Quality of Life and the Concept of “Living Well” With HIV/AIDS in Sub-Saharan Africa

Authors

  • Nthabiseng A. Phaladze,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Sarie Human,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Sibusiso B. Dlamini,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Elsie B. Hulela,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Innocent Mahlubi Hadebe,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Nonhlanhla A. Sukati,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Lucy Nthabiseng Makoae,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Naomi Mmapelo Seboni,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • Mary Moleko,

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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  • William L. Holzemer

    1. Nthabiseng A. Phaladze, RN, PhD, Rho and Tau Lambda-at-Large, Lecturer, University of Botswana, Department of Nursing Education, Gaborone, Botswana; Sarie Human, RN, PhD, Tau Lambda-at-Large, Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria; Sibusiso B. Dlamini, RN, MS, National Coordinator, Care and Support, National Emergency Response Committee on HIV/AIDS, Mbabane, Swaziland; Elsie B. Hulela, RN, MS, Tau Lambda-at-Large, Antiretroviral Program Coordinator, Ministry of Health, Gaborone, Botswana; Innocent Mahlubi Hadebe, RN, MS, National Professional Programme Personnel, United Nations Population Fund, Mbabane, Swaziland; Nonhlanhla A. Sukati, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane; Lucy Nthabiseng Makoae, RN, PhD, Tau Lambda-at-Large, Lecturer, National University of Lesotho, Maseru; Naomi Mmapelo Seboni, RN, PhD, Alpha Eta and Tau Lambda-at-Large, Senior Lecturer, Department of Nursing, University of Botswana, Gaborone; Mary Moleko, RN, MA, Retired Nurse, National Board Member and Treasurer, Democratic Nursing Organization of South Africa, Pietermaritzburg; William L. Holzemer, RN, PhD, FAAN, Alpha Eta, Professor and Associate Dean for International Academic Programs, School of Nursing, University of California, San Francisco, USA. Secure the Future, a program of the Bristol-Myers Squibb Co. and the Bristol-Myers Squibb Foundation, supported this research. Correspondence to Dr. Holzemer, School of Nursing, University of California, San Francisco, 2 Koret Way, N531C, San Francisco, CA 94143–0608, USA; E-mail: bill.holzemer@nursing.ucsf.edu or to Dr. Phaladze, University of Botswana, Department of Nursing Education, Gaborone, Botswana; E-mail: phaladze@mopipi.ub.bw or nphaladze@hotmail.com
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Abstract

Purpose: To increase understanding of the meaning of quality of life for people living with HIV/AIDS in four countries in sub-Saharan Africa: Botswana, Lesotho, South Africa, and Swaziland.

Methods: Using a cross-sectional design and convenience sample, we administered a survey and collected data on demographic characteristics, measures of severity of illness, and perceptions of quality of life. The purposefully selected sample (N=743) consisted of community-based people living with HIV/AIDS in 2002. Based on the Wilson and Cleary framework for organizing variables related to quality of life, a hierarchical multiple regression was conducted with quality of life as the dependent variable.

Results: The sample of 743 persons was 61.2% female with a mean age of 34 years. Approximately 62% of the sample reported having received an AIDS diagnosis. Ten predictor variables explained 53.2% of the variance in life satisfaction. Those participants with higher life satisfaction scores were less educated, had worries about disclosure and finances, did not have an AIDS diagnosis or other comorbid conditions, had lower symptom intensity, had greater functioning, and had fewer health worries. None of these participants was taking antiretroviral medications at the time of this study.

Conclusions: Several dimensions of the Wilson and Cleary model of quality of life were significantly related to life satisfaction for people living with HIV/AIDS in sub-Saharan Africa. Quality of life for this sample was primarily defined as overall functional ability and control over symptom intensity. These findings are similar to studies in developed countries that have shown the significant relationships among functional abilities, symptom control, and perceived quality of life. As antiretroviral medications become more available in these areas, community members and care providers can help clients realize the possibility of living well with HIV/AIDS, and can work with clients to improve functional ability and control symptom intensity to make living well a reality.

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