Browsing by Author "Nagenda, Mapaseka Chabalala"

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    Factors influencing the self-management youth living with HIV in Lesotho
    (Stellenbosch : Stellenbosch University, 2022-04) Nagenda, Mapaseka Chabalala; Crowley, Talitha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: Many adolescents and youth live with the human immunodeficiency virus (HIV) worldwide. The HIV treatment goals and health outcomes of adolescents and youth living with HIV (YLWHIV) are lagging. One way to improve outcomes is through supporting YLWHIV to acquire self-management (SM) skills. Self-Management is a youth’s ability to take control of their health and adopt good health practices. Although SM is associated with improved health outcomes, condition-specific, environmental, individual and family contextual factors influence SM. Knowledge of contextual factors influencing SM of YLWHIV in Lesotho could assist in tailoring SM support strategies. Aim: The study aimed to describe the factors that influence SM of YLWHIV in Lesotho. The specific objectives were to determine the condition-specific, physical, and social environmental factors as well as the individual and family characteristics influencing SM of YLWHIV in Lesotho. Methods: An exploratory-descriptive, cross-sectional quantitative research design was used. Youth living with HIV (n=184), aged 15-24, were conveniently sampled from two HIV treatment sites in Lesotho. The data were collected through a validated self-report questionnaire available in English and Sesotho. Data analysis was done using the Statistical Package of Social Sciences (SPSS) version 27 to obtain descriptive and inferential statistics. The Stellenbosch University Health Research Ethics Committee waived parental consent for adolescents younger than 18. Results: Participants had high SM scores (mean 92.7%), which corresponded with their treatment outcomes. Almost all the participants (98.9%; n=181) indicated that they never missed a dose of their antiretroviral treatment (ART). All the participants (100%; n=183) had viral load values of less than 1000 copies/ml. Although SM scores were high, YLWHIV had lower item mean scores in relational and participatory components, which are crucial for their transitioning to adult care, negotiating condom use and accessing community services. High SM scores in this sample could be attributed to condition-specific factors, including once-daily doses (100%; n=182) and a longer duration on treatment (81.4%; n=149) on ART for more than 10 years). Regarding the physical and social environmental factors, participants had access to youth-friendly health services; 97.9% (n=179) were satisfied with the services. Regarding individual and family factors, participants were older (median age 22; IQR 4) and the majority had stable living conditions (61.7%; n=113) living with their current caregiver for more than 10 years). Individual strengths were associated with higher SM scores (p<0.01); mental health problems were associated with lower levels of SM (p<0.05). Conclusion: The study supports the notion that uncomplicated treatment regimens, longer duration on treatment, access to adolescent-friendly services, and stable living conditions may lead to better SM. However, further exploration of factors influencing SM across various healthcare settings and with more diverse YLWHIV are needed to contextualise SM support interventions for YLWHIV, particularly those transitioning to adult care, to ensure meeting global targets.