Experiences and coping strategies of adolescents living with HIV in Kanyama community, Lusaka Province

Abstract

Background HIV is a cross-cutting problem which does not only affect adults but also affects adolescents. The number of adolescents living with HIV is increasing due to the provision of Highly Active Antiretroviral Therapy (HAART) which enables them to live longer yet little is known about their experiences and the strategies they use to cope with their condition. Such knowledge could help HIV programs to better respond to their needs and help them to cope effectively. Methods This qualitative study examined the experiences of adolescents living with HIV in Kanyama Community in Lusaka, Zambia. It used a phenomenological study design which focuses on the human experiences. The sampling approach which was used to select the sample of the study was purposive sampling. Data was collected using in-depth interviews with 24 adolescents living with HIV. Data was coded using NVIVO and analysed using thematic analysis. Thematic analysis was used to draw out adolescents' feeling and experiences of being HIV positive and to explore the coping strategies used by adolescents at Community level. Results The three dimensions of the disclosure are disclosure to adolescents, adolescents disclosing to others and caregivers disclosing on behalf of the adolescents (third party disclosure). Most adolescents felt bad while a few felt good after knowing their status. Few disclosed to family members. All the girls and few boys were comfortable with third party disclosure and only a few boys were not comfortable with it. With regards to experiences with health services: all the girls appreciated the use of drugs. Both girls and boys had concerns about antiretroviral therapy services provided during weekdays. All participants were in good terms with health care providers. Regarding experiences with other people in society, some participants were taken care of by their family members while a few experienced stigma from peers and family members. Adolescents were able to cope using resilience, non-disclosure, spiritual intervention and the use of supportive systems. Conclusion Adolescents had various experiences with regard to disclosure. Few girls and boys disclosed their status to biological parents and immediate caregivers. Some adolescents were not comfortable with third party disclosure while a few did not have problems with it. Health care services provided during the week when they were expected to be in class posed a challenge. Understanding adolescents’ experiences and what helps them to cope with their condition will help in adopting interventions that bring out positive experiences while mitigating negative ones. This would strengthen the provision of services tailored to the needs and circumstances of adolescents living with HIV in Zambia.