Peer-led interventions: Exploring the peer group leader experience of delivering Sauti ya Vijana, a group-based mental health intervention for youth living with HIV in Tanzania.

Abstract

Youth living with HIV (YLWH) face mental health challenges which 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. Peer group leaders (PGLs) aged 23-29 years at the time of hire and living with HIV were trained to deliver SYV. The study took place across four regions in Tanzania. In depth interviews (IDIs) (N = 25) were conducted in 2023 with PGLs after delivering the scaled pilot test of SYV. IDIs were audio-recorded in Swahili and translated and transcribed into English. Thematic analysis was applied using NVivo for coding and Excel to further summarize data and identify themes. PGLs experiences are organized via two CFIR domains:.Individuals Involved and Inner Setting. Under the Individuals Involved domain, PGLs described motivations such as a desire to help youth, increased confidence, and shared personal growth, as well as emotional challenges related to youth trauma, and how they thought community members perceived them. Within the Inner Setting domain, PGLs highlighted collaboration and collegial support alongside challenges related to social dynamics, compensation, and supervision. Across themes, PGLs emphasized sustainability, offering recommendations to strengthen program expansion and long-term impact. Insights from the PGLs can help enhance and position SYV for sustainability as Tanzania navigates scaling mental health care YLWH and also inform other peer-led mental health interventions in low-resource contexts.