Group Cohesion, HIV Stigma and Care and Treatment

How do we overcome stigma? How do we ensure we all know our status? How can we better care for one another? With support from Microclinics International, the Segal Family Foundation and our supporters around the world, Organic Health Response is exploring these exact questions through our Kanyakla Program.

On Mfangano Island, deep stigma of HIV remains a major obstacle to accessing and remaining in care and treatment for island residents. Even though community members today will say HIV stigma on the island is nowhere near where it was 10 years ago, it continues to block open discussions, effective actions and community solidarity towards reducing the overwhelming rates of HIV – 30% around the lake shores, almost five times higher than the national average.

By the end of July over 450 community members will have disclosed their HIV status to their self-chosen teammates through OHR’s Kanyakla Program. The word for “team” in the local Dhuluo language, “kanyakla” works by organizing small groups of 5-15 people – neighbors, friends, church members, futbol teams – and supporting them through an 8-session curriculum on HIV to better their own health and the health of their kanyakla group. After learning together, each group will take a collective leap of faith in the strength of their commitment to one another and will participate in a group HIV status disclosure session. By being a fully transparent about one another’s HIV status, these groups will become a powerful platform for helping support those who are in need of HIV treatment.

The kanyakla program was rigorously tested during a pilot study from 2011 to 2013 (read the results in this scientific publication). During this evaluation we determined that the intervention reduced drop out of HIV care by 50%. A full randomized control trial (RCT) is currently underway to assess the impact of the kanyakla intervention on improved HIV treatment literacy, retained engagement in HIV care and treatment, reduced stigma and better social support from the community.

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