Self-management of life with HIV
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Several important assumptions underlie the PSMP:

  • People with long-term (chronic) conditions, such as HIV/AIDS have similar concerns and problems.
  • People with HIV/AIDS must deal not only with their disease but also with the impact it has on their lives and emotions.
  • Peers with HIV/AIDS, when given training and a detailed leaders manual, can teach the PSMP as effectively as health professionals.
  • The process or way the PSMP is taught is as important, if not more important, than the subject matter that is taught.

PSMP Leaders Manual, Stanford University 2002.

These principles are exactly the same as those that underlie the CDSMC.

The PSMP consists of seven sessions each of which is 2 ½ hours in duration. They are generally completed over seven successive weeks. Groups of 8 –16 participants work together with two leader/facilitators in a highly participative process. Throughout the emphasis is on the group identifying problems and finding solutions for themselves.

At least one of the two leaders is a person living with HIV. The other leader may be a health professional or a person living with another long-term condition but the course is specifically designed to be delivered by lay volunteers with real experience of living with conditions. The “role-modelling” aspect of having a leader living with the condition is fundamental to the success of the approach. Many people involved with self-management believe that the best results can be achieved where both leaders live with a condition themselves

All course leaders will have attended a standard training programme and will have passed a process of accreditation. They are monitored regularly by trained assessors in order to ensure that quality standards are maintained.

PSMP Content

During the programme the following subjects are covered:

Subject

Weeks when covered

Overview of self-management and chronic conditions

1

Medication issues

1,2,3

Goal setting

1,2,3,4,5,6,7

Problem solving

2,3,4,5,6,7

Dealing with difficult emotions

2

Cognitive symptom management

2,4,5,6

Working with your health care team

3,4

Evaluating common symptoms

3

Depression management

4

Changing negative thinking

4

Understanding laboratory tests

4

Making treatment decisions

4

Advance directives/ Living Wills

5

Sex, intimacy and disclosure

5

Communication skills

5

Fatigue management

6

Healthy eating

6

Exercise

7

Building support systems and finding resources

7

Future plans

7

These activities can conveniently be divided into two types:

  • learning skills, and
  • using skills/information to deal with commonly experienced problems.

For example participants learn problem-solving skills then apply them to commonly experienced problems with medication such as poor adherence. They learn simple relaxation and distraction techniques and to use them to ameliorate common problems such as fatigue, anxiety or the side effects of medications.