Peripheral Neuropathy in HIV Disease in KwaZulu-Natal, South Africa: A U.S. and South African Collaboration

Wednesday, July 13, 2011: 4:05 PM

Patrice K. Nicholas, DHL, MPH, MS, RN, ANP, FAAN1
Inge B. Corless, RN, PhD, FAAN2
Busisiwe Ncama, PhD, RN3
Busisiwe Bhengu, PhD, RN3
Linda Evans, MS, RN, CNOR4
Kathleen Nokes, RN, PhD, FAAN5
Rosanna F. DeMarco, PhD, PHCNS-BC, ACRN, FAAN6
Angelleen Peters-Lewis, PhD, RN7
(1)Division of Global Health Equity and Center for Nursing Excellence, Brigham and Women's Hospital and MGH Institute of Health Professions, Bostonn, MA
(2)Massachusetts General Hospital Institute of Health Professions, Boston, MA
(3)School of Nursing, University of KwaZulu-Natal, Durban, South Africa
(4)Trauma Surgical Department, Brigham and Women's Hospital, Boston, MA
(5)Hunter-Bellevue School of Nursing, Hunter College, New York, NY
(6)School of Nursing, Boston College, Chestnut Hill, MA
(7)Center for Women and Newborns, Brigham and Women's Hospital, Boston, MA

Learning Objective 1: Examine the prevalence and symptoms associated with HIV-related neuropathy in KwaZulu-Natal, South Africa.

Learning Objective 2: Discuss research collaboration among a team from South Africa and the US.

Purpose: As part of an international nursing research team in South Africa and the US, this study examined the prevalence and self-management approaches for neuropathy-related symptoms in a sample of those living with HIV in South Africa (n=80).

Methods: A cross-sectional design was utilized to examine the prevalence of neuropathy and other HIV symptoms. Inclusion criteria for the study were that participants had to be (a) at least 18 years of age, (b) receiving AIDS-related care at their respective facility, (c) able to provide informed consent, and (d) able to complete the questionnaire independently or with the assistance of a research assistant. The instruments were forward and back-translated into isiZulu by two of the researchers. Ethical clearance was obtained at each of the clinic settings (2) and both educational institutions of the investigators. A sociodemographic questionnaire, the Revised Sign and Symptom Checklist for Persons with HIV Disease (SSC-HIVrev): Neuropathy Symptoms and Self-care; and the HIV/AIDS Targeted Quality of Life Instrument (HAT-QoL) were used as data collection instruments.

Results: Neuropathy was reported by 62% of the sample (n =49), however few participants reported specific self-care behaviors to effectively self-manage their neuropathy symptoms. Antiretroviral therapy was found to be associated with increased neuropathy symptoms.  

Conclusion: The study results suggest that peripheral neuropathy is a common, painful symptom and the presence of neuropathy is associated with impaired quality of life in those living with HIV in KwaZulu-Natal. Implications for nursing practice include the importance of assessment and evaluation of nursing interventions related to management strategies for neuropathy.