scholarly journals The Role of Early HIV Status Disclosure in Retention in HIV Care

2015 ◽  
Vol 29 (12) ◽  
pp. 646-650 ◽  
Author(s):  
Latesha Elopre ◽  
Edward W. Hook ◽  
Andrew O. Westfall ◽  
Anne Zinski ◽  
Michael J. Mugavero ◽  
...  
Keyword(s):  
Hiv Care ◽  
Hiv Status ◽  
Retention In Hiv Care ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Self-disclosure of HIV status, disclosure counseling, and retention in HIV care in Cameroon

AIDS Care ◽  
2016 ◽  
Vol 29 (7) ◽  
pp. 838-845 ◽  
Author(s):  
Tiffany L. Breger ◽  
Jamie E. Newman ◽  
Brigitte Mfangam Molu ◽  
Wilfred Akam ◽  
Ashu Balimba ◽  
...  
Keyword(s):  
Hiv Care ◽  
Hiv Status ◽  
Self Disclosure ◽  
Retention In Hiv Care ◽  
Hiv Status Disclosure ◽  
Status Disclosure

scholarly journals The Kanyakla study: Randomized controlled trial of a microclinic social network intervention for promoting engagement and retention in HIV care in rural western Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0255945
Author(s):  
Matthew D. Hickey ◽  
Gor B. Ouma ◽  
Brian Mattah ◽  
Ben Pederson ◽  
Nicholas R. DesLauriers ◽  
...  
Keyword(s):  
Social Support ◽  
Social Network ◽  
Pilot Study ◽  
Hiv Care ◽  
Hiv Status ◽  
Point Scale ◽  
Western Kenya ◽  
Retention In Hiv Care ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Background Existing social relationships are a potential source of “social capital” that can enhance support for sustained retention in HIV care. A previous pilot study of a social network-based ‘microclinic’ intervention, including group health education and facilitated HIV status disclosure, reduced disengagement from HIV care. We conducted a pragmatic randomized trial to evaluate microclinic effectiveness. Methods In nine rural health facilities in western Kenya, we randomized HIV-positive adults with a recent missed clinic visit to either participation in a microclinic or usual care (NCT02474992). We collected visit data at all clinics where participants accessed care and evaluated intervention effect on disengagement from care (≥90-day absence from care after a missed visit) and the proportion of time patients were adherent to clinic visits (‘time-in-care’). We also evaluated changes in social support, HIV status disclosure, and HIV-associated stigma. Results Of 350 eligible patients, 304 (87%) enrolled, with 154 randomized to intervention and 150 to control. Over one year of follow-up, disengagement from care was similar in intervention and control (18% vs 17%, hazard ratio 1.03, 95% CI 0.61–1.75), as was time-in-care (risk difference -2.8%, 95% CI -10.0% to +4.5%). The intervention improved social support for attending clinic appointments (+0.4 units on 5-point scale, 95% CI 0.08–0.63), HIV status disclosure to close social supports (+0.3 persons, 95% CI 0.2–0.5), and reduced stigma (-0.3 units on 5-point scale, 95% CI -0.40 to -0.17). Conclusions The data from our pragmatic randomized trial in rural western Kenya are compatible with the null hypothesis of no difference in HIV care engagement between those who participated in a microclinic intervention and those who did not, despite improvements in proposed intervention mechanisms of action. However, some benefit or harm cannot be ruled out because the confidence intervals were wide. Results differ from a prior quasi-experimental pilot study, highlighting important implementation considerations when evaluating complex social interventions for HIV care. Trial registration Clinical trial number: NCT02474992.

scholarly journals Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Winnie Muyindike ◽  
Robin Fatch ◽  
Rachel Steinfield ◽  
Lynn T. Matthews ◽  
Nicholas Musinguzi ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Contraceptive Use ◽  
Multivariable Analysis ◽  
Hiv Care ◽  
Hiv Status ◽  
Unintended Pregnancies ◽  
Hiv Status Disclosure ◽  
Few Data ◽  
Status Disclosure ◽  
Southwestern Uganda

Background. Preventing unintended pregnancies among women living with HIV is an important component of prevention of mother-to-child HIV transmission (PMTCT), yet few data exist on contraceptive use among women entering HIV care.Methods. This was a retrospective study of electronic medical records from the initial HIV clinic visits of 826 sexually active, nonpregnant, 18–49-year old women in southwestern Uganda in 2009. We examined whether contraceptive use was associated with HIV status disclosure to one’s spouse.Results. The proportion reporting use of contraception was 27.8%. The most common method used was injectable hormones (51.7%), followed by condoms (29.6%), and oral contraceptives (8.7%). In multivariable analysis, the odds of contraceptive use were significantly higher among women reporting secondary education, higher income, three or more children, and younger age. There were no significant independent associations between contraceptive use and HIV status disclosure to spouse.Discussion. Contraceptive use among HIV-positive females enrolling into HIV care in southwestern Uganda was low. Our results suggest that increased emphasis should be given to increase the contraception uptake for all women especially those with lower education and income. HIV clinics may be prime sites for contraception education and service delivery integration.

scholarly journals Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

2021 ◽  
Vol 9 ◽  
Author(s):  
Sokhna Boye ◽  
Seydou Bouaré ◽  
Odette Ky-Zerbo ◽  
Nicolas Rouveau ◽  
Arlette Simo Fotso ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Preliminary Results ◽  
Research Activities ◽  
Medical Consultations ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Context: The rate of HIV status disclosure to partners is low in Mali, a West African country with a national HIV prevalence of 1.2%. HIV self-testing (HIVST) could increase testing coverage among partners of people living with HIV (PLHIV). The AutoTest-VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) program was launched in West Africa with the objective of distributing nearly half a million HIV self-tests from 2019 to 2021 in Côte d'Ivoire, Mali, and Senegal. The ATLAS program integrates several research activities. This article presents the preliminary results of the qualitative study of the ATLAS program in Mali. This study aims to improve our understanding of the practices, limitations and issues related to the distribution of HIV self-tests to PLHIV so that they can offer the tests to their sexual partners.Methods: This qualitative study was conducted in 2019 in an HIV care clinic in Bamako. It consisted of (i) individual interviews with eight health professionals involved in the distribution of HIV self-tests; (ii) 591 observations of medical consultations, including social service consultations, with PLHIV; (iii) seven observations of peer educator-led PLHIV group discussions. The interviews with health professionals and the observations notes have been subject to content analysis.Results: HIVST was discussed in only 9% of the observed consultations (51/591). When HIVST was discussed, the discussion was almost always initiated by the health professional rather than PLHIV. HIVST was discussed infrequently because, in most of the consultations, it was not appropriate to propose partner HIVST (e.g., when PLHIV were widowed, did not have partners, or had delegated someone to renew their prescriptions). Some PLHIV had not disclosed their HIV status to their partners. Dispensing HIV self-tests was time-consuming, and medical consultations were very short. Three main barriers to HIVST distribution when HIV status had not been disclosed to partners were identified: (1) almost all health professionals avoided offering HIVST to PLHIV when they thought or knew that the PLHIV had not disclosed their HIV status to partners; (2) PLHIV were reluctant to offer HIVST to their partners if they had not disclosed their HIV-positive status to them; (3) there was limited use of strategies to support the disclosure of HIV status.Conclusion: It is essential to strengthen strategies to support the disclosure of HIV+ status. It is necessary to develop a specific approach for the provision of HIV self-tests for the partners of PLHIV by rethinking the involvement of stakeholders. This approach should provide them with training tailored to the issues related to the (non)disclosure of HIV status and gender inequalities, and improving counseling for PLHIV.

scholarly journals Determinants of benzodiazepine use in a representative population of HIV-infected individuals: the role of HIV status disclosure (ANRS-EN12-VESPA study)

AIDS Care ◽  
2011 ◽  
Vol 23 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Perrine Roux ◽  
Lionel Fugon ◽  
Laurent Michel ◽  
France Lert ◽  
Yolande Obadia ◽  
...  
Keyword(s):  
Hiv Status ◽  
Benzodiazepine Use ◽  
Hiv Status Disclosure ◽  
Status Disclosure

scholarly journals Stigma and discrimination: barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia.

2020 ◽  
Author(s):  
Fisaha Tesfay ◽  
Sara Javanparast ◽  
Lillian Mwanri ◽  
Anna Ziersch
Keyword(s):  
Family Members ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Services ◽  
Tigray Region ◽  
Stigma And Discrimination ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

Abstract Background: In Ethiopia, stigmatising attitudes towards people living with HIV have reduced over time due to improved HIV knowledge and the expansion of services. However, HIV stigma and discrimination remain a key challenge and have negative impacts on access to and utilisation of HIV services including nutritional programs. A small number of studies have examined the experience of stigma related to nutritional programs, but this is limited. This study explored HIV status disclosure and experience of stigma related to a nutritional program in HIV care settings in Ethiopia and impacts on nutritional program utilisation. Methods: As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff working in the nutritional program in three hospitals in the Tigray region of Ethiopia. Framework thematic analysis using NVivo was employed to analyse the data. Results: The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional program in terms of improving weight and overall health status, adults and caregivers of children living with HIV revealed experiences of stigma and discrimination that were amplified by enrolment to the nutritional program. This was due to: a) transporting, consuming and disposing of the nutritional support itself, which is associated with HIV in the broader community; b) required increased frequency of visits to HIV services for those enrolled in the nutritional program and associated. Conclusion: There was evidence of concerns about HIV-related stigma and discrimination among individuals enrolled in this program and their family members, which in turn negatively affected the utilisation of the nutritional program. Stigma and discrimination are a source of health inequity and undermine access to the nutritional program. Nutritional programs in HIV care should include strategies to take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of facilitating social inclusion to mitigate stigma and improve utilisation.

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