title: On the road to HIV/AIDS competence in the household: building a health-enabling environment for people living with HIV/AIDS.
abstract: When aiming to provide chronic disease care within the context of human resource shortages, we should not only consider the responsibility of the individual person living with HIV/AIDS (PLWHA) but also the capacity of the social environment to actively encourage a lifestyle that fosters health. In this social environment, extensive efforts are thus required to increase HIV/AIDS knowledge, reduce stigma, stimulate HIV testing, improve health care-seeking behavior, and encourage safe sexual practices-described in the literature as the need for AIDS competence. In accordance with socio-ecological theory, one cannot restrict the research focus to communities, as AIDS competence studies should also incorporate the intermediate household level. In responding to this research need, the aim of this article is to conceptualize an "HIV/AIDS competent household" based on qualitative interviews and focus group discussions conducted in a township on the outskirts of Cape Town, South Africa. Our results show that a household's supportive response to disclosure allows a patient to live openly as HIV positive in the household concerned. This may mark the start of the road to HIV/AIDS competence in the household, meaning the PLWHA receives sustainable support throughout the care continuum and positive living becomes the norm for the PLWHA and his or her household. A feedback loop might also be created in which other household members are encouraged to be tested and to disclose their status, which is an important step towards a sustainable response to HIV/AIDS-related challenges. Despite the fact that this road to HIV/AIDS competence at the household level is fragile and prone to various barriers, this article shows that the household has the potential to be a health-enabling environment for PLWHA.
authors: Research Centre for Longitudinal and Life Course Studies (CELLO), University of Antwerp, Sint-Jacobstraat 2, Antwerp 2000, Belgium. caroline.masquillier@uantwerpen.be.
authors: Caroline
authors: C
authors: Masquillier
authors: Research Centre for Longitudinal and Life Course Studies (CELLO), University of Antwerp, Sint-Jacobstraat 2, Antwerp 2000, Belgium. edwin.wouters@uantwerpen.be.|Centre for Health Systems Research and Development, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein 9300, South Africa. edwin.wouters@uantwerpen.be.
authors: Edwin
authors: E
authors: Wouters
authors: Research Centre for Longitudinal and Life Course Studies (CELLO), University of Antwerp, Sint-Jacobstraat 2, Antwerp 2000, Belgium. dimitri.mortelmans@uantwerpen.be.
authors: Dimitri
authors: D
authors: Mortelmans
authors: School of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville 7535, South Africa. bvanwyk@uwc.ac.za.
authors: Brian
authors: B
authors: van Wyk
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000328:Adult; D001294:Attitude to Health; D005191:Family Characteristics; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012931:Social Environment; D057545:Social Stigma; D013019:South Africa