Research That Matters (January 17 - 20, 2008)

The epicenter of the global HIV/AID crisis is sub-Saharan Africa (UNAIDS/WHO 2006). This region accounts for approximately 10% of the world's population, but almost two-thirds (63%) of those living with HIV/AIDS, and 72% of AIDS deaths globally. Among those living with HIV in sub-Saharan Africa, 59% are women. Indeed, in every region of the world, as well as globally, more women are living with HIV now than ever before. Despite the fact that the typical person living with HIV/AIDS globally is a sub-Saharan Africa woman, little research exists on the coping strategies used by these women. Most HIV/AIDS research has focused on populations in developed countries, and within this context men in particular, rather than women in the two-thirds world. The present study addresses this oversight by asking the following research question: how do women living in the epicenter of the HIV/AIDS crisis cope with the extremely trying life-circumstances that accompany living with HIV/AIDS in the two-thirds world?

Methods:

To answer this question, a mixed-method approach was used with a sample of mothers (N = 162) attending an AIDS clinic in Entebbe, Uganda. Mothers attending the clinic on “open clinic days” over a one-month period were invited to participate in the study. A small incentive was provided to encourage participation. In addition to demographic items and questions related to HIV/AIDS, the questionnaire included two open-ended questions to assess 1) general coping strategies, 2) spiritual coping strategies, and a third analog question to assess 3) the importance ascribed to the spiritual coping strategies. Data analysis was conducted using a constant comparative methodology in which emerging themes were continually compared to similar phenomena across interviews. Once the data were organized into relatively discrete categories, variables were constructed incorporating this information. Associations were then explored between these variables and the demographic variables.

Results:

Somewhat surprisingly given their circumstances, only 2% of the women reported that they were unable to cope. Ten coping strategies emerged from the analysis of the first question, of which the three most prominent can be summarized under the rubrics of 1) indigenous service providers, 2) spirituality, and 3) social support. In answer to the second question, six strategies emerged, of which the most prominent were 1) the support of other believers, 2) prayer, and 3) trusting in God. Approximately 85% of the women reported that spirituality played some role in their ability to cope and a number of associations emerged between various coping strategies and the demographic variables.

Conclusions and Implications:

Despite facing a bleak future, childcare responsibilities, and limited resources, the vast majority of Ugandan women in this study reported an array of strategies that enabled to cope. A key implication that flows from these findings is the importance of indigenous NGOs. Given their perceived importance in the lives of women, policy makers should prioritize funding such organizations. Significant implications also exist for practitioners. Developing an understanding of the various strategies typically employed by women can assist providers provide more efficacious and culturally relevant services.