Psychosocial Challenges and Protective Influences for Socio-Emotional Coping of HIV-Positive Adolescents in South Africa: A Qualitative Investigation
December 8, 2010
"While the roll-out of antiretroviral therapy in South Africa should lead to a reduction in mother-to-child transmission, mortality, and orphaning, it will also be accompanied by a large number of children entering adolescence and adulthood with a chronic infectious disease," the study authors noted. Adolescence is an especially vulnerable period for HIV-infected people in relation to mental health problems and engagement in high-risk behaviors, including failure to comply with medical treatment. The researchers undertook the current qualitative study to develop an understanding of the psychosocial challenges as well as protective influences promoting socio-emotional coping in HIV-positive adolescents in order to inform South Africa's mental health promotion and HIV prevention programming for this population.
At a large HIV/AIDS clinic, in-depth qualitative interviews were conducted with 25 HIV-positive adolescents and 15 caregivers of HIV-positive children. NVivo8 software was used to thematically analyze the data.
The adolescents reported psychosocial challenges that included dealing with the loss of biological parents in the case of orphans; coming to terms with their HIV-positive status, including identity difficulties; external discrimination and stigma; and disclosure difficulties. Caregivers identified disclosure and lack of financial, family, and social support as key challenges. Medication, HIV information, a future orientation, and social support emerged as important for coping and well-being of adolescents, and financial and social support were key for promoting supportive caregiving contexts.
HIV-positive adolescents in South Africa experience similar concerns to those in high-income countries, though socio-emotional coping may be "compromised due to the late roll-out of [antiretrovirals] and challenges to caregiving contexts including poverty, stigma, and minimally supported foster care arrangements," the authors concluded. "There is a need for mental health promotion programs for adolescents to adopt an ecological approach, strengthening protective influences at the individual, interpersonal, community, and policy levels."
08.2010; Vol. 22; No. 8: P. 970-978; I. Petersen, A. Bhana, N. Myeza, S. Alicea, S. John, H. Holst, M. McKay, C. Mellins
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