Despite the significant advances in treatment and methods of prevention, HIV/AIDS remains a significant challenge. South Africa has the largest HIV/AIDS epidemic in the world and young people in South Africa are at high risk of HIV infection. Over 15% of young women and 5% of young men aged 15-24 in South Africa are infected with HIV. With the roll-out of medical treatment many who acquired HIV through birth are reaching adolescence. While this is a success, it raises its own challenges, as, in addition to the general issues associated with adolescence, these young people must navigate their developing sexuality and HIV status. Until recently, most of the focus has been on biomedical outcomes but there is growing awareness that HIV/AIDS affected and infected adolescents may be at increased risk of mental health problems. Many live in challenging home environments where their support structures may be limited due to the impact that HIV has had on their households. Levels of stigma towards those infected with, and affected by, HIV remain high. With that, the negative impact on adolescents’ mental health is significant; levels of anxiety and depression are higher amongst HIV positive adolescents. This conglomeration of risk factors has been shown to be significantly associated with problems of non-compliance with medical treatment which can have significant impact on the wellbeing of an HIV positive adolescent.
For reasons of geographical and especially social isolation, many adolescents living with HIV/AIDS are confronting these problems alone, either choosing, or being forced to go without any form of emotional or peer-group support.
The SHM Foundation who have considerable experience in developing support models for those living with HIV/AIDS in Latin America and Africa took the decision to invest in developing a support group model for HIV positive adolescents via mobile phone. In November 2013 we launched Project Khuluma with 35 participants in Pretoria in collaboration with Yale School of Medicine and the University of Pretoria. The principal aims of Khuluma are to enhance social support for HIV positive adolescents with an emphasis on how to improve treatment compliance, improve feelings of social support, coping and life skills.
Much like a physical support group, Khuluma provides facilitated and interactive support to closed groups of 10 to 15 participants. Participants are able to communicate amongst themselves and with a facilitator via mobile phone about a broad range of topics, while remaining anonymous to one another. The adolescents have the opportunity to have direct input into their treatment and support and to come up with the topics that they wanted to discuss. Guest speakers are also invited into the groups to run facilitated discussions on specific topics such as nutrition, education, careers advice or sexual health.
Testing out this model with adolescents has showed that can be very effective in providing ongoing social support. The findings so far from Khuluma have been very encouraging; some of the most significant findings are increased feelings of social support and self efficacy and decreased feelings of stigma amongst the Khuluma participants.