What makes support groups effective and sustainable? an exploratory qualitative study of people living with HIV in...

To explore how people living with HIV (PLHIV) perceive the factors that influence the effectiveness and long-term sustainability of HIV support groups in Nigeria.

Exploratory qualitative study using semi-structured focus group discussions (FGDs).

Twelve health facilities across Nigeria's six geopolitical zones, representing diverse urban and rural contexts affiliated with the Nigeria Implementation Science Alliance and ICON 3 Practice-Based Research Network (ICON-3 PBRN).

110 PLHIV, including support group members and leaders, participated in 12 FGDs. Participants were recruited purposively based on experience with support groups and HIV care.

FGDs were conducted between March and May 2025, audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis. The psychosocial model of mental health guided inquiry and interpretation.

Support groups were perceived as transformative psychosocial and informational spaces that foster belonging, reduce isolation and enhance health literacy and treatment adherence. Key facilitators included vocational skill-building, cooperative income-generating activities and opportunities for economic self-sufficiency. Barriers included stigma and fear of disclosure, financial hardship (especially transport costs and loss of income), leadership instability, weak communication systems, inadequate infrastructure and breaches of confidentiality. Sustainability was linked to improved leadership, livelihood support, community awareness, reliable funding and multi-sectoral partnerships involving NGOs, philanthropists and health facilities.

Support groups in Nigeria function as critical psychosocial and economic support systems for PLHIV but remain constrained by structural, economic and stigma-related challenges. Strengthening their sustainability requires integrating psychosocial and livelihood interventions, improving governance structures and developing multisectoral collaborations. Findings provide context-specific direction for enhancing chronic illness support models in low-resource settings.