Peer-led Interventions: Exploring the Peer Group Leader Experience of Delivering a Mental Health Intervention for Youth Living with HIV in Tanzania

Background: Youth living with HIV (YLWH) face mental health challenges that negatively influence their adherence to antiretroviral medication and HIV outcomes. In sub-Saharan Africa, where the majority of YLWH reside, there are few mental health professionals. Task-shifting interventions to lay peer leaders may be an effective strategy for addressing mental health challenges. This study aims to understand and evaluate peer group leaders’ experiences delivering a peer-led, group-based mental health intervention called The Voice of Youth (Sauti ya Vijana (SYV) in Swahili) to YLWH in Tanzania. Methods: Peer group leaders (PGLs) aged 23 to 29 years and living with HIV were trained to deliver SYV. The study took place at four different sites in Tanzania. In-depth interviews (IDIs) were conducted with PGLs after delivering the SYV pilot study. IDIs were audio-recorded in Swahili and translated to English. English transcripts were analyzed using NVivo, and Excel was used to summarize data further and identify themes. Results: PGLs expressed a multitude of motivators and perceived benefits in their roles, including a desire to help youth, increased confidence, and a newfound hope for the future. Challenges included concerns about compensation and navigating exposure to difficult life events from the youth that triggers past trauma experience by PGLs. PGLs also shared recommendations for the intervention in terms of expansion and sustainability. Conclusions: Insights from the PGLs can help enhance the SYV PGL experience and position SYV for sustainability as Tanzania navigates scaling mental health care YLWH.