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A phenomenological study on experiences of people living with HIV and AIDS : towards the development of a user - led interview model in the Vhembe District, Limpopo ProvinceMabogo, Mokgadi Germina January 2019 (has links)
Thesis (Ph.D. (Social Work)) -- University of Limpopo, 2021 / Background information: Persistent poor health outcomes among People Living with
HIV and AIDS (PLWH) is a concern for service users and the HIV care system. Since its
discovery, different AIDS response strategies were implemented but the level of poor
health outcomes among PLWH prompts the need for other dimensions in the AIDS
response.
Purpose: The purpose of this study was to explore and describe ‘lived experiences’ of
PLWH in order to utilise their personal experiences to develop a user- led intervention
model.
Methods: From a phenomenological orientation, an in-depth interview was used to
gather data from seventeen PLWH who are living in communities. Purposive sampling
was used to locate the participants. The compiled data collected was then analysed
using the Collaizzi’s seven-step data analysis strategy. This was followed by a focus
group discussion session which was held with nine of the seventeen participants.
Findings: The study found that communities’ meaning of HIV and AIDS is outdated as
it is still loaded with stigma and discrimination. Consequently, it alienates PLWH living in
communities, and thus compounds poor health outcomes among PLWH. Many PLWH
view themselves through their communities’ meaning of HIV and AIDS. the shared
meaning of HIV and AIDS by communities created a complex task for PLWH to
reconcile their prior meaning of living with HIV and the ‘new’ meaning they acquired
post-diagnosis. Due to this, many PLWH experience high levels of intrapersonal and
interpersonal challenges. Intrapersonal challenges manifest as self and anticipated
stigma while the interpersonal ones result in poor relationships in different setting. It was
also found that the availability of antiretroviral treatment significantly changed the
meaning of living with HIV and AIDS for many PLWH as it provided tangible medical
support to mitigate the impact of HIV and AIDS. In addition, the availability of different
types of social support from family and non-family sources reassured and gave them
hope for a better life. However, the availability of medical treatment and social support
could not completely buffer the intrapersonal and interpersonal challenges experienced
by PLWH in their daily lives. They had to continually fight for their social space post diagnosis through activation of two major coping strategies, namely emotion and
problem-solving focussed strategies. Significant features of these strategies are that
they changed their thinking patterns and engaged in actual activities to improve the
quality of their lives. Through these strategies, many PLWH attained relative post traumatic growth. This study found that through their lived experiences, they command
personal competence to guide user-led HIV care interventions as they clearly articulated
the design, content and approach for user-driven HIV care.
Conclusions and recommendations: The psychosocial dimension of living with HIV
and AIDS in HIV care is not adequate as many PLWH who are in care experience poor
health outcomes long after they have been diagnosed until they received psychosocial
support from other PLWH. On this basis, a psychosocial seven-step user-led
intervention model was designed to provide psychosocial education, care and support
to PLWH, families, support groups and community mobilisation for HIV care. The
implementation of a true psychosocial user-led intervention model in the continuum of
care which recognises the interaction between the three dimensions of the health
condition should be located at the point of entry into HIV care to ensure timeous access
by PLWH and their families.
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