Stay-at-Home: The Impact of the COVID-19 Lockdown on Household Functioning and ART Adherence for People Living with HIV in Three Sub-districts of Cape Town, South Africa

The purpose of the article is to examine the right to social assistance for households living with HIV/AIDS in South Africa. In particular, the article focuses on the impact of this pandemic on households' access to social assistance benefits in the wake of the HIV/AIDS pandemic, which has wrought untold sorrow and suffering to the overwhelming majority of households in South Africa. The article analyses the consequences of HIV/AIDS in relation to households' support systems, care and dependency burdens, and the extent to which the household members either acknowledge the illness (enabling them to better engage with treatment options) or alternatively, deny its existence. The article commences by reviewing the literature concerning the effects and social impact of HIV/AIDS on the livelihoods of households and their families. The social reciprocity that underpins households' livelihoods is briefly recapitulated. The article concludes that, while recent policy developments are to be welcomed, the current South African legal system of social security does not provide adequate cover for both people living with HIV/AIDS and their families. More remains to be done in order to provide a more comprehensive social security system for the excluded and marginalised people who are living with HIV/AIDS and their families.

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Excess mortality associated with mental illness in people living with HIV in Cape Town, South Africa: a cohort study using linked electronic health records

The Lancet Global Health ◽

10.1016/s2214-109x(20)30279-5 ◽

2020 ◽

Vol 8 (10) ◽

pp. e1326-e1334

Author(s):

Andreas D Haas ◽

Yann Ruffieux ◽

Leigh Luella van den Heuvel ◽

Crick Lund ◽

Andrew Boulle ◽

...

Keyword(s):

South Africa ◽

Mental Illness ◽

Cohort Study ◽

Electronic Health Records ◽

Excess Mortality ◽

Cape Town ◽

People Living With Hiv ◽

Health Records ◽

Electronic Health ◽

Living With Hiv

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High Levels of Risk Behavior Among People Living with HIV Initiating and Waiting to Start Antiretroviral Therapy in Cape Town South Africa

AIDS and Behavior ◽

10.1007/s10461-007-9279-7 ◽

2007 ◽

Vol 12 (4) ◽

pp. 570-577 ◽

Cited By ~ 44

Author(s):

Thomas P. Eisele ◽

Catherine Mathews ◽

Mickey Chopra ◽

Lisanne Brown ◽

Eva Silvestre ◽

...

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Risk Behavior ◽

Cape Town ◽

People Living With Hiv ◽

Living With Hiv

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Alcohol-related intentional nonadherence to antiretroviral therapy among people living with HIV, Cape Town, South Africa

AIDS Care ◽

10.1080/09540121.2019.1587357 ◽

2019 ◽

Vol 31 (8) ◽

pp. 951-957 ◽

Cited By ~ 6

Author(s):

Seth Kalichman ◽

Catherine Mathews ◽

Ellen Banas ◽

Moira Kalichman

Keyword(s):

South Africa ◽

Antiretroviral Therapy ◽

Cape Town ◽

People Living With Hiv ◽

Living With Hiv

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Failed intentions? Meeting the water needs of people living with HIV in South Africa

Water SA ◽

10.17159//wsa/2020.v46.i2.8239 ◽

2020 ◽

Vol 46 (2 April) ◽

Author(s):

Mary Galvin ◽

Linah N Masombuka

Keyword(s):

South Africa ◽

Health Policy ◽

Policy Process ◽

Academic Research ◽

Personal Hygiene ◽

People Living With Hiv ◽

Policy Proposal ◽

Services Delivery ◽

Living With Hiv ◽

The Impact

Researchers, activists, practitioners and policy-makers have grappled with the challenge of providing people living with HIV (PLHIV) with an adequate amount of safe water. Comprising 13% of the overall population of South Africa in 2018, 7.52 million PLHIV need water for drinking and taking medication; preparing food; and personal hygiene and cleaning to minimise infections. This article examines the responses of the different stakeholders to this challenge and their impact on the water and health policy process. It finds that activists were able to emphasise the dimensions of the challenge; practitioners worked to implement provision more effectively within existing policy frameworks; and a range of stakeholders made a thoughtful and promising policy proposal for direct action, which the Department of Water and Sanitation ultimately failed to embrace. This article is based on an extensive review of academic research and publications by development agencies on HIV and water as well as engagement with policies and documents in the South African water sector related to water services delivery for PLHIV. While the widespread provision of antiretrovirals from 2004 has changed the context, the above findings are significant in understanding and reviewing the impact of various stakeholders on the water and health policy process. They raise questions regarding the effectiveness of NGO advocacy, the means of delivering improved services to specific populations, and the ability of a range of stakeholders to inform the policy approaches of government departments.

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The Impact of Community Support Initiatives on the Stigma Experienced by People Living with HIV/AIDS in South Africa

AIDS and Behavior ◽

10.1007/s10461-014-0865-1 ◽

2014 ◽

Vol 19 (2) ◽

pp. 214-226 ◽

Cited By ~ 17

Author(s):

Caroline Masquillier ◽

Edwin Wouters ◽

Dimitri Mortelmans ◽

Frederik le Roux Booysen

Keyword(s):

South Africa ◽

Community Support ◽

People Living With Hiv ◽

Living With Hiv ◽

The Impact ◽

Hiv Aids

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Challenges Faced by People Living with HIV/AIDS in Cape Town, South Africa: Issues for Group Risk Reduction Interventions

AIDS Research and Treatment ◽

10.1155/2010/420270 ◽

2010 ◽

Vol 2010 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Allanise Cloete ◽

Anna Strebel ◽

Leickness Simbayi ◽

Brian van Wyk ◽

Nomvo Henda ◽

...

Keyword(s):

South Africa ◽

Risk Reduction ◽

Cape Town ◽

People Living With Hiv ◽

Gender Based Violence ◽

Fear Of Rejection ◽

Gender Based ◽

And Gender ◽

Living With Hiv ◽

Hiv Aids

This paper presents the findings of an exploratory study to investigate the challenges faced by people living with HIV/AIDS (PLWHA) in communities in Cape Town, South Africa. The primary goal of the study was to gather data to inform the adaptation of a group risk reduction intervention to the South African context. Qualitative methods were used to examine the experiences of PLWHA. Eight focus group discussions (FGDs) were conducted with 83 HIV-positive participants and 14 key informants (KIs) involved in work with PLWHA were interviewed. Findings revealed that AIDS-related stigma was still pervasive in local communities. This was associated with the difficulty of disclosure of their status for fear of rejection. Also notable was the role of risky behaviours such as lack of condom use and that PLWHA considered their HIV/AIDS status as secondary to daily life stressors like poverty, unemployment, and gender-based violence. These findings have implications for the adaptation or development of behavioural risk reduction interventions for PLWHA.

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Motivational Interviewing in Global Practice Settings

Motivational Interviewing in HIV Care ◽

10.1093/med/9780190619954.003.0014 ◽

2019 ◽

pp. 135-140

Author(s):

Sarah Dewing ◽

Cathy Mathews

Keyword(s):

South Africa ◽

Global Health ◽

Motivational Interviewing ◽

Cape Town ◽

Standard Of Care ◽

People Living With Hiv ◽

Information Giving ◽

The World ◽

Living With Hiv

Motivational interviewing (MI) in increasingly used to support people living with HIV around the world. When MI strategies represent a large departure from standard of care, learning and implementing MI can be challenging. Chapter 14 focused on experiences in Cape Town, South Africa, as counselors moved from more education/information-giving approaches to MI-informed approaches. In practice, the role of ongoing supervision and support is critically important. We emphasize the value of supervision in MI for the all MI-based interventions and particularly for these kinds of interventions in global health settings where they may be quite different from current norms.

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Treatment adherence in HIV stigmatized environments in South Africa: stigma avoidance and medication management

International Journal of STD & AIDS ◽

10.1177/0956462418813047 ◽

2018 ◽

Vol 30 (4) ◽

pp. 362-370 ◽

Cited By ~ 6

Author(s):

Seth C Kalichman ◽

Catherine Mathews ◽

Ellen Banas ◽

Moira O Kalichman

Keyword(s):

South Africa ◽

Medication Management ◽

Management Strategies ◽

People Living With Hiv ◽

Art Adherence ◽

Community Clinic ◽

Social Settings ◽

Younger Age ◽

Living With Hiv ◽

Stigma Experiences

Stigmatization of HIV infection undermines antiretroviral therapy (ART) adherence. The current study examined strategies that people living with HIV employ to manage their ART in stigmatized environments. We conducted an anonymous survey with 439 patients receiving ART at a community clinic in Cape Town, South Africa. Measures included demographic and health characteristics, ART adherence, stigma experiences, efforts to conceal ART to avoid stigma (stigma–medication management strategies), and beliefs that ART nonadherence itself is stigmatizing. One in four participants had forgone taking their ART in social settings to avoid stigmatization, a behavior associated with younger age, experiencing greater stigma, and poorer ART adherence. Regression models found stigma–medication management strategies significantly predicted ART nonadherence over and above age, gender, alcohol use, and HIV stigma experiences. We also found that a significant majority of participants believed that having unsuppressed HIV and ART nonadherence are irresponsible and should be reprimanded by clinicians. Results show that the behavioral effects of stigma directly impede ART adherence. The behaviors that patients may employ to avoid stigma are amenable to interventions to directly improve ART adherence while managing stigma concerns.

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