Introduction: cognitive behavioural therapy (CBT), a psychotherapeutic treatment, has been reported to effectively reduce self-stigma among people living with HIV; however, to date, there are barely any studies that have tested its effectiveness when delivered by lay counsellors. This study assessed the effectiveness of the expert client-delivered group CBT in reducing self-stigma among HIV positive pregnant adolescent girls and young mothers (AGYM) living in urban informal settlements of Kampala, Uganda. Methods: this was a quasi-experimental pre-post-test study of 253 pregnant AGYM attending Elimination of Mother-to-Child Transmission of HIV (EMTCT) and Early Infant Diagnosis (EID) clinics at four public health facilities serving the urban poor in Kampala, Uganda. In total, 142 participants in the treatment group were assigned to a 10-session CBT group, while 111 participants in the control group continued receiving treatment as usual. A difference-in-differences (DiD) analysis was conducted. Results: the DiD analysis demonstrated that the expert client delivered group CBT intervention showed a significant change/reduction of -1.121 percentage points (pp) in HIV self-stigma between baseline and endline, with P<0.001, after controlling for differences in various demographic variables and confounders between the intervention and control groups. Conclusion: this study provides evidence for the effectiveness of the expert-client-delivered group CBT HIV self-stigma reduction model among AGYM in Uganda. The use of peer-to-peer group CBT may be a promising approach for increasing access to psychosocial services in resource-limited settings like Uganda, where trained psychologists and mental health counsellors are few and psychosocial services are expensive.
Babirye et al. (Thu,) studied this question.