Supportive relationships aim to improve the quality of people's lives. They are at the core of providing effective treatment for people living with HIV/AIDS.
Supportive relationships are important in HIV/AIDS-related treatment work for the following reasons:
• they bring together someone who needs treatment and someone who can respond to those needs in a supportive and effective way;
• they are based on identifying the needs of the person seeking treatment and helping that person to live a better and longer life;
• they are two-way - with both people needing openness, cooperation and information for treatment to be effective; and
• they are based on trust and need to grow over time.
There are many kinds of supportive relationships such as that between a doctor and a patient and that between a community volunteer and someone who is ill at home.
Supportive relationships in treatment work are built and maintained in different ways.
• Making treatment available and accessible helps to build trust within supportive relationships. Supportive relationships promote good use of treatment - because even drug-based treatments need a supportive environment in order to work properly.
• People living with HIV/AIDS can both help themselves and support others affected by HIV/AIDS. Any relationship involving people living with HIV/AIDS needs to be based on a positive attitude and a belief that treatment is worthwhile.
• A health worker who prescribes HIV/AIDS-related drugs has special technical knowledge and skills that people needing treatment often do not have. The skilled helper and the person living with HIV/AIDS should decide together what treatment is useful and what effect it might have on the person's life, not just medically but also economically and socially.
• A person living with HIV/AIDS needs to be respected as someone who can make choices about treatment. Treatment will be more effective if the helpers, with technical knowledge, encourage people living with HIV/AIDS to be actively involved in their own treatment.
• A person living with HIV/AIDS who helps her/his seronegative partner to avoid infection, and a seronegative person who supports a person living with HIV/AIDS to maintain treatment use, are also examples of supportive relationships.
Participatory group activity
To understand the different supportive relationships involved in providing treatment for people living with HIV/AIDS.
1. Explain the aim of the activity.
2. Divide participants into small groups of four to six people.
3. Ask each group to think of a 'typical' person living with HIV/AIDS in their community. Ask the group to brainstorm about who might be involved in supportive relationships in providing treatment for that person.
4. Give each group a large piece of flipchart paper. Ask the groups to draw their typical person living with HIV/AIDS in the centre. Then ask them to write around the person the names of those they thought of while brainstorming.
5. Give each group a different coloured pen. Ask them to draw lines to show where supportive relationships occur between the people that they have drawn. This will result in a web of supportive relationships.
6. Bring everybody back together and ask the groups to present their results. Encourage the participants to ask each other questions and to make comments.
7. Facilitate a group discussion about what has been learned from the activity, based upon questions such as:
• Why are supportive relationships necessary for providing effective treatment?
• Is the person living with HIV/AIDS the only one to benefit from supportive relationships?
• Should a supportive relationship be one-way or two-way? How can a 'receiver' help a 'provider'?
• What sort of help can be given through a supportive relationship?
• Participants may think of a supportive relationship as being only between a doctor and a patient. Therefore, encourage them to think as broadly as possible about all types of people that might be involved, including family, friends, colleagues, health workers, counsellors and other people living with HIV/AIDS.
• Emphasize to participants that it is important to see people living with HIV/AIDS as active providers as well as receivers within supportive relationships.
• Encourage participants to consider how providers of support might be able to help each other. For example, the family of a person living with HIV/AIDS could help health workers by sharing information about their needs and how they might be met.
At a skills-building workshop, participants drew a diagram to show all the different people who could be involved in supportive relationships in providing treatment to a typical person living with HIV/AIDS. They then drew lines to show how those people relate to the person living with HIV/AIDS and to each other, resulting in a web of supportive relationships:
Afterwards, the facilitator led a group discussion about what had been learned from the activity. For example, participants agreed that, for treatment to be effective, a person living with HIV/AIDS needs to be both a provider and a receiver in supportive relationships.
Reference: Adapted from a workshop on access to HIV-related treatment, Catholic Dioceses of Ndola and the International HIV/AIDS Alliance, Zambia, April, 2001.