A needs assessment during 2000 guided the design of a buddy system in Botswana.
Implementation of this care and support system for and by 39 HIV+ve female buddyclient
pairs started in 2002. During April and November 2002, levels of disclosure, selfcare,
support and quality of life of buddy-client pairs and the controls (n = 38) were
compared. Orem's self-care theory, Maslow's hierarchy of needs and Cohen and Syme's
conceptualisation of social support formed the theoretical framework. By November
2002, clients' disclosure levels, self-care for TB, and antiretroviral therapy adherence had
improved. Higher income, higher education and older age predicted higher levels of selfcare
for antiretroviral therapy. The social support survey reported satisfaction with types
of support available in November 2002 (N = 112). Clients' scores for self-care for TB,
antiretroviral therapy and social support improved more than those of controls over the
study period. The personal resource questionnaire measured perceptions of support:
buddies' scores increased more than those of clients. Women on antiretroviral therapy
completed the adherence attitudes inventory in April and November 2002 and reported a
downward trend in adherence. Findings of the quality of life (SF 36) instrument showed
that during the six-month study period, physical and mental health component summary
scores improved but remained low (N = 112). During 2003 Botswana's community-based
buddy-support programme was adopted by four other countries in Southern Africa in an
attempt to enhance the quality of life of HIV+ve women in these countries.