Psychosocial and physical factors that influence instrumental activities of daily living of people living with human immune-deficiency virus in Blantyre, Malawi

Abstract

Background: More than one million people are living with HIV (PLWH) in Malawi. Blantyre has the highest number of PLWH compared to other districts. PLWH face psychosocial and physical challenges including discrimination, stigma depression anxiety, dizziness, fatigue, leg pain, and many more. These challenges affect how they perform and participate in instrumental activities of daily living (IADLs) which impacts quality of life. There is limited information in the literature that shows how experienced challenges influence IADLs. Therefore this study aimed at exploring how psychosocial and physical factors influence IADLs of PLWH in Blantyre, Malawi. Method: This was a qualitative study that used a pre-interview questionnaire and semi-structured interviews. A purposive sample of fourteen (seven men and women) participants who consented were recruited into the study from the Light-house ART clinic at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Face-to-face interviews were conducted in participant’s home language (Chichewa) and data were analyzed manually using thematic content analysis. Results: From the analysis, the following psychosocial factors emerged: discrimination, anxiety, worries, stigma, and acceptance of HIV status, memory loss, experiences in the community, disclosure, and violation of the human right to information which means not disclosing that one is HIV positive until their spouses discover on their own. The physical challenges that emerged were physical impairments such as dizziness, leg pain, fatigue, yellow eyes, nausea and vomiting, opportunistic infections such as tuberculosis and pneumonia, and food insecurity problems. These factors influenced work, household chores, mobility, walking, sleep, business, farming, child care, and social interaction. Conclusion: PLWHface psychosocial and physical challenges that influence their work, mobility, sleep, household chores, farming, business, child care, and social interaction. There is a need for therapeutic interventions that target these physical and psychosocial challenges to minimize participation restrictions associated withthese factors