How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review

Area of Science:

• Public Health
• Health Services Research
• Chronic Disease Management

Background:

• Self-management (SM) is crucial for managing chronic conditions like HIV.
• Understanding how SM is conceptualized in low- and middle-income countries (LMIC) is vital for effective HIV care.
• Existing research often originates from high-income settings, potentially limiting applicability in LMIC.

Purpose of the Study:

• To conduct a scoping review of how the term 'self-management' is used in peer-reviewed literature concerning HIV populations in LMIC.
• To identify and analyze the varied conceptualizations and applications of self-management within this specific context.
• To inform future research and practice regarding HIV self-management in LMIC.

Main Methods:

• A systematic scoping review methodology was employed, adhering to PRISMA-ScR guidelines.
• Searches were conducted across multiple databases (OVID Medline, Embase, CAB Abstracts, EBSCO CINAHL, Scopus, Cochrane Library) up to September 2021.
• Two independent reviewers screened titles, abstracts, and full texts, with data extraction performed using a standardized tool.

Main Results:

• A total of 103 articles were included in the review.
• A 74% increase in articles using 'self-management' in relation to HIV in LMIC was observed since 2015.
• Fifty-three articles defined SM as a complex, collaborative process between patients and providers, while 50 articles viewed it as an individual's strategy for managing care.

Conclusions:

• The term 'self-management' is applied with diverse meanings in HIV literature from LMIC.
• These varied conceptualizations have significant implications for the design and implementation of HIV management strategies in these settings.
• Further research is needed to assess the suitability of self-management frameworks developed in high-income countries for LMIC contexts.