The millions of people living with HIV/AIDS are in urgent need of effective care and support interventions. Such interventions should take people's reported needs, coping strategies, and context into account. Usually, active problem-focused coping strategies have been encouraged because they are considered to be more beneficial than passive emotion-focused strategies. However, this may not be the case in the South African context. This study was based on in-depth interviews with Black, rural, South African women about their coping strategies. The overriding aim of coping was to solve the tasks of physical, psychological, and social survival. Strategies involving avoidance of, escaping from, or minimizing HIV/AIDS and its accompanying emotional distress were predominant. We argue that such strategies could be adaptive in a society with scarce resources and marked by gender inequalities. Our findings suggest that care and support interventions should be sensitive to culture and context, should be holistic and participatory, and should include income generation and child care services.
Abt. Associates. (2001). Impending catastrophe revisited. An update on the HIV/AIDS epidemic in South Africa . Report commissioned by Henry J. Kaizer family Foundation . Parklands, South Africa: loveLife.
2.
Ankrah, E.M. (1993). The impact of HIV/AIDS on the family and other significant relationships: The African clan revisited. AIDS Care, 5(1), 6-22.
3.
Bajos, N., & Marquet, J. (2000). Research on HIV sexual risk: Social relations-based approach in a cross-cultural perspective. Social Science and Medicine, 50, 1533-1546.
4.
Beattie, J. (1980). Review article: Representations of the self in traditional Africa: La notion de personne en Afrique Noire. Africa, 50(5), 313-320.
5.
Bentley, K. (2004). Women's human rights and the feminisation of poverty in South Africa. Review of African Political Economy, 100, 247-261.
6.
Bogart, L.M., Catz, S.L., Kelly, J.A., Gray-Bernhardt, M.L., Hartmann, B.R., Otto-Salaj, L.L., Hackl, K.L., & Bloom, F.R. (2000). Psychosocial issues in the era of new AIDS treatments from the perspective of persons living with HIV. Journal of Health Psychology, 5(4), 500-516.
7.
Bolton, P., & Wilk, C.M. (2004). How do Africans view the impact of HIV? A report from a Ugandan community. AIDS Care, 16(1), 123-128.
8.
Bond, V., Chase, E., & Aggleton, P. (2002). Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia. Evaluation and Program Planning, 25(4), 347-356.
9.
Budlender, D. (1998). Women and men in South Africa (Report). Pretoria: Central Statistics South Africa, Directorate of Analysis and Statistical Consulting.
10.
Bungener, C., Marchand-Gonod, N., & Jouvent, R. (2000). African and European HIV-positive women: Psychological and psychosocial differences. AIDS Care, 12(5), 541-548.
11.
Campbell, C.A. (1997). Migrancy, masculine identities and AIDS: The psychosocial context of HIV transmission on the South African gold mines. Social Science and Medicine, 45(2), 273-281.
12.
Campbell, C. (2000). Selling sex in the time of AIDS: The psycho—social context of condom use by sex workers in a Southern African mine. Social Science & Medicine, 50(4), 479-494.
13.
Carver, C.S., Scheier, M.F. & Weintraub, J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283.
14.
Chalmers, B. (1996). Western and African conceptualizations of health . Psychology and Health, 12, 1-10.
15.
Charmaz, K. (1990). “Discovering” chronic illness: Using grounded theory. Social Science and Medicine, 30(11), 1161-1172.
16.
Chikore, J. (2000). Sexuality and AIDS. In C. de Kat-Reynen (Ed.), HIV/AIDS. Grasping the reality of its gender dimension (pp. 36-42). Annual conference report. Brussels: Association of World Council of Churches Related Development Organizations in Europe [APRODEV] Gender Orientation on Development Group [GOOD].
17.
Collins, D.L., Baum, A., & Singer, J.E. (1983). Coping with chronic stress at Three Mile Island: Psychological and biochemical evidence. Health Psychology , 2, 149-166.
18.
Corin, E., & Murphy, H.B.M. (1979). Psychiatric perspectives in Africa: The Western viewpoint. Transcultural Psychiatric Research Review, 16, 147-178.
19.
Crossley, M.L. (2000). Rethinking health psychology. Open University Press: Buckingham.
20.
Dageid, W. (2002). “I'm just like anybody.” Balancing between normality and social death—South African women living with HIV/AIDS. Master's thesis, Department of Psychology, University of Oslo, Norway.
21.
Department of Health (2005). National HIV and syphilis antenatal sero-prevalence survey in South Africa 2004. Pretoria: National Department of Health.
22.
Farber, E.W., Mirsalimi, H., Williams, K.A., and McDaniel, J.S. (2003). Meaning of illness and psychological adjustment to HIV/AIDS. Psychosomatics, 44, 485—491.
23.
Fleishman, J.A., & Fogel, B. (1994). Coping and depressive symptoms among people with AIDS. Health Psychology, 13(2), 156-169.
24.
Gnanadason, A. (2000). Gender-based violence: Violence against women in the time of AIDS. In C. de Kat-Reynen (Ed.), HIV/AIDS. Grasping the reality of its gender dimension (pp. 43-49). Annual conference report. Brussels: Association of World Council of Churches Related Development Organizations in Europe [APRODEV] Gender Orientation on Development Group [GOOD].
25.
Green, G. (1993). Editorial review: Social support and HIV. AIDS Care, 5(1).
26.
Harrison, A., & Montgomery, E. (2001). Life histories, reproductive histories: Rural South African women's narratives of fertility, reproductive health and illness. Journal of Southern African Studies, 27(2), 311-328.
27.
Jackson, A.P., & Sears, S.J. (2001). Implications of an Africentric worldview in reducing stress for African American women. Journal of Counseling & Development, 71, 184-190
28.
Janoff-Bulmann, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York: The Free Press .
29.
Kiecolt-Glaser, J.K., McGuire, L., Robles, T.F., & Glaser, R. (2002). Psychoneuroimmunology: Psychological influences on immune function and health. Journal of Consulting & Clinical Psychology, 70(3), 537-547.
30.
Kitzinger, J. (1994). Focus groups: Method or madness? In M. Boulton (Ed.), Challenge and innovation: Methodological advances in social research in HIV/AIDS (pp. 159-175). Bristol, PA: Taylor and Francis.
31.
Lazarus, R.S. (1990). Stress, coping, and illness. In H. S. Friedman (Ed.), Personality and disease (pp. 97-120). New York: Wiley.
32.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
33.
Lewis, O. (1966). La vida—A Puerto Rican family in the culture of poverty. New York: Vintage Books .
34.
Lie, G.T. (1996). The disease that dares not speak its name. Studies on factors of importance for coping with HIV/AIDS in Northern Tanzania. Doctoral thesis, University of Bergen.
35.
Magubane, P. (1998). Vanishing cultures of South Africa. Changing customs in a changing world. Cape Town, South Africa: Struik Publishers (Pty) Ltd.
36.
Marais, H. (2000). To the edge. AIDS Review 2000. Pretoria, South Africa: University of Pretoria.
37.
Mashego, T.A.B. (2000). Perceptions of father—daughter incest in African families with special reference to the mothers' role. A cultural contextualisation for intervention. Doctoral thesis, Department of Psychology , University of the North, South Africa.
38.
Meursing, K. (1997). A world of silence. Living with HIV in Matabeleland, Zimbabwe. Amsterdam: Royal Tropical Institute. Doctoral thesis, University of Amsterdam .
39.
Miller, G.E., & Cohen, S. (2001). Psychological interventions and the immune system: A meta-analytic review and critique. Health Psychology, 20, 47-63.
40.
Moneyham, L., Hennessy, M., Sowell, R., Demi, A., Seals, B., & Mizuno, Y. (1998). The effectiveness of coping strategies used by HIV-seropositive women. Research in Nursing &Health, 21, 351-362.
41.
Moorey, S., & Greer, S. (1989). Psychological therapy for patients with cancer: A new approach. Heinemann Medical Books: Oxford.
42.
Muecke, M.A. (1994). On the evaluation of ethnographies. In J. M. Morse (Ed.), Critical Issues in Qualitative Research Methods (pp. 187-209). Thousand Oaks: Sage.
43.
Mulder, C.L., & Antoni, M.H. (1992). Psychosocial correlates of immune status and disease progression in HIV-1 infected homosexual men: Reviewing preliminary findings, and commentary. Psychology and Health, 6, 175-192.
44.
Myers, L.J. (1988). Understanding an Afrocentric world view: Introduction to an optimal psychology. Dubuque, IA: Kendall-Hunt.
45.
Namir, S., Wolcott, D.L., Fawzy, F.I., & Alumbaugh, M.J. (1990). Implications for different strategies of coping with AIDS. In L. Temoshok & A. Baum (Eds.), Psychosocial perspectives on AIDS—Etiology, prevention and treatment (pp. 173-190). Hillsdale, New Jersey: Lawrence Erlbaum Associates .
46.
O'Leary, A. (1990). Stress, emotion, and human immune function. Psychological Bulletin,108(3), 363-382.
47.
Osei-Hwedie, K. (1994). AIDS, the individual, family and community: Psychosocial issues. Journal of Social Development in Africa, 9(2), 31-43.
48.
Pakenham, K.I. (2001). Application of a stress and coping model to caregiving in multiple sclerosis. Psychology, Health and Medicine, 6(1), 13-27.
49.
Pakenham, K.I., & Rinaldis, M. (2001). The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: The direct and buffering effects. Journal of BehavioralMedicine, 24(3), 259-279.
Preston-Whyte, E., & Zondi, M. (1989). To control their own reproduction: The agenda of Black teenage mothers in Durban. Agenda, 47-68.
52.
Remien, R.H., Rabkin, J.G., & Williams, J.B.W. (1992). Coping strategies and health beliefs of AIDS longterm survivors. Psychology and Health , 6, 335-345.
53.
Roper, J.M. (2000). Ethnography in nursing research. Thousand Oaks: Sage.
54.
Siegel, K., & Schrimshaw, E.W. (2000). Coping with negative emotions: The cognitive strategies of HIV-infected gay/bisexual men. Journal of Health Psychology, 5(4), 517-530.
55.
Siegel, K., Schrimshaw, E.W., & Pretter, S. (2005). Stress-related growth among women living with HIV/AIDS: Examination of an explanatory model. Journal of BehavioralMedicine, 28(5), 403-411.
56.
Simoni, J.M., Martone, M.G., & Kerwin, J. (2002). Spirituality and psychological adaptation among women with HIV/AIDS: Implications for counseling. Journal of Counseling Psychology, 49(2), 139-147.
57.
Statistics South Africa. (2004). Census 2001: Primary tables South Africa. Census '96 and 2001 compared. (Report 03-02-04). Pretoria: Author.
58.
Strauss, A. (1987). Qualitative analysis for social scientists. Cambridge, MA: Cambridge University Press.
59.
Strebel, A. (1995). Whose epidemic is it? Reviewing the literature on women and AIDS. South African Journal of Psychology, 25(1), 12-19.
60.
Syamalevwe, B. (2000). Women living with the virus: An African woman's experience. In C. de Kat-Reynen (Ed.), HIV/AIDS. Grasping the reality of its gender dimension (pp. 56-58). Annual conference report. Brussels: Association of World Council of Churches related Development Organizations in Europe [APRODEV] Gender Orientation on Development Group [GOOD].
61.
Taylor, S.E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. American Psychologist, 38, 1161-1173.
62.
Taylor, S.E., Helgeson, V.S., Reed, G.M., & Skokan, L.A. (1991). Self-generated feelings of control and adjustment to physical illness. Journal of Social Issues, 47, 91-109.
63.
Triandis, H.C., Bontempo, R., Villareal, M.J., Asai, M., & Lucca, N. (1988). Individualism and collectivism: Cross-cultural perspectives on self in group relationships. Journal of Personality and Social Psychology, 54, 323-338.
64.
Unaids. (2005). 2005 report on the global AIDS epidemic. Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO).
65.
Van Woudenberg, J. (1998). Women coping with HIV/AIDS. We take it as it is . Amsterdam: Royal Tropical Institute .
