The subjective experience of being HIV-positive : needs, strengths and coping strategies

Abstract

Adequate assessment of the needs of HIV-positive individuals in the South African context is essential, as it may provide insight concerning limitations in healthcare. This study focuses on the subjective experience of nine HIV-positive individuals, in order (a) to investigate their needs; (b) to gain knowledge and understanding of the strengths available to them; (c) to investigate their coping strategies; and (d) to generate a set of guidelines for the development of a secondary prevention programme to improve their psychological well-being and immune functioning. This article employs a qualitative research method, utilising hermeneutic thematic analysis to gain a greater understanding of the subjective psychological functioning of HIV-positive individuals in the South African multicultural context. To a great extent, this research focuses on the salutogenic/fortigenic perspective, where the focus is on strengths, capacities and emotional/psychological well-being. Semi-structured interviews were conducted with nine asymptomatic HIV-positive individuals. The needs identified during this study involved the psychological, economical, informational and social categories. The strengths available to HIV-positive individuals in order to make sense or construct meaning in their lives, consisted of four themes, namely internal, social, self-regulative and spiritual strengths. The study further indicates that the psychological strengths utilised by HIV-positive individuals are closely related to the concept of meaningfulness, the mechanisms of coping and psychological resilience. A broad range of coping strategies was identified that participants employed in the management of the disease and in dealing with the negative emotions associated with an HIV-positive diagnosis. These strategies could be conceptually grouped into five categories based on the functions these strategies served, namely self-management coping strategies, cognitive coping strategies, social support coping strategies, religious coping strategies, and avoidance coping strategies. The implications of this study are that the various identified concepts related to needs, strengths and coping strategies, may contribute to the development of a secondary prevention programme, in order to improve HIV-positive individuals' psychological well-being and immune functioning. The concept of "Sense of Coherence" which consists of three elements, namely Comprehensibility, Manageability and Meaningfulness, could be successfully incorporated into an intervention programme in order to achieve a positive redefinition of participants' subjective feeling that life is meaningful, as well as to improve their comprehensibility and manageability of their illness.