Experiences of patients living both with Human Immunodeficiency Virus and diabetes co-morbidities in Polokwane Municipality, South Africa

Abstract

Background: HIV and AIDS is the leading cause of death among adults in subSaharan Africa, and the burden of non- communicable diseases such as diabetes mellitus is high and growing as well. This has resulted in the increase of dual diagnosis of HIV and Diabetes Mellitus in recent years increasing disease burden and self-care challenges being experienced by these patients. This study explored patient challenges arising from this dual diagnosis, and investigated how well the Limpopo healthcare system is servicing these lived experiences, and disease burden challenges these patients have to bear. Methods: A qualitative study approach was used and a phenomenology study design employed in this study. Patients‟ lived experiences and their capability to cope with the co-morbidity of HIV and Diabetes Mellitus was investigated. Sixty four (64) HIV patients with Diabetes Mellitus were identified representing 48% of HIV patients in the HIV/AIDS program at the sites of the study (Mankweng hospital POP clinic, Nobody and Dikgale Clinics) in the Polokwane municipality area of the Limpopo province in South Africa. Fifteen (15) of these patients made the sample and were interviewed. In addition, the five (5) of the seventeen (17) health care providers participated in the interviews. Criterion purposive sampling was used whereby the subjects had to have HIV and AIDS and diabetes in order to be part of the study. The semi-structured interview was conducted. An interview schedule was created to ensure that the key research questions related to workload and capacity are adequately covered during the interviews. Results: The evidence collected suggested that HIV and Diabetes comorbidity patients had increased workload and capacity challenges for self-care. Among the challenges was despondency. Patients found it difficult to adjust to symptoms and demands of the dual diagnosis. Counseling and education was noted as easing anxiety and lowered despondency. Poor services at the clinics worsened their experience and disease burden. Shortage of staff, poor housing of clinics, poor facilities and equipment, lack of training and occasional shortage of drugs were the reasons put forward by the health

2 care professional for the poor services. Separate clinics for HIV and Diabetes Mellitus increased the patients time away from a productive life, increased expenses, and somewhat complicated their lives. Good compliance to treatment was observed. Most patients coped well with medication and had no side effects, the few that had side effects continued to take their medication incorporating additional instructions from the health workers who managed the side effects. Family and buddy support improved the capability to cope with the disease burden and their general attitude to life. Conclusion and recommendations: Primary health care must be strengthened to meet the challenges disease convergence is bringing through continued education of staff and improvement of facilities and equipment, and streamlining service delivery processes. Note of significance is that despite the health care professionals being poorly prepared and under staffed, the clinic facility being poorly housed and poorly equipped, the healthcare professionals are managing to meet their service mandate through commitment and hard work.