The role of culture in health care provision to people living with HIV (PLHIV) in uMkhanyakude District, north of KwaZulu-Natal: a nursing communication perspective.

Abstract

Background: There is a sparse literature documenting the health-seeking behaviours of people living with HIV (PLHIV) who seek modern and traditional medicine and the cultural competence of nurses who provide healthcare services to them. The cultural practices of PLHIV who live in rural South Africa have an implication on their clinical outcomes. This study was conducted in order to explore ways in which nurses may / may not practice cultural competence in negotiating traditional and modern treatments for PLHIV and their communication, their practice of cultural sensitivity in their provision of care to PLHIV and to identify and analyse the benefits of cultural competence in nursing associated with PLHIV. Methodology and Theory: The study adopted a qualitative methodology using a phenomenological design which facilitated the collection of data through open-ended in-depth interviews with six nurses in uMkhanyakude district. The data was analysed thematically and interpreted using the culture-centred approach jointly with the cultural competence model. Results: The results showed that although all the nurses interviewed have been trained in Nursing Initiated Management of Antiretroviral Therapies (NIMART), but there was a lack of cultural competence. Their cultural awareness level differed and were low due to diverse barriers to cultural competence including the cultural imposition, the negative attitudes towards traditional medicine, lack of trust as an impediment to dialogic communication and the lack of cultural knowledge. Conclusion: Nurses need to learn cultural competency concerning the PLHIV they work with, in order to be able to learn to appreciate diversity, avoid prejudice and provide culturally sensitive care to PLHIV. It is also important for nurses to recognise and respect PLHIV cultural values in order to render culturally competent care and to prevent cultural imposition. Nurses should be aware and cognisant of the Campinha-Bacote’s five cultural constructs.