Table 1. Key characteristics of HIV/AIDS interventions from 22 quantitative studies (organized by study design).
| Author/date | Study location/age range | Sample | Intervention strategy | Outcome measurements | Main findings |
|---|---|---|---|---|---|
| Panel A: Focusing on adult PLWHA only (eight quantitative studies) | |||||
| Pre/post one group study (two studies) | |||||
| Allen et al. (2009) | Australia; adult mean age 40 | N = 41 | Community-based mental health drug and alcohol nurse role with 6–8 week FU | Depression; quality of life; health | Improvement in impairment and social problems |
| No effect on depression or quality of life | |||||
| Operario et al. (2010) | Oakland, CA; adult mean age 46.5 | N = 36 | The Bruthas project: information- and motivation–behavioral skills model of HIV preventive behavior change and the AIDS risk reduction model | Social support; self-esteem; loneliness | Increased social support, self-esteem at FU |
| Reduced loneliness at FU | |||||
| Cluster RCT (one study) | |||||
| Apinundecha et al. (2007) | Thailand; adult mean age 44.8 | Intv: n = 32, Cntl: n = 34 | Community participation intervention of HIV knowledge and stigma reduction education | Five stigma indices | Reduction in HIV/AIDS stigma |
| RCT at the individual level (three studies) | |||||
| Munoz et al. (2010) | Peru; adults mean age 32 | Intv: n = 60; Cntl: n = 60 | Cntl: controls from a neighboring district; Intl: community-based CASA | Depression; stigma; social support; quality of life; self-efficacy | Improvements in all five outcome indices |
| Sacks et al. (2011) | Philadelphia; adult mean age 39.8 | Intv: n = 42; Cntl: n = 34 | The MTC-A program | Depression; mental health component | MTC-A clients with greater psychological functioning and stable physical health at baseline had greater improvement overall than counterparts in the comparison group |
| Weiss et al. (2011) | Florida, New York, New Jersey in the USA; adult aged 18+ | SWPI: RCT; Intv: n = 212; Cntl: n = 239 | Cntl: the SMART/EST women's program (SWP) | Distress; social support; self-efficacy; coping skills; quality of life | Improved social support, self-efficacy, coping skills, and quality of life |
| SWPII: RCT; total n = 482 | Intv: cognitive-behavioral stress management/expressive-supportive therapy | Reduced distress | |||
| Post-intervention cross-sectional survey (one study) | |||||
| Ramirez-Valles et al. (2005) | New York city and Washington, DC; adult mean age 40 | N = 155 | Community participation in AIDS and gay-related organizations (volunteerism and activism) | Self-esteem; depression; loneliness | It compensated for the association between stigma, depression, and loneliness |
| It buffered the negative association between stigma and self-esteem | |||||
| Quasi-experimental design with a comparison group (one study) | |||||
| Heckman et al. (2006) | Four sites in the USA (Ohio, Pennsylvania, Arizona, New York); older adults 50+ | Immediate trt: n = 44; Delayed trt: n = 46 |
Twelve-session telephone-delivered coping improvement group intervention with 3 mth FU | Psychological symptoms; life stressor burden, coping self-efficacy, avoidance coping | Higher coping self-efficacy |
| Fewer psychological symptoms | |||||
| Lower levels of life stressor burden | |||||
| Less frequent use of avoidance coping | |||||
| Panel B: Focusing on OVCY, adolescents, and/or their adult caregivers (14 quantitative studies) | |||||
| Cluster RCT (one study) | |||||
| Kumakech et al. (2009) | Uganda; AIDS orphans aged 10–15 | Total orphans: n = 326; Intv: n = 159; Cntl: n = 167 | School-based peer-group support intervention | Self-concept; anxiety; depression; anger | Improvement in depression, anger and anxiety; no effect on self-concept |
| RCT at the individual level (two studies) | |||||
| Lee et al. (2007) | New York city; adolescent mean age 14.7, parent mean age 38 | Parents: Intv: n = 153; Cntl: n = 154; adolescents: Intv: n = 206; Cntl: n = 207 | Cntl: standard care group; Intv: coping skills interventions with 2-yr FU | Depression | Lower levels of depression |
| Rotheram-Borus et al. (2006) | New York city; adolescents mean age 14.77 | Intv: n = 153; Cntl: n = 135 | Project TALC; Cntl: standard care condition; Intv: coping skills intervention | Emotional distress; positive expectations | Reduced emotional distress at 3 yrs and increased positive future expectations at 6 yrs |
| Post-intervention cross-sectional survey (six studies) | |||||
| Horizons (2007) | Rwanda; youth aged ≤24 | Baseline: n = 692; FU: n = 593 | Adult mentoring program for YHHs | Perception of adult support; grief; marginalization; maltreatment; depression | A decrease in feelings of marginalization, depressive symptoms, and feelings of grief |
| Horizons (2006) | Zimbabwe; youth aged 14–20 | N = 1258 | STRIVE/community-level efforts project. – PSS – Residential camps |
Psychosocial well-being; psychosocial distress; lingering grief | A greater improvement in self-confidence, especially among males |
| Limited association between intervention and hopefulness, self-efficacy, and ability to hope | |||||
| Thurman et al. (2006) | Rwanda; youth aged 12–24 | N = 692 | Trained adult volunteers from the community provide mentoring to YHHs | Depression; grief; marginalization | An improvement in overall psychosocial outcomes |
| MEASURE (2009a) | Mbeya, Tanzania; OVC aged 8–14; caregivers mean age 41.4 | OVC: n = 564; caregivers: n = 488 | The Mama Mkubwa community-centered psychosocial support program implemented by TSA program staff – Volunteer home visits – Kids club participation |
Self-esteem; psychosocial outcomes (positive, negative, marginalization, community stigma) | Home visit were positively associated with OVC's global self-esteem, and made caregivers have better emotional health, feel less marginalized |
| Kids club: no effect | |||||
| MEASURE (2009b) | Kilifi, Kenya; OVC aged 8–14; guardians mean age 41.6 | OVC: n = 1036; guardians: n = 771 | Kilifi OVC project: – Volunteer CHWs – Guardian support groups |
Self-esteem; pro-social behavior; total difficulties; social isolation; perceived stigma | OVC: increased pro-social behavior, reduced behavioral problem, lower social isolation, and perceived negative attitudes. No effect on self-esteem |
| Caregivers: lower marginalization and perceived negative attitudes | |||||
| MEASURE (2009c) | Thika, Kenya; OVC aged 8–14; guardians: aged 18+ | OVC: N = 3423; guardians: n = 2487 | The IAP – Home visit – School-based HIV education – OVC care and support community sensitization meeting |
Child protection; child social isolation; extended family support; in-kind transfer | OVC: reduced social isolation, more family support, and in-kind transfers from the community |
| Caregivers: reduced stigma | |||||
| Quasi-experimental design with a comparison group (five studies) | |||||
| Clacherty and Donald (2006) | Kagera, Tanzania; older child group 13–18; younger child group 9–12 |
Older group: Intv: n = 78, Cntl: n = 78; younger group: Intv: n = 60, Cntl: n = 60 | VSI project: child-led organizations providing HIV counseling | Emotional stress; social networks | A significant lower level of emotional stress, more emotional and practical support from adults, a greater variety of strategies for solving their problems, and a stronger internal locus of control |
| Lavin et al. (2010) | Rwanda; OVCY aged 10–17 | Intv: n = 95; Cntl: n = 83 | COSMO program | Marginalization; adult support; peer relationship; authority assistance; CES-D score | Less frequently experienced people speaking badly of them or their families or making fun of them. More frequently reported having a reliable adult in their life, stronger peer relationship, jealousy, experienced certain psychological symptoms at very high levels |
| MEASURE (2009d) | Iringa, Tanzania; OVC aged 8–14; caregivers mean age 44.1 | Caregivers: total n = 845; OVC: Intv: n = 552, Contl: n = 552 | Allamano/Tumaini HBC program – Home visit by volunteers – Kids club – Link community to the Allamano health clinic – Ensuring possession of basic school materials |
Self-esteem (two measures); psychosocial outcomes (positive, negative, marginalization, perceived community sigma) | Home visits: better psychosocial outcomes for caregivers; no effect on OVC's global self-esteem or family related self-esteem |
| Kids club: reduced emotional problems and improved social behavior | |||||
| Link to health clinic: no effect | |||||
| School supplies: better psychosocial outcomes | |||||
| MEASURE (2009e) | Kagera, Tanzania; MVC aged 7–15; caregivers mean age 43.4 | Caregivers (766): Intv: 335, Cntl: 431; OVC (895): Intv: n = 434, Cntl: n = 461 | The SAWAKA Jali Watoto program – HIV/AIDS prevention, care and support activities – Direct support to MVC and caregivers |
Self-esteem (two measures); psychosocial outcomes (positive, negative, marginalization, stigma) | OVC: better global self-esteem, more positive feelings about life, feeling more community jealousy and resentments |
| Caregivers: More positive feelings about life, feeling more jealousy and more negative community attitudes toward HIV-affected families | |||||
| Mueller et al. (2011) | South Africa; OVC aged 8–18 | Intv: n = 177, Cntl: n = 120 | MAD about ART program | Self-esteem; depression; self-efficacy; emotional problems | Increase self-efficacy |
| No effect on self-esteem, depression, or emotional problems | |||||
Note: mth, month; yr, year; trt, treatment; FU, follow-up; INTV, intervention group; CNTL, control group; RCT, randomized controlled trial; OVC, orphans and vulnerable children; PWH, parents with HIV; PLWHA, people living with HIV or AIDS; VCT, voluntary counseling and testing; MVC, most vulnerable children; OVCY, vulnerable children and youth; MTC-R, modified therapeutic community residential treatment; MTC-A, modified therapeutic community aftercare program; SMART/EST, the stress management and relaxation training/expressive–supportive therapy; CES-D, Center for Epidemiologic Studies Depression Scale.