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The Centre for Sexual Health & HIV/AIDS Research (CeSHHAR) Zimbabwe, led by project director Webster Mavhu, CeSHAAR deputy director, and global health expert Sarah Bernays, will examine and measure how an intervention can help adolescents living with HIV (ALHIV) flourish within their communities by developing the character strengths embedded within the indigenous concept of Zvandiri (Accept Me as I Am).
While great progress has been made in controlling the HIV epidemic overall, for adolescents the situation continues to worsen. The Zvandiri intervention provides peer-delivered psychosocial support to ALHIV (aged 10-19) through community adolescent treatment supporters (CATS, young people aged 18-24 years who are HIV positive themselves). It has been identified by the World Health Organization (WHO) as an exemplar of best practice, integrated into Zimbabwean national policy and adopted in eight other African countries.
A recent Zvandiri intervention by the team (2016-2019) demonstrated that ALHIV participants receiving Zvandiri had a significant and clinically important reduction in HIV viral load after two years compared to ALHIV receiving standard care. The intervention, delivered at scale, thus offers a substantial opportunity to redress ALHIV’s poor outcomes. However, knowing exactly why Zvandiri works, a question the team seeks to answer, is key to replicating and fine-tuning the treatment for use across the continent. Whereas the prevailing logic argues that viral suppression leads to improved quality of life, the team proposes the inverse: that viral suppression is likely achieved through developing life-enhancing Zvandiri Character Strength (ZCS).
Key project outputs will include a validated scale to measure Zvandiri, materials and tools for use in a subsequent feasibility trial, as well as dissemination materials (open-access peer-reviewed journal articles, workshops, webinars, conference presentations, and animation documenting project findings and policy briefs).
Sub-Saharan Africa bears the greatest burden of HIV, with comorbid mental conditions highly prevalent in people living with HIV. It is important to evaluate the mental health of adolescents and young adults living with HIV (AYALHIV) comprehensively by measuring both negative and positive psychological constructs. There has been a proliferation of interest in positive psychological outcome measures, but the evidence of their psychometric robustness is fragmented. This review sought to: 1) Identify positive psychological outcomes and corresponding outcome measures used in AYALHIV in sub-Saharan Africa. 2) Critically appraise the psychometrics of the identified outcome measures.
