Table 4.
Summary of comparative explanatory models used by patients and health care providers
| Components of explanatory model | HIV - | HIV + | Health care providers | Comments |
|---|---|---|---|---|
| 1. Name given to symptoms | -Problems of the mind | -Problems of the mind -Depression and stress | -Depression, stress -problems of the mind | -Occasional differences exists in the name given to symptoms between the health professionals and the traditional healers |
| 2. Cause of symptoms | -Poverty, marital problems, -witchcraft | -Worries about course of disease, worry about future of family - HIV infection | -Social-economic problems, intercurrent illnesses - bad spirits | Witchcraft was cited as a cause among some the traditional healers. HIV infection was cited as a cause mostly among HIV+ not on ARV's |
| 3.Common symptoms of experience | Headache, sleeplessness, poor appetite, worthlessness, crying | Worthlessness, loss of hope. Somatic symptoms | - Somatic symptoms, - Social withdraw | Significant differences noted based on HIV status and (if on) duration on ARVs |
| 4. Greatest fear about their experiences | - Worries about future of children, - death, - disability from illness, - not ever getting married | - Children's future, - Death, - Stigma from relatives and friends - Course of illness | - Future of family, - Death, - Stigma from family and friends, - Short life expectancy | - Worries about future of family were the majority. Short life expectancy was next and the newly diagnosed worried more about stigma |
| 5. Severity of experience | - Severe but can have a remedy | Extremely severe, no way back, hope for the best | Severity depends on other circumstances such as poverty and family support | Severity depended a lot on level of adjustment to HIV status and severity of circumstances |
| 6. Choice of treatment | Clinic, pain killers, majority no treatment | Clinic, counselling, - Religion, - no treatment | - Counselling, - Exorcism, - Support groups, family involvement, - Antidepressants | Choice of treatment depended on what was thought to cause the problem |
| 7. Factors leading to choice of treatment | Severe symptoms (headache, tiredness, loss of sleep) | Severity of symptoms, - family support, - Disclosure | Severity of symptoms, cause of symptoms, previous failed consultations, Family involvement | Factors associated with treatment options were, perceived cause of illness, family support. |
| 8. Course of symptoms and alleviating factors | - Short course, - Finding cure, - Solution possible (finding a job, improved marital relationships), may have a chronic course | Chronic course, - ARVs, - Family support, social support groups, - Prayer - No hope | - Can be modified by counselling and medication - Support groups - Traditional medicine - | - Course of illness associated with perceived course of illness, ARVs - Alleviation of symptoms dependent on adjustment to illness, medication and counselling |