Enhancing self-management of HIV patients in low- and middle-income countries

Summary: This thesis examined the impacts of HIV, the importance of self-management from the perspectives of experts and providers, the lived experiences of patients, and the development and validation of a HIV self-management questionnaire for LMICs. HIV patients face multidimensional challenges including facility limitations, socioeconomic hardship, stigma, drug effects, and personal beliefs that shape their ability to manage. While some adopt positive coping strategies that improve outcomes, others respond negatively, leading to poor health. Evidence shows that misinformation, low self-efficacy, stigma, and non–patient-centered care further hinders self-management and quality of life. Strengthening patient empowerment is therefore essential. Guided by the IFSMT framework, this thesis developed and validated the HIV-SM LMIC questionnaire, a 20-item tool designed for the unique contextual needs of developing countries, assessing disease-related factors, beliefs, self-efficacy, coping, and self-management practices.