1
|
Davis VH, Nixon SA, Murphy K, Cameron C, Bond VA, Hanass-Hancock J, Kimura L, Maimbolwa MC, Menon JA, Nekolaichuk E, Solomon P. How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review. AIDS Behav 2022; 26:3386-3399. [PMID: 35429310 DOI: 10.1007/s10461-022-03668-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
Abstract
This scoping review assessed how the term 'self-management' (SM) is used in peer-reviewed literature describing HIV populations in low- and middle-income countries (LMIC). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. OVID Medline, Embase, CAB Abstracts, and EBSCO CINAHL, Scopus, and Cochrane Library were searched up to September 2021 for articles with SM in titles, key words, or abstracts. Two team members independently screened the titles and abstracts, followed by the full-text. A data extraction tool assisted with collecting findings. A total of 103 articles were included. Since 2015, there has been a 74% increase in articles that use SM in relation to HIV in LMIC. Fifty-three articles used the term in the context of chronic disease management and described it as a complex process involving active participation from patients alongside providers. Many of the remaining 50 articles used SM as a strategy for handling one's care by oneself, with or without the help of community or family members. This demonstrates the varied conceptualizations and uses of the term in LMIC, with implications for the management of HIV in these settings. Future research should examine the applicability of SM frameworks developed in high-income settings for LMIC.
Collapse
Affiliation(s)
- Victoria H Davis
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, M5T 3M6, Toronto, Ontario, Canada.
| | - Stephanie A Nixon
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kathleen Murphy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Cathy Cameron
- International Centre for Disability and Rehabilitation, Toronto, Canada
| | - Virginia A Bond
- Global and Health Development Department, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jill Hanass-Hancock
- School of Health Science, University of KwaZulu-Natal, Durban, South Africa
- Gender and Health Research Unit, South African Medical Research Council (SAMRC), Durban, South Africa
| | - Lauren Kimura
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Patricia Solomon
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| |
Collapse
|
2
|
Copeland T. To Keep this Disease from Killing You: Cultural Competence, Consonance, and Health among HIV-positive Women in Kenya. Med Anthropol Q 2017; 32:272-292. [PMID: 28766753 DOI: 10.1111/maq.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 12/26/2022]
Abstract
The HIV/AIDS crisis continues in sub-Saharan Africa, where nearly 70% of infections are found. Despite recent efforts to supply antiretroviral therapy to those infected, most are not receiving medication and are forced to rely on self-management to remain healthy. In Kenya, many of those infected are women living in extreme poverty. This article presents the findings of research among poor women in Nairobi that examined the relationship between knowledge of a cultural model of self-managing HIV/AIDS, cultural consonance, and health. This biocultural study expands on earlier findings showing that knowledge of the model (competence) is a significant predictor of health by examining here how behavior consistent with that knowledge (consonance) affects health outcomes, as measured by CD4 counts, perceived stress, depressive symptoms, and recent illnesses.
Collapse
Affiliation(s)
- Toni Copeland
- Department of Anthropology and Middle Eastern Cultures, Mississippi State University
| |
Collapse
|
3
|
Copeland T. Self-managing HIV/AIDS: cultural competence and health among women in Nairobi, Kenya. Anthropol Med 2017; 25:176-190. [PMID: 28492085 DOI: 10.1080/13648470.2017.1285002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite recent efforts to supply antiretroviral therapy, many in Africa are not receiving medication, instead relying on self-management in their attempts to remain healthy. In Kenya, the majority of those infected are women who are below the extreme poverty level. Building on research demonstrating a link between knowledge of HIV/AIDS management and the length of time HIV-positive women have lived in Nairobi, this article uses a cognitive anthropological approach that conceives of culture as shared models and explores the relationship between how well women know a cultural model of self-managing HIV/AIDS and health among women who are not receiving biomedical treatment. Outcomes include reported perceived stress, depressive symptoms, and recent illness episodes. Here, this association of competence in the shared cultural model and health among women living in extremely marginal economic conditions is explored from a biocultural perspective to better understand this relationship. Knowledge of the model is a significant predictor of better overall health even after controlling for age, education, income, marital status, internal locus of control, and how long women have known that they are HIV-positive. This article adds to the HIV/AIDS literature by quantitatively linking health to cultural knowledge among an HIV-positive population. It also contributes to the cultural consensus literature by demonstrating health benefits of cultural knowledge.
Collapse
Affiliation(s)
- Toni Copeland
- a Department of Anthropology , The University of Alabama , Tuscaloosa , AL , USA
| |
Collapse
|
4
|
COPELAND TONI. Teaching the research process through student engagement: Cultural consensus analysis of HIV/AIDS. ANNALS OF ANTHROPOLOGICAL PRACTICE 2016. [DOI: 10.1111/napa.12098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Stress, diabetes, and infection: Syndemic suffering at an urban Kenyan hospital. Soc Sci Med 2015; 146:11-20. [PMID: 26476849 DOI: 10.1016/j.socscimed.2015.10.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/02/2015] [Accepted: 10/07/2015] [Indexed: 01/17/2023]
Abstract
The complexity of sickness among Kenya's urban poor cannot be dissociated from how social and health problems become syndemic. Increasingly diabetes and other non-communicable diseases (NCDs) are emerging among low-income populations that also are most afflicted by social stress and infection. This article examines how social stress, psychological distress, and physical illness among patients in a public hospital in Nairobi, Kenya, produce syndemic suffering, defined by lived experiences of syndemic clustering such as diabetes with depression and infection. We recruited 100 urban public hospital patients, of which half were women, and half had type 2 diabetes from June to August 2014. We administered written informed consent and collected anthropometrics and blood samples before we conducted lengthy mixed qualitative and survey interviews. We analyzed social stress in narrative interviews using content analysis and evaluated social and physical contributors to mental distress with frequency tables and logistic regression. We found that people experienced diabetes through a complex social and medical framework, where social problems were cause and consequence to psychological and physical suffering. Women's narratives revealed more social suffering as well as more mental distress and somatic symptoms, including multi-morbidities, than men's. People with diabetes reported not only concurrent anxiety and depression but also common infections, including malaria, tuberculosis, and HIV/AIDS. Narratives reveal how NCDs concurrent with infections, and HIV in particular, produce financial challenges for patients, especially when HIV treatment is free and patients must pay out-of-pocket for diabetes care. Future studies should investigate syndemic clustering of infections and NCDs among low-income populations at the population-level.
Collapse
|
6
|
Gonzalez L, Seley C, Martorano J, Garcia-Moreno I, Troncoso A. Infections and inequalities: anemia in AIDS, the disadvantages of poverty. Asian Pac J Trop Biomed 2015; 2:485-8. [PMID: 23569955 DOI: 10.1016/s2221-1691(12)60081-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 11/19/2011] [Accepted: 12/12/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To study anemia in AIDS patients and its relation with socioeconomic, employment status and educational levels. METHODS A total number of 442 patients who visited the Infectious Diseases University Hospital in Buenos Aires, Argentina were included in the study. Patients were dividied into two groups, i.e. one with anemia and the other without anemia. Anemia epidemiology and its relationship with educational level, housing, job situation, monthly income, total daily caloric intake and weekly intake of meat were evaluated. RESULTS Anemia was found in 228 patients (54%). Comparing patients with or without anemia, a statistically significant difference was found (P<0.000 1) in those whose highest educational level reached was primary school, who lived in a precarious home, who had no stable job or were unable to work, whose income was less than 30 dollars per month, whose meat consumption was less than twice a week or received less than 8 000 calories per day. CONCLUSIONS The high prevalence of anemia found in poor patients with AIDS suggests that poverty increases the risk to suffer from this hematological complication. The relationship between economic development policies and AIDS is complex. Our results seem to point to the fact that AIDS epidemic may affect economic development and in turn be affected by it. If we consider that AIDS affects the economically active adult population, despite recent medical progress it usually brings about fatal consequences, especially within the poorest sectors of society where the disease reduces the average life expectancy, increases health care demand and tends to exacerbate poverty and iniquity.
Collapse
Affiliation(s)
- Lucia Gonzalez
- Departments of Nutrition and Microbiology, School of Nutrition, Buenos Aires University
| | | | | | | | | |
Collapse
|
7
|
Martin F, Kiwanuka T, Kawuma R, Zalwango F, Seeley J. Tasks and strategies of self-management of living with antiretroviral therapy in Uganda. AIDS Patient Care STDS 2013; 27:697-706. [PMID: 24219780 DOI: 10.1089/apc.2013.0254] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Faith Martin
- School of International Development, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Thadeus Kiwanuka
- Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
| | - Rachel Kawuma
- Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
| | - Flavia Zalwango
- Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
| | - Janet Seeley
- School of International Development, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
- Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
| |
Collapse
|
8
|
Lind JD, Powell-Cope G, Chavez MA, Fraser M, Harrow J. NEGOTIATING DOMAINS OF PATIENT DIGNITY IN VA SPINAL CORD INJURY UNITS: PERSPECTIVES FROM INTERDISCIPLINARY CARE TEAMS AND VETERANS. ANNALS OF ANTHROPOLOGICAL PRACTICE 2013. [DOI: 10.1111/napa.12027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jason D. Lind
- HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital; Tampa FL
| | - Gail Powell-Cope
- HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital; Tampa FL
| | - Margeaux A. Chavez
- HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital; Tampa FL
| | - Marsha Fraser
- HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital; Tampa FL
| | - Jeffrey Harrow
- HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital; Tampa FL
| |
Collapse
|