Support measures for the next of kin who has experienced the unexpected loss of a family member to HIV/AIDS

**Background:** The unexpected death of a close family member is a profoundly traumatic event, and grief reactions vary widely. Youth (defined as persons aged 18–25) are particularly vulnerable, yet little was known about the support measures available to them after losing a family member to HIV/AIDS in the South African context. The study aimed to understand the lived experiences of youth regarding self-management and support following such a loss.

**Methods:** A descriptive phenomenological design was used. The accessible population was youth visiting a Comprehensive Primary Healthcare clinic in Cape Town (Khayelitsha, Western Cape) in February 2020. Purposive sampling was employed with inclusion criteria: youth who had lost a close family member to HIV/AIDS and lived in the same household within the previous six months. Eleven semi-structured individual interviews were conducted using an interview guide, lasting approximately 45 minutes each, until data saturation was reached. Interviews were audio-recorded, and field notes were taken. Data were transcribed and, where necessary, translated from isiXhosa to English with back-translation by an independent editor. Open coding was performed, and an independent coder held a consensus meeting with the researcher on themes and categories. Trustworthiness was ensured through triangulation (interviews and field notes), an independent coder, reflexivity, and thick description. Ethical approval was obtained from Cape Peninsula University of Technology (CPUT/HW-REC 2019/H2) and the Western Cape Department of Health (WC_201911_032).

**Key Results:** Four overarching themes emerged from the data; this article reports specifically on the theme "Support measures for the next of kin." Six categories were identified: (1) Communicating and speaking out as part of emotional support — participants reported that talking about the death helped reduce grief difficulties, but stigmatisation of death in some cultures hindered open communication. One participant noted that self-confidence in speaking out was therapeutic, helping to decrease the burden of keeping things to oneself. (2) Financial assistance — participants expressed need for financial support through jobs, social grants, or food assistance. One participant mentioned receiving support from church members. The foster care grant was cited as potentially helpful for pursuing university studies, though some reported that grants were misused by caregivers. (3) Social worker availability — participants valued the role of social workers in providing individual support, counselling, and facilitating access to grants. One participant planned to visit a social worker for help with stress and accepting her sister's death. (4) The realisation of stumbling blocks and new possibilities — participants showed insight into behaviours and thinking that could enable moving forward. One participant emphasised the importance of education for getting a job. Another noted that living with HIV/AIDS initially seemed to take away her freedom, but over time she developed the ability to focus on helping her family. (5) Own role in providing hope for the future — participants described becoming stronger through caring for others. One participant spoke of her dreams of academic achievement vanishing because she had to become head of the family. Another showed awareness that others looked to her to stay strong. (6) Counselling — participants expressed a clear need for professional grief counselling. One participant felt counselling sessions would help her cope and relieve stress. Another spoke of informal peer counselling. Group counselling sessions were reported as helpful for stress reduction. Participants also expressed a need for guidance with both practical life aspects (e.g., applying for university) and emotional support.

**Clinical Implications:** The study reveals a critical gap in support services for youth bereaved by HIV/AIDS in this South African community. Youths lacked access to therapeutic sessions, counselling, and social worker support, leaving them unable to manage their grief effectively. The findings underscore the need for healthcare facilities to provide accessible counselling services, social worker availability, and support groups. Recommendations include establishing youth support groups, integrating grief counselling into primary healthcare, training nurses in grief support, and involving community and church groups. All 11 participants were female, which limits transferability; the study notes that males were absent at the clinic and recommends similar research with male participants.