Tasks and strategies of self-management of living with antiretroviral therapy in Uganda.
There is increasing interest in promoting and supporting self-management of HIV and antiretroviral treatment (ART), including in resource-limited settings. Although the impact of HIV and ART on people in Uganda has been explored, little attention has been paid to how people self-manage. This qualitative study collected data from 20 participants on ART in Wakiso district, Uganda, using in-depth interviews, life histories, and observations to explore the tasks and strategies of living with ART. The identified strategies were compared to two existing self-management frameworks. Results highlighted a range of tasks including obtaining, taking, and adhering to ART medication, monitoring their condition, living with stigma and managing disclosure, maintaining general health, and adjusting to new roles. Participants described a range of strategies or behaviors to manage, which they actively created and used, tailored to their needs and environment. Comparison with existing frameworks revealed many similarities, with some local differences in enactment, and greater emphasis in our sample on obtaining the medication. Interventions to support people with self-management in Uganda, and possibly other resource-limited settings, require careful adaptation to local settings. The degree to which each of these strategies may improve health and quality of life requires further investigation.
1 School of International Development, University of East Anglia , Norwich Research Park, Norwich, United Kingdom .
Faith
F
Martin
Thadeus
T
Kiwanuka
Rachel
R
Kawuma
Flavia
F
Zalwango
Janet
J
Seeley
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D012648:Self Care; D057545:Social Stigma; D014342:Truth Disclosure; D014454:Uganda
D044966:Anti-Retroviral Agents