Table 2.
Establishing Discordant Couple Self-help Groups in Rakai, Uganda.
Rationale |
• To reduce myths and misinformation about the realities of couple HIV discordance, mitigate associated stigma and discrimination, and consequently improve self esteem and coping strategies among discordant couples. |
Objectives |
• To provide opportunity for fellowship and peer support. |
• To provide opportunity for the negative partners to get information on risk reduction and address questions on couple HIV discordance. |
• To provide forum where discordant couples can share experiences and challenges |
• To help discordant couples develop ability to communicate accurate empathic understanding skills in marriage and family. |
Anticipated Benefits |
• Experiences will be shared with other members of the community and belonging will be cultivated. |
• Group cohesiveness & Universality (all clients share the same problem and this is both supportive and therapeutic) |
• Feedback will be shared among client’s themselves. |
• Destructive criticism is unlikely |
• The feelings of powerlessness which many people experience when they are sick/infected will be overcome as a result of the therapeutic effects of group membership |
• Will allow clients to act as both clients and therapists |
• Corrective emotional experiences (Clients who have been defensive and guarded will be encouraged to share their feelings with others and in doing so will become more self-confident and self-accepting) |
• Imitative Behaviours (Clients will also learn from one another through observations and modelling and new ideas and attitudes will be explored and nurtured through group interaction.) |
Requirements for Becoming a Member |
• Discordant the last time they received their HIV results and know the status of one another |
• Willing to continue participating in couple meetings regularly or as convened |
• Willing to share with peers issues regarding HIV disclosure/discordance challenges and coping strategies |
• Willing to respect Human rights and Human dignity of their partners |
• Willing to provide support to either partner as necessary |
• Willing to explore and implement realistic and concrete risk reduction steps/strategies |
• Willing to keep and maintain confidentiality of all issues discussed in the group and abide by the restrictions of shared confidentiality |
Counsellor/Group Leader roles |
Beginning sessions |
• Helping members get acquainted |
• Setting a positive tone |
• Clarifying the purpose of the group |
• Explaining the leader’s role |
• Explaining how the group sessions will be conducted |
• Helping members verbalize expectations |
• Checking out the comfort levels of the members |
• Explaining group rules including the group contract |
• Focusing on the content |
• Addressing questions |
Subsequent sessions |
• Assessing the benefits |
• Assessing members’ interest and commitment |
• Assessing each member’s participation |
• Assessing members’ level of trust and group cohesion |
• Assessing how much to focus on the content or process |