Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient–provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient’s trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient–provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.

BackgroundMeta-synthesis is used to generate and understand new insights from a qualitative perspective. Caregiving is associated with a range of physical and psychological symptoms. Caregivers bear the brunt of caregiving and this has become worse since the inception of de-institutionalisation, as more patients are discharged into the community under the care of their families.ObjectivesThe purpose of this study was to synthesise phenomenological qualitative studies and create a comprehensive chronicle of phenomena of family caregivers’ experiences of caring for relatives living with mental illness.MethodGoogle Scholar and different electronic databases, which included CINAHL, MEDLINE, EBSCO and PubMed, were searched using keywords for relevant studies published from 1994 to 2014. To obtain an in-depth view of caregivers’ lived experiences, a qualitative meta-synthesis was employed to review the findings of 10 studies.ResultsA total of 10 studies were included in the meta-synthesis. The family caregivers described their caregiving experiences under four themes: perceived responsibility of caregiving, experiences of emotional effect, experiences of support needs and experiences of changed perspective.ConclusionThe meta-synthesis revealed a lack of emotional coping among the family caregivers. This calls for robust family caregiver interventions to facilitate their mental health.

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Participants reported the following problems, which were hindering the success of the programmes: problems in the ABC message; permissive campus environment; lack of entertainment; and students' perceptions about HIV/AIDS and their own vulnerability. Participants came up with suggestions for improving the initiatives. The authors discuss implications of the study findings for the university's initiatives.

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