Nursing Recommendations for the Management of HIV and Hypertension in a rural Primary Health Care Setting, Eastern Cape, South Africa

Abstract

South Africa has an increased number of people living with the human immunodeficiency virus (PLWH). In addition, older PLWH are prone to developing non-communicable diseases (NCDs) as co-morbid illnesses, in particular hypertension. South Africa is experiencing a dual burden of care, that being the co-morbidity of HIV and hypertension. The integration of HIV and non-communicable disease management is needed towards a synergised and comprehensive approach within primary health care (PHC) settings. This article presents nursing recommendations yielded by a descriptive phenomenological study on the management of HIV and hypertension in a rural PHC context. A qualitative research approach, using Husserl’s descriptive phenomenology, was employed, and data were gathered using semi-structured interviews. The interviews were conducted by the first author at Sakhisizwe sub-district clinics, Eastern Cape. Purposive sampling was used to select nine participants. Giorgi’s phenomenological steps underpinned data analysis. Six nursing recommendations were developed to support professional nurses in the management of the co-morbidity of HIV and hypertension: 1) disease-specific health education as opposed to generic health education; 2) utilisation of existing programmes on the integration and management of chronic illnesses; 3) creating social support platforms or spaces; 4) referral pathways; 5) surveillance and monitoring; and 6) management of disease-related stigma. Professional nurses working in PHC clinics have several guidelines to manage chronic illnesses. However, there are limited nursing recommendations on how to manage the co-morbidity of HIV and hypertension. This study focused on a smaller sample of nine participants, in one sub-district and in one district.