A longitudinal evaluation of a culturally tailored group intervention for people of sub-Saharan African descent living with HIV in Belgium

Background: Although HIV is now considered a chronic condition, it continues to impose substantial psychosocial burdens on people living with HIV. Among people of sub-Saharan African descent (SSA) in Europe, these burdens are exacerbated by intersecting structural, social, and cultural disadvantages.

 

Approach: We employed a longitudinal mixed-methods design with a single-group repeated-measures approach. Quantitative data were collected at baseline, post-intervention, and 6–12 months follow-up using validated psychometrics to assess coping strategies (Brief COPE), Self-management (Patient Activation Measure), treatment adherence (Case Adherence Index), and Health-related Quality of Life – HrQoL (EQ-5D-5L). Qualitative data were collected through in-depth interviews at follow-up to explore participants’ experiences, perceived impacts and mechanisms of change. Participants were recruited through community-based organisations using convenience sampling.

 

“Living with HIV? You are not Alone” is a group-level, culturally sensitive psychosocial intervention integrating psychoeducation, skills-building, and cognitive-behavioural techniques to maintain or improve HrQoL among PLHIV of SSA descent in Belgium. It aims to enhance coping strategies, self-management, HIV status disclosure, and engagement with healthcare and community-based psychosocial services. The intervention was developed iteratively using a simplified Intervention Mapping Protocol. Two behavioural change theories—the Information-Motivation-Behavioural Skills model and Social Cognitive Theory—guided its design, addressing identified psychosocial determinants to achieve changes in individual behaviour, social learning, and health outcomes.

The evaluation aimed to assess the effects of the intervention on self-reported psychosocial and behavioural outcomes over time, and to explore participants’ experiences of change.

 

Results: We enrolled 38 participants in the study. Quantitatively, we observed modest improvements between baseline and endline in adherence (mean score 11.6→13.1), self-management (41.0→43.8), and HrQoL (68.3/100→71.1/100). Changes in coping strategies were mixed: active coping remained stable, planning declined, while denial and substance use slightly increased. Reductions were observed in venting, behavioural disengagement, and self-blame with an increase in acceptance. Qualitatively, participants described improved HIV literacy, better acceptance of their diagnosis, and the adoption of more constructive coping strategies. Some reported progress in disclosing their HIV status to family or trusted social networks, which they associated with reduced psychological distress and improved mental well-being. Disclosure remained one of the most challenging aspects of living with HIV.

 

Implications: This evaluation suggests that a culturally tailored group-level psychosocial intervention can support positive behavioural and psychosocial outcomes among PLHIV of SSA descent in European settings, particularly in fostering acceptance of the diagnosis, engagement, and self-management. Modest quantitative gains were complemented by meaningful qualitative insights into lived experiences of change. Integrating such interventions alongside clinical care may strengthen holistic HIV care for migrant populations in Europe.

This presentation aims to actively engage PLHIV and others living with chronic conditions, healthcare professionals, and psychosocial support organizations. We particularly seek to involve individuals from ethnic minority communities and those who support them to share their lived experiences.