4.6 Article

Perceptions of multiple chronic conditions and coping strategies among migrants from Sub-Saharan Africa living in France with diabetes mellitus and HIV: An interview-based qualitative study

Journal

PLOS ONE
Volume 18, Issue 6, Pages -

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PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0284688

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This study aimed to analyze the perception of polypathology among migrants from Sub-Saharan Africa living with HIV/AIDS and type 2 diabetes in France, and identify barriers and facilitators to their self-management. A total of 12 semi-structured interviews were conducted and analyzed using thematic analysis. The study highlighted the challenges and complexity related to the socioeconomic and cultural specificities in self-managing diabetes and HIV in this population. Self-management could be more successful if individual coping resources are identified and patients and carers move in the same direction.
Although diabetes is common among people living with HIV/AIDS (PLWHA), few data exists on how migrants from Sub-Saharan Africa (SSA) experience living with these two coexisting conditions in France. The objective of this study was to analyze perception of polypathology among PLWHA from SSA with type 2 diabetes and identify barriers and facilitators to their self-management. A qualitative study was conducted using semi-structured interviews from November 2019 to April 2020 with participants selected from a cohort of PLWHA and diabetes at Avicenne University Hospital. A total of 12 semi-structured interviews were conducted and analyzed using thematic analysis with inductive approach. Stigma remained a major issue in self-managing HIV, and some participants did not consider themselves as having a polypathology, as HIV has always been considered as a distinct condition. In general, emotion-based resources (e.g spirituality, trust in the medical discourse) and social support were mobilized more than problem-solving resources (e.g perception of medication as life-saving). Participants used the same main resource in self-management of HIV and diabetes, and resources used differed from participant to participant. This study highlighted challenges in self-management of diabetes and HIV in this population and complexity related to the socioeconomic and cultural specificities. Self-management could be more successful if patients and carers move in the same direction, having identified the individual coping resources to reach objectives.

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