ZIMBABWE INSTITUTE OF HIV & AIDS TRUST

KUDZANAI GEORGE HANYIRE

Student Number: Z0110114

Supervisor: Dr R. Makurumidze

A Research Project Submitted to Zimbabwe Institute of HIV & AIDS Trust in Partial
Fulfilment of the requirements for the Diploma in HIV & AIDS Counseling, Care & Support

[May, 2015], Harare, Zimbabwe

Copyright© Zimbabwe Institute of HIV& AIDS Trust 2015

List of Abbreviations

AIDS Acquired Immuno Deficiency Syndrome

BCCCs Behaviour Change Community Coordinators

CBO Community Based Organisation

CD4 Cluster of differentiation 4

HIV Human Immunodeficiency Virus

PLWH People Living With HI/AIDS

WHO World Health Organisation

ZNNP+ Zimbabwe National Network of People Living with HIV and AIDS

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Table of contents

Research title..............................................................................3

Introduction................................................................................3

Background................................................................................4

Problem statement......................................................................4

Significance of the study...........................................................4

Preliminary literature review......................................................5

Research question.......................................................................8

Aims and objectives...................................................................9

Delimitations..............................................................................9

Methodology..............................................................................9

Inclusion or Exclusion Criteria..................................................10

Plan for Data collection procedure............................................11

Plan for Data presentation analysis...........................................11

Permission and ethical considerations........................................11

References..................................................................................12

Appendix 01 questionnaire.........................................................13

Appendix 02 concept paper........................................................16

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The Research Title:

An investigation into factors leading to poor participation of members of support groups in

Mvurwi town 2014-2015.

Introduction

Human Immunodeficiency Virus (HIV) is a virus that causes Acquired Immuno Deficiency
Syndrome (AIDS) which is the most advanced stage of HIV infection. HIV is a retrovirus
that occurs as two types: HIV-1 and HIV-2. both types are transmitted through direct contact
with infected body fluids such as blood, semen and genital secretions or from an HIV
infected mother to her child during pregnancy , birth or breastfeeding (through breast milk).
AIDS is a disease of the body immune system caused by the human immunodeficiency virus.
AIDS is characterised by the death of CD4 cells (an important part of the body's immune
system) which leaves the body vulnerable to life threatening conditions such as infections and
cancers (Brady et al05).

Counseling is a principled relationship characterised by the application of one or more

psychological theories and a recognised set of communication skills, modified by experience,
intuition and other interpersonal factors to client's intimate concerns, problems or aspiration
(Feltharn & Dryden 1993). Care is the prevention, treatment and management of illness and
preservation of mental and physical well being through the services offered by the medical
and allied health professionals. Support is to agree or give encouragement to someone
because you want him or her to succeed.

As international efforts to increase access to health care, pharmaceuticals and supportive

services for people living with HIV/ AIDS and their families are strengthened, there is need
for care and support which is a dynamic field that will continue to evolve over a number of
years. to enable people seeking care to determine their serostatus and to access relevant
HIV/AIDS care, treatment and support services, all opportunities should be used to promote
HIV testing and counseling within general outpatient and inpatient services, tuberculosis and
sexually transmitted infection programmes, community health services, workplace clinics and
any other site where resources allow. Upon diagnosis, counseling and HIV/ AIDS care needs
should be established and follow-up referral to comprehensive care must be ensured.
Partnerships and collaboration between all the various providers are therefore essential to
enable timely access to appropriate services.

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Background

Kurainashe Organisation is a Community Based Organisation (CBO) which is located in

Mvurwi area about 100 km from Harare under Mazowe District in Mashonaland Central
Province in Zimbabwe. The Organisation’s core business include formation and
strengthening of support groups, community and home based care, counselling and
psychosocial support services, nutritional gardens, referrals, awareness and prevention,
income generating projects, drug adherence, condom distribution and sexual and reproductive
health. It conducts this business with the help of voluntary behaviour change community
coordinators (BCCCs) who teach community members about the core business of the
organisation. One of its major roles is formation and strengthening of psychosocial support
groups. However, the researcher who is a student found out that there is poor participation
among members of these support groups in Mvurwi town ward 28.

Problem Statement

People living with HIV/AIDS (PLWH) in Mvurwi are not committing themselves in their
respective support groups. Mvurwi town has 36 support groups but only 5 of the 36 are the
only ones who are participating as from June 2014- 2015 which poses great risks of
transmitting HIV to the community as they won’t have time to discuss of behaviour change.
Awareness campaigns were done to try to mobilize the community on joining support groups
but to no avail. The researcher seeks to identify factors that are leading to poor participation
in support groups.

Significance of the study

Research is one of the most important aspects in the running of an organisation or a nation as
it is used to identify the new opportunities and problems that a certain area. It is one of the
most reliable sources of information when formulating a strategy. The research on identifying
factors leading to poor participation of members of support groups in Mvurwi town may be
significant to the following stakeholders:

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To the government

The government is the largest stakeholder in this research. The government may benefit from
the research in finding challenges that are being faced by PLWH in their support groups in
Mvurwi town. It may also be able to formulate strategies that can be implemented to
overcome the challenges.

To other organisations

Other organisations may benefit from this research as they will know why there is poor
participation in support groups. They will also be able to find out challenges that are being
faced in support groups that are leading to poor participation. With this information other
organisations are going to formulate strategies to overcome these challenges.

To HIV and AIDS Orphans

They are going to benefit from this research as issues concerning them may be raised and a
strategy will be formulated to address those issues and gaps.

To the institute

The institute may benefit to the research on the acquired new knowledge. It also gives room
for further research that can be conducted in further studies. The research may also be used
for further study referencing.

To the researcher

The research may improve the research skill to the research. It also may give the researcher a
sound experience of the aspects of research. The research may acquire new knowledge in
other concepts.

Preliminary Literature Review

What is a support group?

A group of people with the same problem trying to find ways to cope with and defeat the
problem. With HIV, support groups have to go beyond psychological support and have to
also focus on improving services. Support groups were proposed as a key psychosocial
intervention for people living with HIV and AIDS (PLWH) since the beginning of the HIV
epidemic. Countries like Uganda, Zambia, and Zimbabwe were in the forefront for the

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establishment of community based care and support for PLWH in Sub Saharan Africa. A key
element in care and support is the provision of psychosocial support through the
establishment of peer support groups for PLWH (Cele 2012). Psychosocial support addresses
the on-going psychological and social problems of PLWH, their partners, families, and
caregivers (World Health Organisation [WHO], 2004). In many parts of the world, HIV
support groups were established as an integral part of care and support for PLWH by
community based HIV organisations, governmental organisations, and by PLWH. As a result,
support groups have been used as a key intervention to help PLWH in dealing with the
changes that come with their illness for the past three decades. Furthermore, HIV support
groups have become the most common and popular way of providing social support services
for PLWHI in resource-limited settings.

Benefits of support groups

The purpose of support groups amongst others is to help members cope with stressful events,
neutralize stigma and allow members to practice new behaviors. A systematic review of
literature shows that support groups are a useful, effective, helpful, and supportive
intervention for PLWH. Participating in support groups enhances the quality of life, decrease
isolation and feelings of shame, improve self-care behaviors, and create mutually empathetic
relationships among members. The interaction with other HIV positive people is an important
component in the success of the support groups and creates a sense of belonging.
Furthermore, participation in support groups offer benefits of improved medication
compliance, decreased risk behavior for re-exposure, and reduced feelings of shame. An
additional benefit is that support groups can play an important role in addressing HIV
prevention behaviors such as safer sex practices, HIV status disclosure, and condom use to
decrease the spread of the disease (Maldonado 1996).

Barriers for Participation

Access to Support Groups Most participants had not heard about support groups before the
focus group interviews. They consequently said that the unavailability of support groups in
their local communities was a reason for not attending. In my community, there are no
support group, I would like to join, another stumbling block is my work, I have very little
time, but if they could be established where I stay I would attend(36 year old male). Support
groups are far from where I stay…, distance is a problem for me, as well as the times when
support group meetings start (44 year old male).

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Location of Support Groups The location where the support group meetings are held was a
barrier for some participants. Data show that to some participants the issue of the venue
where the support groups are run is linked to the fear of being recognised as an HIV positive
person. I like support groups, but I have a problem with the place where they are run, for
instance in my local clinic. If they can be run somewhere else, I can participate in the support
groups (50 year old male). My reason not to be interested to take part in a support group that
is run in my community, is because people are making fun of us when they know that you are
infected with HIV. It might be better to attend in an area where you do not stay. Then I could
go and join if it is at a distance from where I stay (31 year old male)(Madibaeteal 2012).

Unintended Disclosure For several participants, the reason for not attending support groups
was the fear of being recognised as a HIV infected person. They perceived attending support
groups as comparable to disclosing their HIV status to other people. I would not say I will
join the support group in my community because I do not want people to know that I am
positive; I do not want to disclose my status. I would rather join a support group that is
established here in this clinic (50 year old male). My problem is that I do not want to expose
myself…, I do not want other people to know that I am HIV positive (46 year old male). The
people just despise you once they are aware that you are infected with HIV. This is the reason
that I will not participate in the support groups. Some other people mock you because of your
status, especially if the support group is in the community where you live (41 year old male).

Timing for Meeting The time scheduled for support group meetings was also mentioned as a
reason for not attending support groups. Timing mostly affected employed participants. I
think support groups are good, but I do not have time to attend because I am working. Time
is a problem that is why I am unable to participate (42 year old male). I wanted to attend,
but my employer does not want to release me, so I have no time (40 year old male).

Men only Support Groups Mixed gender support groups were one of the reasons for not
participating. Participants strongly advocated for men only support groups and cited various
reasons for that. There are things that men might not feel free to share amongst women. I
think men could advise each other freely without the presence of women. Secondly, women
like to dominate in meetings especially when they are together with men. If men are alone,
they will be responsible for their own group (43 year old male). Most men feel uncomfortable
amongst women. I personally feel uncomfortable as well. I would like that we are separated

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from women, they should have their own groups and we our own. Then I think I can be able
to attend (31 year old male).

Support from Family One other reason for not attending support group meetings was because
some participants felt that they received adequate support from their families and partners.
My support group is my wife and kids, they look after me, and they give me support (46 year
old male). I think I receive good support at home with my family. Another thing I am very
busy, I will not be able to join any support group. For most of the time, I receive the support
that I need at home (29 year old male).

Intention to Attend Several participants would like to participate in support groups in the
future. They further suggested conditions that would facilitate their participation. I would
like to join, if they could be established where I stay I would attend. I do not mind people
knowing how I am, but because they are not there, otherwise I would not mind attending and
joining them (36 year old male). My suggestion is that it could be better if the support group
meeting could be on the same day we fetch our medication (35 year old male).If it is possible,
I will like the times for meetings to be adjusted so that they do not clash with work. I wish
these meetings could be held over the week end, and not during the week (28 year old male).

In contrast, a few participants had no intention to attend support groups and cited various
reasons for their view point. I have a slight problem about the support groups, I think that I
will not gain anything more than what I received from the counselling. I think it would be
better if someone who has an experience about what happens in support groups could share
his knowledge with us. Share things that are different from what we heard during the
counselling process. Maybe I could be interested (28 year old male). I do not see a need for
me to attend the support groups because I was counselled and that was enough for me. I do
not see any need now for further counseling (33 year old male). I do not want to pre occupy
my mind with my positive status. Even if these groups were available in my area, I was not
going to attend. I am also busy, I am studying (35 year old male)(Madiba et al 2012).

Research question

What are the factors contributing to poor participation in support groups?

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Aims and Objectives

 To identify demographic factors that contributes to poor participation in support

groups.
 To investigate economic factors that contributes to poor participation in support
groups.
 To identify social factors that contributes to poor participation in support groups.
 To assess knowledge or awareness on the benefits of joining support groups.
 To come up with recommendations that will lead to improvement is support group
participation.

Delimitations

The research will focus on poor participation of support group members in Mvurwi town.
The research will focus on why PLWH are not fully supporting their support groups.The
research will be conducted in Mvurwi town ward 28 under Mazowe District in Mashonaland
Central where PLWH are poorly participating in their support groups.

Methodology

Study design

This research is going to use a questionnaire and the researcher to obtain the information
required for the research.

Study setting

The researcher is going to carry out the research in Mvurwi town ward 28.

Population

The research population consist of support group chairpersons of people living with HIV/
AIDS in Mvurwi town ward 28. The researchers will use a sample size of 15 respondents.

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Sample

The researchers will use a sample size of 15 respondents. As there are a number of active
support groups in Mvurwi community with some that have maximum participation and
somethat are not. The sample size will be put into groups according to marital status married,
single or widowed 6, 5 and 3 respectively.

Sampling Procedure

The study will make use of quantitative non- probability (convenience) sampling technique.
The researcher is going to give the questionnaire to any support group chairperson that the
researcher is going to come across during the research.

Inclusion or Exclusion Criteria

Only support groups chairpersons are going to be included and other members of support
groups are going to be excluded in the research.

Plan for Data Collection Procedure

Permission will be sought from Kurainashe Organisation and Zimbabwe National Network of
People Living with HIV and AIDS (ZNNP+) so that the researcherwill be able to give the
questionnaire to any support group chairperson that may come across.

Plan for Data Analysis

The researcher will conduct a pre test of the questionnaire. The researchers will check for
errors from the data collected, correcting it and omitting meaningless data. Data will be
analysed using EPI info.

Permission and Ethical considerations

The researcher shall seek permission from Kurainashe Organisation and Zimbabwe National
Network of People Living with HIV and AIDS (ZNNP+). Consent forms will be provided to
participants and confidentiality and ethics shall be considered and observed.

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References

1. Brady Michael T, Oleske JM, Williams PL, AIDSinfo (2005), Glossary of

HIV/AIDS- Related term 5th Edition.
2. Cele Thabo (2012), HIV and Support groups.
3. Feltharn and Dryden (1993), Dictionary of Counseling.

4. Maldonado Jose, Cheryl Cole-Felton, Ron Duran, Susan Diamond, CheryleKoopman

and David Spiegel (1996), Supportive- Expressive group therapy for people with HIV
infection: A primer.
5. MadibaSpiwe and VuyokaziCanti-Sigaqa (2012), Barriers to Participate in Support
Groups for People Living with HIV: A Qualitative Study with Men Receiving
Antiretroviral Treatment in a HIV Clinic in Mthatha, South Africa.
6. Shuttleworth Martyn (June 19, 2008), Different Research Methods Retrieved April 01
2015 from Explorable.com:https://explorable.com.different-research-methods.

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Appendix 01

Data Collection Tool: Questionnaire

I am Kudzanai George Hanyire a student at Zimbabwe Institute of HIV and AIDS

Trust studying a Diploma in HIV and AIDS Counseling, Care and Support. In partial
fulfilment of the requirements for the Diploma in HIV & AIDS Counseling, Care &
Support I would like to carry out a research in factors leading to poor participation in
support groups of people living with HIV and AIDS in Mvurwi Town ward 28. The
information that you are going to give shall be kept private and confidential.

Thank you for your cooperation.

Please tick were applicable.

SECTION A: Demographic Data

1. Sex [Male □] [Female□]2. Age: ....... 3. D.O.B....................

4. Marital status: [Married □] [Single□] [Divorced□] [Widowed/ widower□]

5. Number of children..............

SECTION B: Economic factors

6. Employment [self □] [fully□] [contract□] [none□]

7. Is your job a barrier for you to fully participate in a support group?

[Yes □] [No□]

8. Are you affording to pay support group affiliation fees? [Yes □] [No□]

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SECTION C: Social factors

9. What is your religion?

[Christian □] [Moslem□] [African Traditional Religion□]

10. Have you disclosed your HIV status to a friend of family member?

[Yes □] [No□]
11. Have you ever been influenced or forced by a friend or family member not to

attend support group meetings? [Yes□] [No□]

12. Is there a friend or family member disturbing you to participate in a support

group? [Yes □] [No□]

13. Are you comfortable with the time and place of meeting with your support group?

[Yes □] [No□]
SECTION D: Knowledge/ Awareness

14. Level of education: [primary□] [secondary□] [tertiary□]

15. Are you aware of the importance of being in a support group?

[Yes □] [Partially□] [No□]

16. Are you seeing any benefits of being in a support group? [Yes □] [No□]
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 17. Why did you decide to join a support group?

(A) Because we have been promised material things e.g. projects. [Yes □] [No□]

(B) Because I was influenced by friends or family to join. [Yes □] [No□]

(C) Because I knew the benefits of being in a support group. [Yes □ ] [No□]
(D) None of the above

reason...............................................................................................................................
......................................................................................................................................................
...............................................

SECTION E: RECOMENDATIONS

18. What are your recommendations to improve maximum participation in support

groups?

..........................................................................................................................................
......................................................................................................................................................
......................................................................................................................................................
........................................................................

Thank you

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 Appendix 02

Concept paper

Name: Kudzanai George Hanyire Number: Z0110114

Title: An investigation into factors leading to poor participation of members of support

groups in Mvurwi town 2014-2015.

Problem Statement

People living with HIV/AIDS (PLWH) in Mvurwi are not committing themselves in their
respective support groups. Mvurwi town has 36 support groups but only 5 of the 36 are the
only ones who are participating as from June 2014- 2015 which poses great risks of
transmitting HIV to the community as they won’t have time to discuss of behaviour change.
Awareness campaigns were done to try to mobilize the community on joining support groups
but to no avail. The researcher seeks to identify factors that are leading to poor participation
in support groups.

Research Question

What are the factors contributing to poor participation in support groups?

Broad Objective

To identify factors leading to poor participation in support groups by its members.

Specific Objectives

 To identify demographic factors that contributes to poor participation in support

groups.
 To assess knowledge or awareness on the benefits of joining support groups.
 To investigate economic factors that contributes to poor participation in support
groups.
 To identify social factors that contributes to poor participation in support groups.
 To come up with recommendations that will lead to improvement is support group
participation.
Methodology

An investigation study will be done. Clients will be put in their support groups according to
marital status married, single or widowed. Assessment of findings will be done after 2
months. Data will be investigated using qualitative method.

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