1. www.aids2014.org Hopefulness among People living with HIV fosters positive affects and cognitions that support adaptive coping in Dar es Salaam, Tanzania H. Siril & S. Kaaya: Muhimbili University of Health and Allied Sciences, Department of Psychiatry and Mental Health, Dar es Salaam, Tanzania, M.C.S. Fawzi: Harvard Medical School, Boston, USA J. Kilewo: Muhimbili University of Health and Allied Sciences, Department of Epidemiology J. Todd: National Research institute, Mwanza W. Monique N. & Ware: Harvard Medical School, Department of Global Health and Population, USA WEPDD0120

2. www.aids2014.org Background Hopefulness is reported to increase coping with chronic illnesses but understudied and underutilized in HIV care Goal: to understand the meaning of hope as perceived by PLH and potential role of hope in promoting good health, treatment outcomes and quality of life from the perspective of PLH WEPDD0120

3. www.aids2014.org Methods Multi-site 10 FGD, 8 IDI with 82 PLH In-depth interviews done with PLH who had depressive symptoms Used an interview guide exploring meaning, dimensions, and outcomes of hopefulness among PLH Study location: Dar es Salaam, Tanzania in April to June 2012 Eligibility: HIV infected, ≥18 years, on ART Thematic analysis of narrative data was performed using grounded theory WEPDD0120

4. www.aids2014.org Results Three dimensions of hope: cognitive change, positive emotions, positive actions to normalize life after HIV diagnosis. Step1:Knowing HIV diagnosis not a death sentence & ART were the first steps! “I wasn’t living anymore since I knew of my HIV even though I was walking around. Life was meaningless to me, I wasn’t able to sleep or do my routine work. But afterwards I was told that there is medicine (ART) that can treat me. I became happy again because I won’t die as I thought. that is how I got hope” (FGD participant woman ≥35 yr Step 2 &3: Positive emotions, active engagement in health seeking behaviors “I was not sure of continuing with my life anymore. Mmmh I mean when this problem of (HIV) came my way, I lost all my inner strength, but a nurse assured us that, the treatment is available. Suddenly I knew this is not the end of my life! I can be treated… huh! And so it gave me much joy and happiness that caused my heart [to] gain strength again.. So I came to this hospital and that is where I was started [on] treatment (ART).” (FGD participant / man between the ages of 18-34 years). WEPDD0120

5. www.aids2014.org Conclusion Although our study involved a sub group of PLH who are on ART in urban areas and lacks PLH not taking ART or living in rural areas, the findings point to a possibility of positive benefits of promoting aspects of care which increase hope, among PLH attending ART care programs and complement ART on improving the quality of lives for PLH. WEPDD0120