Aspects of the care of people with HIV/AIDS in South Africa.

The study was aimed at exploring the realization of counseling, palliative care, and terminal care in the care of people with HIV/AIDS in seven settings in South Africa. A descriptive study was performed in seven sites where a model of home-based care was implemented that links hospitals, clinics, and home-based care in a continuum. Data was collected from people with HIV/AIDS (PWA), their caretakers, health care workers, and community members using semistructured interviews, observation, taping of onsite meetings, and completion of questionnaires. Descriptive and nonparametric statistics were used to analyze the quantitative data, and the template approach was used to analyze the qualitative data. There is a need to extend counseling before and after diagnostic testing to counseling about living with HIV/AIDS. There is also a need to equip counselors to deal with children. Fifty-seven percent of patients died at home or in hospice. There is a significant relationship between a "good" death and dying at home. Palliative care in the formal health services was generally poor due mainly to lack of specific training in this field and the stigma associated with this diagnosis. Health care providers can change the experience of illness and death for PWA through adequate counseling, palliative care, and terminal care that meet professional standards.