Quality of life of people living with HIV and AIDS in Swaziland who are on antiretroviral therapy

Abstract

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research.