Experiences of grandmothers caring for female adolescents living with HIV in rural Manzini, Eswatini: a caregiver stress model perspective

Abstract

The HIV pandemic has immense effects on the Eswatini population. The burden of caregiving rests on women, typically grandmothers who are  elderly and dealing with chronic diseases themselves. The purpose of this study was to explore and describe the experiences of grandmothers in Eswatini caring for female adolescents living with HIV. The study draws on phenomenological fieldwork of six case studies of grandmother–granddaughter pairs who were purposively sampled. Data were collected through in-depth individual interviews that commenced with broad
questions: “How is it for you to care for a female adolescent living with HIV?” for the grandmothers, and “How is it for you to live with HIV?” for female adolescents. Data were transcribed verbatim and analysed thematically following the elements of the caregiver stress theory. Drawing on the caregiver stress model, grandmothers and female adolescents experienced input stimuli of financial difficulties related to daily provisions for food and transport fare. Control processes experienced by grandmothers and female adolescents related to feelings of loss, grief, fear, hopelessness and isolation along with suicidal ideation for female adolescents. Regarding output stimuli, grandmothers and female adolescents  developed psychological unrest related to difficulty accepting the HIV diagnosis and concerns about the future. Grandmothers experienced ill health due to the demands of the caregiving role. It is recommended that family, financial and psychological support be made available for grandmothers to lighten the duty of caregiving.

Keywords: burden of care, isolation, psychological effects, psychosocial support, unresolved grief