AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #208 - The effects of successful mobilisation of resources by support groups on the confidence of HIV-positive mothers in Vietnam
Authors: Presenting Author: Ms Pauline Oosterhoff - Royal Tropical Institute
Additional Authors: Mr. Bach Tran Xuan,
Aim: Historically, grassroots activism and support groups have been very important in improving access to anti-retro viral therapy (ART) in both resource-rich and resource-poor settings. Yet, activists’ success can eliminate their initial raison d’etre, and collective success may not empower individuals. This study examines collective and individual changes in the circumstances and priorities of 419 HIV-positive mothers in five support groups (the “Sunflowers”) across four provinces in northern Vietnam between June 2004 and June 2008 and the effects of collective action on personal self-esteem.
Method / Issue: We conducted participant observation amongst Sunflower groups both during regular programme activities and at almost all major meetings between group members and state authorities. For this study we also analyze data from yearly personal development plans (PDP) made by HIV-positive mothers. When new members join a Sunflower group they can independently complete a PDP to prioritize their medical, economic and social needs. Each year the PDP is evaluated and adapted by the member together with another core member. These qualitative and quantitative data are recorded using EPI Info.
Results / Comments: As members of a support group for HIV-positive mothers the women studied were able to accomplish collective and individual changes such as the mobilization of health, social and economic support. These occurred in a context where resources such as ART were also increasingly available. The study found a more dynamic process in which for people who already had access to ART the group was a place to find additional health support. For others, the group provided an entry point for accessing ART. These processes also inevitably reflect more general contextual changes, including increased international funding. A dramatic decrease in health-related concerns was reported; these were replaced by either economic concerns or in a few cases by a disappearance of pressing concerns altogether. On first joining a group, most women reported feelings of worthlessness and social stigma within their families. Over time, both women’s perceptions of stigmatization and their reported needs changed. Members accessed essential social, health and economic services including ART, PMTCT, loans, and social and legal support through the referral network of the support groups. Most women also reported being able to participate in family meals, they were able to send their children to school, their health concerns rapidly decreased, and they came to focus on economic problems. The study confirms earlier findings that HIV-positive women who have marketable skills but cannot access formal credit channels because of discrimination are able to improve their income with targeted support. But the groups successes in mobilizing access to essential services, support and resources had little impact on the prevailing problem of individual women’s perceptions of their personal ability to make strategic decisions; group members still reported low self-esteem.
Discussion: Positive health and social changes in groups and the lives of members are not necessarily contributing to enhanced confidence in the capacity to act at an individual level, questioning how empowerment of individual women can be promoted.
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