocial healthcare professionals. Lessons from the process evaluation will be discussed with the view of scaling-up the intervention to a broader public of PLHIV.