scholarly journals Sociocultural Factors Influencing HIV Disclosure Among Men in South Africa

2014 ◽  
Vol 9 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Juliet Iwelunmor ◽  
Yewande Sofolahan-Oladeinde ◽  
Collins O. Airhihenbuwa
Keyword(s):  
South Africa ◽  
Hiv Transmission ◽  
Hiv Disclosure ◽  
Sociocultural Factors ◽  
People Living With Hiv ◽  
Heterosexual Intercourse ◽  
Community Factors ◽  
Factors Influencing ◽  
African Context ◽  
Living With Hiv

In South Africa, more than 2 million people living with HIV are men aged 15 years and older, and heterosexual intercourse remains the predominant mode of HIV transmission. Knowledge of the sociocultural factors that influence men’s decisions about whether, when, or how to disclose seropositive status remains incompletely understood. Using the PEN-3 cultural model as a guide, this study explored the sociocultural factors influencing HIV disclosure among men in South Africa. Four focus group discussions with 27 participants were used to determine the perceptions, enabling and nurturing factors that influence how men chose to reveal or conceal knowledge of their seropositive status. The results revealed that notions of male identity in the South African context, family, and community factors contribute to disclosure and nondisclosure of seropositive status among men living with HIV/AIDS. Future interventions should work to address these factors, as they are necessary with supporting disclosure among men living with HIV.

A Counselling Intervention for Psychological Distress Among People Living with HIV and AIDS in the Eastern Cape.

2018 ◽  
Vol 47 (1) ◽  
Author(s):  
Nomvula Twaise ◽  
Thokozile Mayekiso ◽  
Diane Elkonin ◽  
Calvin Gwandure
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Workers ◽  
Hiv And Aids ◽  
People Living With Hiv ◽  
Eastern Cape ◽  
Care Workers ◽  
African Context ◽  
Living With Hiv ◽  
Counselling Intervention

The aim of this study was to develop and evaluate the effectiveness of an integrative counselling intervention for people living with HIV and AIDS who are prone to   distress in the Eastern Cape. The counselling intervention was developed using a multidisciplinary approach, which included psychological and traditional approaches to counselling. Health care workers and people living with HIV and AIDS were recruited to participate in the development of the intervention. Thirteen health care workers and 18 people living with HIV (PLHIV) participated in the study. The health care workers evaluated the feasibility of the counselling intervention. The findings of the study showed that the counselling intervention content was designed in a manner that appealed to health care workers when providing counselling to PLHIV. The health care workers found the counselling intervention useful but challenging in alleviating distress among clients, as it incorporated counselling dimensions not relevant to the South African context. The findings of the study indicated that there is a need for alternative counselling interventions in South Africa to complement western models of interventions in alleviating distress among PLHIV in South Africa.

scholarly journals Modelling of HIV prevention and treatment progress in five South African metropolitan districts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cari van Schalkwyk ◽  
Rob E. Dorrington ◽  
Thapelo Seatlhodi ◽  
Claudia Velasquez ◽  
Ali Feizzadeh ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Transmission Model ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Treatment Target ◽  
Specific Data ◽  
Living With Hiv

AbstractGlobally, large proportions of HIV-positive populations live in cities. The Fast-Track cities project aims to advance progress toward elimination of HIV as a public health threat by accelerating the response in cities across the world. This study applies a well-established HIV transmission model to provide key HIV estimates for the five largest metropolitan districts in South Africa (SA): Cape Town, Ekurhuleni, eThekwini, Johannesburg and Tshwane. We calibrate the model to metro-specific data sources and estimate progress toward the 90-90-90 targets set by UNAIDS (90% of people living with HIV (PLHIV) diagnosed, 90% of those diagnosed on antiretroviral therapy (ART) and viral suppression in 90% of those on ART). We use the model to predict progress towards similarly defined 95-95-95 targets in 2030. In SA, 90.5% of PLHIV were diagnosed in 2018, with metro estimates ranging from 86% in Johannesburg to 92% in eThekwini. However, only 68.4% of HIV-diagnosed individuals nationally were on ART in 2018, with the proportion ranging from 56% in Tshwane to 73% in eThekwini. Fractions of ART users who were virally suppressed ranged from 77% in Ekurhuleni to 91% in eThekwini, compared to 86% in the whole country. All five metros are making good progress to reach diagnosis targets and all (with the exception of Ekurhuleni) are expected to reach viral suppression targets in 2020. However, the metros and South Africa face severe challenges in reaching the 90% ART treatment target.

The Bio/Necropolitics of ACTG 076: Lessons from Pregnant Women of Colour Living with HIV for Treatment for Prevention in the Twenty-first Century

Somatechnics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 233-253
Author(s):  
Eli Manning
Keyword(s):  
Hiv Transmission ◽  
Ethical Dilemmas ◽  
Hiv Treatment ◽  
First Century ◽  
Hiv Positive ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Hiv Positive Women ◽  
Aids Clinical Trials ◽  
Living With Hiv

Since the pharmaceutical turn, using HIV treatment to prevent transmission is increasingly common. Treatment as Prevention®, or TasP, has relied on HIV treatment to prevent HIV transmission, targeting people living with HIV. However, TasP is predicated on troublesome heterosexist, classist, and racist medical practices borrowed from various times and spaces that enact biopolitical and necropolitical relations. This paper discusses the debate surrounding the first clinical trial that used HIV treatment to prevent transmission from woman-to-foetus. The 1994 landmark AIDS Clinical Trials Group 076 study laid the groundwork for using HIV treatment to prevent HIV transmission, the essential precursor to TasP. By examining the concerns of HIV positive women of colour and other AIDS activists, we are able to understand the ethical dilemmas and practical consequences that still haunt today's game-changing uses of HIV treatment for prevention and to see how biopolitics and necropolitics persist in TasP.

scholarly journals Differential relationships of stress and HIV disclosure by gender: a person centered longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chengbo Zeng ◽  
Shan Qiao ◽  
Xiaoming Li ◽  
Xueying Yang ◽  
Zhiyong Shen ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Growth Mixture Modeling ◽  
Hiv Disclosure ◽  
Lower Probability ◽  
People Living With Hiv ◽  
Target Number ◽  
Cross Sectional ◽  
Growth Mixture ◽  
Cross Sectional Design ◽  
Living With Hiv

Abstract Background Existing literature mostly consider HIV disclosure as a static event and investigate its relationship with stress using a cross-sectional design. It is unclear about the dynamic changes of HIV disclosure levels (defined as the number of disclosure targets) and how stress may influence these changes. This study explored different disclosure levels using a person-centered longitudinal approach, examined whether stress could predict these disclosure levels, and investigated if this relationship differed by gender among people living with HIV (PLWH). Methods Data were derived from a prospective cohort study conducted from November 2016 to January 2018 in Guangxi, China. Four hundred forty-four PLWH were included. Participants were assessed on perceived stress, sociodemographic characteristics, and number of HIV disclosure targets at baseline, 6-month, and 12-month follow-ups. Growth mixture modeling was used to characterize disclosure levels based on the changes of disclosure target number. Multinomial logistic regression was used to predict disclosure levels with baseline stress after adjusting for covariates. The interaction effect of stress by gender was examined. Adjusted odds ratio (AOR) with its 95% confidence interval were reported to show the strength of association.  Results Three levels of disclosure were characterized as “Low levels of disclosure” (Level One), “Increased levels of disclosure” (Level Two), and “High levels of disclosure” (Level Three). Accordingly, 355 (81.2%), 28 (6.4%), and 64 (12.4%) of PLWH were categorized respectively under low, increased, and high levels of disclosure. The interaction of baseline stress by gender was significant in differentiating Level One from Three (AOR = 0.85 [0.74 ~ 0.99]) while it was not significant between Level One and Two (AOR = 0.96 [0.81 ~ 1.15]). Compared to female, male PLWH with higher baseline stress had lower probability to have consistent high disclosure levels over time. PLWH who were married/cohabited had lower probability of being classified into consistent high levels of disclosure than low level (AOR = 0.43 [0.19 ~ 0.94]). Conclusions There was gender difference in the relationship between stress and levels of HIV disclosure. To promote HIV disclosure, gender tailored interventions should be employed to help PLWH cope with stress.

scholarly journals Prevalence and Correlates of Snuff Use, and its Association With Tuberculosis, Among Women Living With HIV in South Africa

2018 ◽  
Vol 21 (8) ◽  
pp. 1087-1092 ◽  
Author(s):  
Jessica L Elf ◽  
Ebrahim Variava ◽  
Sandy Chon ◽  
Limakatso Lebina ◽  
Katlego Motlhaoleng ◽  
...  
Keyword(s):  
South Africa ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
People Living With Hiv ◽  
Potential Health ◽  
Adjusted Analysis ◽  
Women Living With Hiv ◽  
Urine Cotinine ◽  
Smokeless Tobacco Use ◽  
Living With Hiv

Abstract Introduction A higher proportion of people living with HIV (PLWH) smoke compared to the general population, but little information exists about the prevalence and correlates of smokeless tobacco use among PLWH. In South Africa, dry powdered tobacco is inhaled nasally as snuff. Methods A cross-sectional survey among PLWH attending three HIV clinics was conducted. Snuff use was assessed via self-report and urine cotinine. Results Given the low (3%) prevalence of snuff use among men, analysis was restricted to n = 606 nonsmoking women living with HIV. Half (n = 298, 49%) were snuff users, the majority of whom (n = 244, 84%) had a positive urine cotinine test. In adjusted analysis, snuff use was negatively associated with higher education (relative risk [RR] 0.55; 95% confidence interval [CI]: 0.39, 0.77) and mobile phone ownership (RR 0.83; 95% CI: 0.71, 0.98), and positively associated with ever having tuberculosis (TB) (RR 1.22; 95% CI: 1.03, 1.45). In adjusted analysis, with current TB as the outcome, snuff use was marginally statistically significantly associated with a twofold increase in odds of a current TB diagnosis (odds ratio [OR] 1.99; 95% CI: 0.98, 4.15). Discussion A high proportion of nonsmoking South African women living with HIV use snuff, which was a risk factor for TB. Additional research is needed to understand the relationship between snuff, TB, and other potential health risks. Implications PLWH have a higher prevalence of smoking than their seronegative peers, but there is a paucity of research on smokeless tobacco use in this population, especially in low-resource settings. TB is the leading cause of death among PLWH, and with improvements to HIV treatment and care, PLWH are at greater risk of tobacco-related diseases. We report an extremely high prevalence of snuff use among women living with HIV in South Africa. Further, in this population snuff use is positively associated with ever having a TB diagnosis, as well as currently having TB.

scholarly journals Exploring the Factors Considered by People Living with HIV and Their Partners during Preconception

2016 ◽  
Vol 16 (3) ◽  
pp. 239-246 ◽  
Author(s):  
V. Logan Kennedy ◽  
Micaela Collins ◽  
Mark H. Yudin ◽  
Lena Serghides ◽  
Sharon Walmsley ◽  
...  
Keyword(s):  
Logit Model ◽  
Hiv Transmission ◽  
Horizontal Transmission ◽  
People Living With Hiv ◽  
Relative Importance ◽  
Hiv Status ◽  
Ordered Logit Model ◽  
Living With Hiv ◽  
Shed Light ◽  
Hiv Negative

Data are lacking on factors that may impact conception-related decision-making among individuals living with HIV. This study’s aim was to shed light on these considerations. Participants were invited to complete a survey on preconception considerations. A rank-ordered logit model was fit to estimate the relative importance of listed consideration factors; the interaction of HIV status and the factors was assessed. Fifty-nine participants living with HIV and 18 partners (11 HIV-negative participants and 7 living with HIV) were included. Risk of vertical and horizontal HIV transmission and the effect of antiretroviral therapy on the fetus were the top considerations. However, individuals living with HIV prioritized vertical transmission, whereas HIV-negative participants prioritized horizontal transmission. Other factors of importance were probability of conception, stress of trying to conceive, cost associated with fertility clinics, and stigma associated with certain conception methods. This study builds our understanding of the preconception considerations for people living with HIV.

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