SciELO - Scientific Electronic Library Online

vol.15 issue1The health care needs of the physically disabled patient in a home-based care environment: Implications for the training of ancillary health care workersStakeholders' perceptions of the delivery and quality of sexually transmitted infection treatment by private practitioners in Windhoek, Namibia author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Health SA Gesondheid (Online)

On-line version ISSN 2071-9736
Print version ISSN 1025-9848

Health SA Gesondheid (Online) vol.15 n.1 Cape Town  2010




Self-care symptom-management strategies amongst women living with HIV/AIDS in an urban area in KwaZulu-Natal



Regis R. Marie ModesteI; Sisana J. MajekeII

ISchool of Nursing, University of the Western Cape, South Africa
IISchool of Nursing, University of KwaZulu-Natal, South Africa





People living with HIV and AIDS experience a number of symptoms such as fatigue, nausea and vomiting, fever and anxiety during the various stages of the illness. This has a negative effect on their quality of life. Women are the most commonly infected group and are at greater risk of acquiring HIV than men. In addition to their vulnerability, women have other responsibilities in society and expectations from society to fulfil. Women's health-seeking and health practice behaviours are often hindered by a number of factors, including family responsibilities, poverty and fear.
This paper presents the findings of a qualitative study aimed at exploring the self-care symptommanagement strategies used by women living with HIV and AIDS in an urban area in KwaZulu-Natal in 2006.
Eleven participants were selected through a purposive sampling method until saturation was reached. Individuals were assessed in depth, using the symptom-management strategy interview. Qualitative content analysis was used to examine the transcribed interviews, using a deductive approach based on the categories of self-care symptom-management strategies.
Various physical and psychological symptoms and a number of self-care symptom-management strategies were reported by the participants and these included taking medication and seeking help.
The study makes recommendations on how to improve women's ability to employ a self-care strategy in managing their HIV- and AIDS-related symptoms.

Keywords: HIV and AIDS; HIV and AIDS in KwaZulu-Natal; self-care; symptom management; South African women


Mense wat met MIV en Vigs leef, ervaar verskeie simptome in die verskillende stadiums van die siekte, soos moegheid, naarheid en braking, koors en angstigheid. Dit het 'n negatiewe effek op hul lewensgehalte. Vroue is die groep wat die meeste besmet word, en staan 'n groter risiko om MIV op te doen as mans. Benewens hul vatbaarheid, het vroue ook ander verantwoordelikhede en verwagtinge om in die samelewing te vervul. Vroue se gesondheidsbevorderende en gesondheidspraktykgedrag word dikwels gekniehalter deur 'n aantal faktore, wat familieverantwoordelikhede, armoede en vrees insluit.
Hierdie artikel bied die bevindinge aan van 'n kwalitatiewe studie gemik op die verkenning van selfsorg-simptoombeheerstrategieë wat deur vroue met MIV en Vigs in 2006 in 'n stedelike gebied in KwaZulu-Natal gebruik is.
'n Steekproef van 11 respondente is geselekteer deur middel van 'n doelbewuste steekproefmetode totdat versadiging bereik is. Individuele diepte-onderhoude is gevoer deur gebruik te maak van die simptoombeheerstrategie-onderhoud. Kwalitatiewe inhoudelike analise is gebruik om die getranskribeerde onderhoude te analiseer deur middel van 'n deduktiewe metode gegrond op die kategorieë van selfsorg-simptoombeheerstrategieë.
Verskeie fisiese en psigologiese simptome asook 'n aantal selfsorg-simptoombeheerstrategieë is deur die respondente gerapporteer. Die selfsorg-simptoombeheerstrategieë wat in die studie identifiseer is, het die neem van medikasie en die soek na hulp ingesluit.
Die studie maak aanbevelings oor hoe om vroue se vermoë om 'n selfsorg-strategie om MIV- en Vigs-verwante simptome te beheer, te verbeter.



“Full text available only in PDF format”




Abdool Karim, Q., 2001, 'Barriers to preventing human immunodeficiency virus in women: Experiences from KwaZulu-Natal, South Africa', Journal of the American Medical Women's Association 56(4), 193-196.         [ Links ]

Adam, M.A. & Johnson, F., 2009, 'Estimations of adult antiretroviral treatment coverage in South Africa', South African Medical Journal 99(9), 661-667.         [ Links ]

Bowie, C., Kalilane, L., Cleary, P. & Bowie, C., 2006, 'The pattern of symptoms in patients receiving home-based care in Bangwe, Malawi: A descriptive study', BioMed Central (BMC) Palliative care 5(1), Viewed 4 July 2006 from        [ Links ]

Brink, H.I., 1996, Fundamentals of research methodology for health care professionals, Juta, Cape Town.         [ Links ]

Bunch, E.H., 2004, 'Symptom management for HIV-positive persons in Norway', International Nursing Review 51, 167-175.         [ Links ]

Busch, C., De Maret, P.S., Flynn, T., Kellum, R., Le, S., Meyers, B., Saunders, M., White, R., and Palmquist, M., 2005, 'Content analysis', Writing@CSU. Colorado State University Department of English, viewed 4 July 2006, from        [ Links ]

Chou, F., 2004, 'Testing a predictive model of the use of HIV and AIDS symptom self-care strategies', AIDS Patient Care 18(2), 109-117.         [ Links ]

Chou, F. & Holzemer, W.L., 2004, 'Linking HIV and AIDS clients' self-care with outcomes', Journal of the Association of Nurses in AIDS Care 15(4), 58-67.         [ Links ]

Chou, F., Holzemer, W.L., Portillo, C.J. & Slaughter, R., 2004, 'Self-care strategies and sources of information for HIV and AIDS symptom management', Nursing Research 53(5), 332-339.         [ Links ]

Department of Health, 2003, The impact of HIV and AIDS on the health sector: National survey of health personnel, ambulatory and hospitalized patients and health facilities 2002, Department of Health, Pretoria.         [ Links ]

Department of Health, 2004, National HIV and Syphilis Antenatal Sero-prevalence Survey in South Africa 2003, Department of Health, Pretoria.         [ Links ]

Department of Health, 2006, National HIV and Syphilis Antenatal Sero-prevalence Survey in South Africa 2005, Department of Health, Pretoria.         [ Links ]

Department of Health, 2008, National HIV and Syphilis Antenatal Sero-prevalence Survey in South Africa 2007, Department of Health, Pretoria.         [ Links ]

Giddy, J., 2005, 'HIV care at McCord Hospital, Durban, South Africa', Passages 2, viewed 2 August 2005, from        [ Links ]

Global HIV Prevention Working Group, May 2003, Access to HIV prevention: Closing the gap, viewed 17 March 2005, from        [ Links ]

Global HIV Prevention Working Group, June 2004, HIV prevention in the era of expanded treatment access, viewed 17 March 2005, from        [ Links ]

Goggin, K., Catley, D., Brisco, S.T., Engelson, E.S., Rabkin, J.G. & Kotler, D.P., 2001, 'A female perspective on living with HIV disease', National Association of Social Workers 20(2), 80-89.         [ Links ]

Helman, C.G., 1994, Culture, health and illness, 3rd edn., Butterworth - Heinemann, Oxford.         [ Links ]

Holzemer, W.L., 2002, 'HIV and AIDS: The symptom experience. What cell counts and viral loads won't tell you', American Journal of Nursing 102(4), 48-52.         [ Links ]

Holzemer, W.L., Henry, S.B., Nokes, K.M., Corless, I.B., Brown, M.A., Powell-Cape, G.M., Turner, J.G. & Inouye, J., 1999, 'Validation of the sign and symptom check-list for persons with HIV disease (SSC-HIV)', Journal of Advanced Nursing 30(5), 1041-1049.         [ Links ]

Holzemer, W.L., Hudson, A., Kirksey, K.M., Hamilton, M.J. & Bakken, S., 2001, 'The revised sign and symptom check-list for persons with HIV disease (SSC-HIVrev)', Journal of the Association of Nurses in AIDS Care 12(5), 60-70.         [ Links ]

Hudson, A.L., Kirksey, K. & Holzemer, W.L., 2004, 'The influence of symptoms on quality of life among HIV-infected women', Western Journal of Nursing Research 26(1), 9-23.         [ Links ]

Hudson, A.L., Lee, K.A. & Portillo, C.J., 2003, 'Symptom experience and functional status among HIV-infected women', AIDS Care 15(4), 483-492.         [ Links ]

Hughes, A., 2004, 'Symptom management in HIV-infected patients', Journal of the Association of Nurses in AIDS Care 15(5), suppl., 7S-13S.         [ Links ]

Hung, C.C., Hsiao, C.F., Chen, M.Y., Hsieh, S.M., Chang, S.Y., Sheng, W.H., Sun, H.Y. & Chang, S.C., 2006, 'Improved survival of person with human immunodeficiency virus type 1 in the era of highly antiretroviral therapy in Taiwan', Journal of Infectious Diseases 59, 222-228.         [ Links ]

Kemppainen, J.K., Eller, L.S., Bunch, E., Hamilton, M.J., Dole, P., Holzemer, W., Kirksey, K., Nicholas, P.K., Corless, I.B., Coleman, C., Nokes, K.M., Reynolds, N., Sefcik, L., Wantland, D. & Tsai, Y.F., 2006, 'Strategies for self-management of HIV-related anxiety', AIDS Care 18(6), 597-607.         [ Links ]

Korff, M.V., Gruman, J., Schaefer, J., Curry, S.J. & Wagner, E.H., 1997, 'Collaborative management of chronic illness', Annals of Internal Medicine 127(12), 1097-1102.         [ Links ]

Leenerts, M.H., 1998, 'Barriers to self-care in a cohort of low-income white women living with HIV and AIDS', Journal of the Association of Nurses in AIDS Care 9(6), 22-36.         [ Links ]

Makoae, L.N., Seboni, N.M., Molosiwa, K., Moleko, M., Human, S., Sukati, N.A. & Holzemer, W.L., 2005, 'The symptom experience of people living with HIV and AIDS in Southern Africa', Journal of the Association of Nurses in AIDS Care 16(3), 22-32.         [ Links ]

Medley, A., Garcia-Moreno, C., McGill, S. & Maman, S., 2004, 'Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: Implications for prevention of mother-to-child transmission programmes', Bulletin of the World Health Organization 82(4), 299-307.         [ Links ]

Miles, M.S., Holditch-Davis, D., Eron, J., Black, B.P., Pedersen, C. & Harris, D.A., 2003, 'An HIV self-care symptom management intervention for African American mothers', Nursing Research 52(6), 350-360.         [ Links ]

Nicholas, P.K., 2005, 'Women and HIV: Symptoms and quality of life in women', Bulletin of Experimental Treatment for AIDS, viewed 3 March 2005, from http://www.thebody,com/sfaf/winter05/women_hiv.html        [ Links ]

Plach, S.K., Stevens, P.E. & Heidrich, S.M., 2006, 'Social roles and health in women living with HIV and AIDS: A pilot study', Journal of the Association of Nurses in AIDS Care 17(2), 58-64.         [ Links ]

Polit, D.F. & Hungler, B.P., 1999, Nursing research: Principle and methods, 6th edn., Lippincott, Philadelphia.         [ Links ]

Pratt, R., 1995, HIV and AIDS: A strategy for nursing care, 4th edn., Edward Arnold, London.         [ Links ]

Shawn, E.R., Campbell, L., Mnguni, M.B., Defilippi, K.M. & Williams, A.B., 2005, 'The spectrum of symptoms among rural South Africans with HIV infection', Journal of the Association of Nurses in AIDS Care 16(6), 12-23.         [ Links ]

Shisana, O. & Simbayi, L., 2002, Nelson Mandela/HSRC study of HIV and AIDS: South African national HIV prevalence, behavioral risks and mass media household survey 2002, Human Sciences Research Council Publishers, Cape Town.         [ Links ]

Spirig, R., Moody, K., Battegay, M. & De Geest, S., 2005, 'Symptom management in HIV and AIDS: Advancing conceptualization', Advances in Nursing Science 28(4), 333-344.         [ Links ]

Sukati, N.A., Mndebele, S.C., Makoa, E.T., Ramukumba, T.S., Makoae, L.N, Seboni, N.M., Human, S. & Holzemer, W.L., 2005, 'HIV and AIDS symptom management in Southern Africa', Journal of Pain and Symptom Management 29(2), 185-192.         [ Links ]

Tsai, Y., Hsiung, P. & Holzemer, W.L., 2002, 'Symptom management in Taiwanese patients with HIV', Journal of Pain and Symptom Management 23(4), 301-309.         [ Links ]

UNAIDS, 2004, Report on the global AIDS epidemic, June 2004, Geneva.         [ Links ]

UNAIDS, 2008, 2008 report on the global AIDS epidemic, June 2007, Geneva.         [ Links ]

UNAIDS/WHO, 2004, AIDS epidemic update, December 2004 Geneva.         [ Links ]

Veenstra, N. & Oyier, A., 2006, 'The burden of HIV-related illness on outpatient health services in KwaZulu-Natal, South Africa', AIDS Care 18(3), 262-268.         [ Links ]



Regis Marie Modeste
Room G4
Senate Building
School of Nursing, University of the Western Cape
Modderdam Road
Bellville 7535
South Africa

Received: 16 Oct. 2009
Accepted: 26 July 2010
Published: 17 Nov. 2010

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License