A model to facilitate self-management of human immunodeficiency virus in students within a university setting and promoting their mental health

Background: The introduction of antiretroviral treatment (ART) has resulted in people with HIV living longer. Antiretroviral treatment demands a lifelong commitment from patients not only in terms of adherence to the medication but also in relation to lifestyle changes in general. This poses a challenge to a student living with HIV (SLHIV) who only spends a few years at university before entering the workplace and relocating. It also means that the care, support and treatment received at the university will no longer be available to them as these services are only offered to enrolled students. It is imperative for practitioners at universities to help SLHIV effectively manage their illness.Aim: The aim of the article is to illustrate the process followed to develop a model that could serve as a frame of reference to facilitate the management of HIV as an integral part of the mental health of SLHIV within a university.Setting: The model is designed for professional practitioners in university settings who support students living with HIV in managing their illness.Methods: A theory-generative, qualitative, exploratory, descriptive and contextual study design was utilised. The central concept was derived from the experiences of practitioners and SLHIV by conducting individual interviews using appreciative inquiry. The common themes and categories identified in the interviews served as a basis for the identification of the central concept for the study. The process included the identification, definition and classification of the central concept and essential attributes. The conceptual framework was then described. Measures to ensure trustworthiness were also adhered to in the study and approval for the study was granted (Ethical clearance #2014-071).Results: The central concept was identified as the 'facilitation of self-management'. It was defined and classified, and these definitions and classifications were used as the basis for the model. Thereafter, the model was described.Conclusion: The model can be used as a frame of reference to assist SLHIV in effectively managing their illness

Experiences of grandmothers caring for female adolescents living with HIV in rural Manzini, Eswatini: a caregiver stress model perspective

The HIV pandemic has immense effects on the Eswatini population. The burden of caregiving rests on women, typically grandmothers who are elderly and dealing with chronic diseases themselves. The purpose of this study was to explore and describe the experiences of grandmothers in Eswatini caring for female adolescents living with HIV. The study draws on phenomenological fieldwork of six case studies of grandmother­granddaughter pairs who were purposively sampled. Data were collected through in-depth individual interviews that commenced with broad questions: "How is it for you to care for a female adolescent living with HIV?" for the grandmothers, and "How is it for you to live with HIV?" for female adolescents. Data were transcribed verbatim and analysed thematically following the elements of the caregiver stress theory. Drawing on the caregiver stress model, grandmothers and female adolescents experienced input stimuli of financial difficulties related to daily provisions for food and transport fare. Control processes experienced by grandmothers and female adolescents related to feelings of loss, grief, fear, hopelessness and isolation along with suicidal ideation for female adolescents. Regarding output stimuli, grandmothers and female adolescents developed psychological unrest related to difficulty accepting the HIV diagnosis and concerns about the future. Grandmothers experienced ill health due to the demands of the caregiving role. It is recommended that family, financial and psychological support be made available for grandmothers to lighten the duty of caregiving