The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China

AIDS Care ◽  
2022 ◽  
pp. 1-8
Author(s):  
Yuanyuan Chi ◽  
Daoping Huang ◽  
Teri Lindgren ◽  
Lloyd Goldsamt ◽  
Jing Zhou ◽  
...  
2020 ◽  
Vol 14 (1) ◽  
pp. 84-89
Author(s):  
A. O. Olaseni

Introduction: The spate of non-disclosure among individuals diagnosed with Human-Immunodeficiency-Virus and Acquired-Immune-Deficiency-Syndrome (HIV/AIDS) has continually been a primary global concern, especially in developing countries. Meta-analysis findings in Nigeria reported poor disclosure rates of 12.5% - 39.5%, which were far below the average disclosure benchmark of 79.0% standard stipulated for developing nations by the World Health Organization. There is no consensus regarding the roles of CD4 counts in disclosure intention. In Nigeria, there is a paucity of literature providing detailed understanding of the predictors of disclosure intention by the duration of diagnosis knowledge and CD4 counts. Methods: This study, therefore, investigated the implication of duration of diagnosis knowledge and CD4 counts in the prediction of HIV disclosure intention among people seeking HIV treatment. Longitudinal survey research designs were adopted. 390 participants were purposively selected to respond to HIV Self-Disclosure Intention Index (α=0.92), while information on CD4 counts and Duration of Diagnosis Knowledge was obtained from the selected respondents’ case files periodically. Binomial logistic regression analysis was used to analyze data at 0.05. Respondents’ mean age was 39.5±10.5 years. Results: Findings revealed that the duration of diagnosis knowledge and CD4 counts interactively predicted the outcome of disclosure intention among treatment-seeking PLHIV. (χ2 = 12.78, df = 2, p < 0.001) and further showed that the likelihood of disclosing HIV positive status increases by 13% between Time 1 (OR = -0.49, p < 0.01; 95%CI = 01.14-12.74) and Time 2 (OR = -0.36, p < 0.05; 95%CI = 01.11-10.93). Increase in CD4 counts was also found to increase the likelihood of HIV self-disclosure by 15% between Time 1 (OR = - 0.84, p < 0.01; 95%CI = 01.09-03.06) and Time 2 (OR = - 0.99, p < 0.01; 95%CI = 00.29-03.06). Conclusion: It was concluded that the duration of diagnosis knowledge and CD4 counts have significant implications in determining the intention to disclose HIV positive status. The study limitations and recommendations were further discussed.


2019 ◽  
Vol 13 (3) ◽  
pp. 1-7
Author(s):  
Drusilla Makworo ◽  
Theresa Odero

Background The number of children living with HIV has increased worldwide, largely due to improvements in antiretroviral therapy. Most of these children are living in sub-Saharan Africa. The rate of disclosure to children of their HIV-positive status is low in low-resource countries compared to high-resource countries. Aim To explore health professionals' experiences of caring for HIV-positive children before and after their HIV-positive status was disclosed to them. The health professionals included nurses, counsellors, nutritionists, social workers, pharmacists and clinicians with at least 1 year of experience at the paediatric section of the comprehensive care centre. Methods Nine health professionals were interviewed. Findings Results revealed that there were more challenges before disclosure than after. The main challenge was communicating with the children. The children's main concerns before disclosures included the reason for treatment and its duration, and clinic follow-up. Conclusions Health professionals should be trained on the benefits of HIV disclosure to children, in order to allow for open and direct communication between healthcare providers, parents/carers and children.


Author(s):  
Seth Appiah ◽  
Inge Kroidl ◽  
Michael Hoelscher ◽  
Olena Ivanova ◽  
Jonathan Dapaah

Disclosure of HIV status to infected children, though challenged by caregiver dilemma, remains central in achieving the United Nations Programme on HIV and AIDS (UNAIDS) global goal of 90/90/90. This study explores children’s HIV disclosure experiences across Northern and Southern Ghana. A qualitative interpretative phenomenological design facilitated the recruitment of 30 HIV positive disclosed children and adolescents aged 9–19 years in 12 antiretroviral treatment (ART) centers in Northern and Southern Ghana between January 2017 and June 2018. Data was collected via in-depth interviews. We used phenomenological analysis applying concepts and categories identification, patterns and interconnections searching, mapping, theme building and constant comparative technique to draw conclusions. Disclosure of HIV status to children occurred with little or no preparation. Caregivers intentionally or out of dilemma often prolonged or postponed disclosure to when children aged older. Illness severity and disease progression principally defined the need for disclosure. Children preference for early status disclosure averaged at age 10 was demonstrated despite the initial disclosure experience of shock and disappointment. There was improved medication adherence despite the challenge of limited knowledge about HIV transmission, financial difficulty and food insecurity. Context and culturally adapted pre- and post- disclosure guideline laced with social protection package is needed to support HIV positive children.


First Monday ◽  
2020 ◽  
Author(s):  
Calvin Liang ◽  
Jevan Alexander Hutson ◽  
Os Keyes

Online dating and hookup platforms have fundamentally changed people’s day-to-day practices of sex and love — but exist in tension with older social and medicolegal norms. This is particularly the case for people with HIV, who are frequently stigmatized, surveilled, ostracized, and incarcerated because of their status. Efforts to make intimate platforms “work” for HIV frequently focus on user-to-user interactions and disclosure of one’s HIV status but elide both the structural forces at work in regulating sex and the involvement of the state in queer lives. In an effort to foreground these forces and this involvement, we analyze the approaches that intimate platforms have taken in designing for HIV disclosure through a content analysis of 50 current platforms. We argue that the implicit reinforcement of stereotypes about who HIV is or is not a concern for, along with the failure to consider state practices when designing for data disclosure, opens up serious risks for HIV-positive and otherwise marginalized people. While we have no panacea for the tension between disclosure and risk, we point to bottom-up, communal, and queer approaches to design as a way of potentially making that tension easier to safely navigate.


2015 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro

Background: HIV disclosure from parent to child is challenging. While disclosure is expected to be emotional for parents and children, the total disclosure experience has not been described. The purpose of this study was to understand the lived experiences of HIV-positive parents and their children in Kenya during the disclosure process. Methods: Phenomenological qualitative data were collected using in-depth semistructured interviews. Thirty four participants consisting of HIV-positive parents, children (infected and uninfected), and healthcare professionals (HCPs) were enrolled. Data analysis was performed using NVivo 8 and the Van Kaam method. Results: Pre-disclosure, parents were plagued with fear/worry of stigma, judgment, rejection, blame; and the reaction/consequences of disclosure on their children. Guilt and shame for bringing the illness into the home abounded. Children sensed, wondered, and worried about secrets within their homes. During disclosure, parents experienced catharsis, guilt, confusion, and panic when children reacted negatively. Children experienced shock, disbelief, anger, sadness, worry, depression, confusion, and catharsis from finally knowing what was wrong. Post-disclosure parents alternated between relief, guilt, and depression as their children’s behavior changed due to disclosure. Children experienced unhappiness, depression, hopelessness, self-hate, and withdrawal. Recovery time varied lasting from a few hours to four months later; some children ultimately felt relief and self-acceptance. However, stress exposure caused disclosure emotions to reappear. Conclusion: HIV disclosure process is accompanied by alternating negative and positive feelings for both parents and children. To ease the process, HCPs should provide support services such as disclosure practice sessions/training, counseling, peer support groups, and stress management.


2014 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro

Background. HIV disclosure is a challenging process for parents and healthcare professionals. The majority of HIV-infected persons live in Sub-Saharan Africa where HIV disclosure guidelines for a parent's and a child's illness are nonexistent. While there are two theoretical models of HIV disclosure, their utility in explaining disclosure in African cultures is largely unknown. Methods. This qualitative phenomenological study was conducted in Kenya to describe the lived experiences of HIV-positive parents and their children during the disclosure process. Thirty four participants consisting of 16 HIV-positive parents, 7 HIV-positive children, 5 HIV-negative children, and 6 healthcare professionals were engaged in in-depth, semistructured interviews. Interview data were analyzed using the modified Van Kaam method. Results. HIV disclosure is a complex process involving factors such as a parent's and child's state of health, ART consumption, stigma/discrimination, and sexuality concerns. Parents take years to prepare for and perform disclosure of theirs and/or their children's illnesses to their infected and noninfected children. They perform disclosure when they feel ready in stages, based on the birth order of their children, the perception of “the right time,” the child's understanding and maturity level, and whose illness(es) they intend to disclose at the time of disclosure. Conclusion. HIV disclosure is challenging and each disclosure session performed is planned and geared to the particular child receiving disclosure. Parents and healthcare professionals are challenged by disclosure and can benefit from creation of HIV disclosure guidelines accompanied by culturally sensitive manuals and training programs aimed at parents and healthcare professionals to ease the process of disclosure.


2014 ◽  
Author(s):  
Grace Gachanja ◽  
Gary J Burkholder ◽  
Aimee Ferraro

The aim of this research brief is to describe a study that examined how HIV-positive parents prepared themselves and their children for HIV disclosure in Kenya. This is the first study from Sub-Saharan Africa (SSA) that provides comprehensive data on how HIV-positive parents prepare themselves and their HIV-positive and negative children for disclosure of a parent’s and/or a child’s illness. Prior studies in SSA have provided limited details about the activities performed by parents to prepare for disclosure of a parent’s or a child’s illness. Key aspects of preparing for disclosure to children: 1. Most parents take years to prepare for disclosure, proceeding when they judge themselves ready to impart the news and their children receptive to receive the news. 2. Parents’ preparation activities for disclosure proceed through four major phases which include secrecy, exploration, readiness, and finally full disclosure of illness. 3. In the secrecy phase parents do not disclose; in the exploration phase they plan how they will disclose; in the readiness phase they seek activities that will help them to fully disclose; finally when ready they fully disclose to their children based on birth order. 4. Parents who have many children remain simultaneously within the different preparation phases as they move their children from a state where none are disclosed to, to a state when all of them have been fully disclosed to. The original research article is located at: http://scholarworks.waldenu.edu/jsbhs/vol8/iss1/1/


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