Okweraliikirira and Okwenyamira: Idioms of Psychological Distress Among People Living with HIV in Rakai, Uganda

July 2, 2024 by
Okweraliikirira and Okwenyamira: Idioms of Psychological Distress Among People Living with HIV in Rakai, Uganda
Aber Maurine
Nora S. West1; Rosette Nakubulwa2; Sarah M. Murray3; William Ddaaki2; Denis Mayambala2; Neema Nakyanjo2; Fred Nalugoda2; Heidi E. Hutton4; Pamela J. Surkan5; Caitlin E. Kennedy5

Affiliations:

1Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine
2Rakai Health Sciences Program
3Johns Hopkins Bloomberg School of Public Health, Department of Mental Health
4Johns Hopkins School of Medicine, Division of Psychiatry and Behavioral Sciences
5Johns Hopkins Bloomberg School of Public Health, Department of International Health

ORCID: Nora S. West

Abstract

Introduction: Health and illness experiences are positioned within social and cultural contexts. Understanding the mental health and psychological distress of people living with HIV in highly affected communities is critical to addressing their needs and to ensure programming and interventions are targeted and appropriate.

Methods: Grounded in the ethnomedical theoretical perspective, we conducted qualitative interviews to understand the experience and expression of psychological distress by people living with HIV in Rakai, Uganda. Participants included adults living with HIV (n=20), health workers (counselors, peer health workers, nurses, n=10), and key informants (n=12). Interviews were audio recorded, transcribed/translated, coded, and analyzed using thematic analysis.

Results: Two idioms of distress, okweraliikirira (worry/apprehension) and okwenyamira (deep/many thoughts/lots of thoughts) were described as impacting people living with HIV. Both idioms were said to be alleviated by social support or counseling, but if left unaddressed could lead to more severe mental health problems and poor ART adherence.

Conclusion: People living with HIV understand their psychological distress through culturally specic idioms; such distress can have deleterious impacts on well-being. Incorporating idioms of distress into screening and treatment for people living with HIV may improve identication of individuals in need and overall health services to address this need.

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