"Knowledge I seek because culture doesn't work anymore … It doesn't work, death comes": the experiences of third-generation female caregivers (gogos) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care

Real experience of caregivers of patients with HIV/AIDS from the perspective of iceberg theory: a qualitative research

OBJECTIVE

This study aimed to investigate the caregiving behaviours and supportive needs of caregivers of patients with HIV/AIDS and provide a basis for healthcare institutions to carry out caregiver interventions.

DESIGN

A purposive sampling method was used to select 11 caregivers of patients with HIV/AIDS in the Infectious Disease Department of a tertiary hospital in Nanjing, China, to conduct semistructured interviews. Colaizzi analysis was used to collate and analyse the interview data.

SETTING

All interviews were conducted at a tertiary hospital specialising in infectious diseases in Nanjing, Jiangsu Province.

PARTICIPANTS

We purposively sampled 11 caregivers of people with HIV/AIDS, including nine women and two men.

RESULTS

Analysing the results from the perspective of iceberg theory, three thematic layers were identified: behavioural, value and belief. The behavioural layer includes a lack of awareness of the disease, physical and mental coping disorders, and an increased sense of stigma; the values layer includes a heightened sense of responsibility, the constraints of traditional gender norms, the influence of strong family values and the oppression of public opinion and morality and the belief layer includes the faith of standing together through storms and stress.

CONCLUSION

Healthcare professionals should value the experiences of caregivers of patients with HIV/AIDS and provide professional support to improve their quality of life.

"I don't know if you have searched through the scriptures to find a reference on HIV/AIDS. I mean there isn't going to be one, right?": HIV stigma solutions from dialogues between faith leaders and health care workers

In South African communities, both faith leaders and health care workers play a vital role in supporting the health of community members and people living with HIV in particular. This study describes HIV stigma when faith leaders and health care workers engaged in discourse. The study used a descriptive qualitative inquiry design. Data were gathered between 2015 and 2016 in the areas of Masiphumelele and Gugulethu in Cape Town, South Africa. Three themes emerged: (1) participants identified influences that can increase HIV stigma; (2) participants shared the challenges that they face to reduce HIV stigma; and (3) participants suggested solutions to reduce HIV stigma. Themes discussed include ground-level problems and practical solutions to address HIV stigma in faith communities. Collaboration between faith leaders and health care workers are vital resources in the fight against HIV stigma. Future research and interventions should aim to promote organised collaboration between faith communities and health care structures.

Factors influencing adolescent girls and young women's uptake of community-based PrEP services following home-based HIV testing in Eastern Cape, South Africa: a qualitative study

Home-based service delivery has been used to improve access to HIV testing and antiretroviral initiation across sub-Saharan Africa, but it has yet to be leveraged to improve pre-exposure prophylaxis (PrEP) uptake. We interviewed 37 adolescent girls and young women (AGYW) in Eastern Cape, South Africa to explore why they chose to initiate PrEP or not following home-based HIV testing and referral for PrEP, and what influenced time to PrEP initiation. Participants reported that home visits provided a source of trusted information and a way to involve family members in their PrEP initiation decisions, motivating some to start PrEP. AGYW who initiated PrEP were more likely to qualitatively perceive themselves to be at high risk for HIV compared with those who never initiated PrEP. Integrating home-based HIV testing with PrEP education and referral may be a valuable way to reduce familial barriers and boost PrEP uptake among AGYW in South Africa. Trial registration: NCT03977181. Retrospectively registered on June 6, 2019.

Which communication technology is effective for promoting reproductive health? Television, radio, and mobile phones in sub-Saharan Africa

The use of radio and television as means to spread reproductive health awareness in Sub-Saharan Africa has been extensive, and its impacts significant. More recently, other means of communication, such as mobile phones, have received the attention of researchers and policy makers as health communication tools. However, evidence on which of the two types of communication (i.e. passive communication from TV/radio, or active communication through phones) is more effective in fostering better reproductive health choices is sparse. This study aims to identify the potential influence of TV or radio ownership as opposed to cell phone ownership on contraceptive use and access to maternal healthcare. Cross-sectional, individual analysis from eleven high-maternal mortality Sub-Saharan African countries is conducted. A total of 78,000 women in union are included in the analysis. Results indicate that ownership of TV or radio is more weakly correlated to better outcomes than mobile phone ownership is. Results are stronger for lower educated women and robust across all levels of wealth. Interestingly, the study also finds that decision-making power is a relevant mediator of cell phone ownership on contraceptive use, but not on maternal healthcare access. A key takeaway from the study is that, while the role of television and radio appears to have diminished in recent years, mobile phones have become a key tool for empowerment and behavioural change among Sub-Saharan African women. Health communication policies should be designed to take into account the now prominent role of mobile phones in affecting health behaviours.