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 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.

Stigma and discrimination: A barrier to the utilisation of a nutritional program in HIV care services in Ethiopia

2019 ◽  
Author(s):  
Fisaha Tesfay ◽  
Sara Javanparast ◽  
Lillian Mwanri ◽  
Anna Ziersch
Keyword(s):  
Social Inclusion ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Northern Ethiopia ◽  
Hiv Status ◽  
Framework Analysis ◽  
Stigma And Discrimination ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

Abstract Background In Ethiopia, stigmatizing attitudes towards people living with HIV have reduced over time. This is mainly due to improved HIV knowledge and the expansion of access to HIV care and support 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 provided to people living with HIV, but this is limited. This study explored HIV status disclosure and experience of stigma among people living with HIV enrolled in a nutritional program in HIV care setting in Ethiopia and impacts on program utilisation.Methods and participants 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 in the nutritional program in three hospitals in the Tigray region of Northern Ethiopia. Framework analysis was employed to analyse the data and NVivo 11 was used to assist data analysis.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 in terms of improving their weight and overall health status, adults and caregivers of children living with HIV revealed experience of stigma and discrimination and fear of discovery of positive HIV status due to: a) nutritional support (Plumpynut/sup) to HIV by the community; b) increased frequency of visits to HIV services.Conclusion There is evidence that enrolment in the nutritional program is associated with increased concern about stigma and discrimination, which in turn negatively affected the utilisation of the nutritional program and HIV service more broadly. Nutritional programs in HIV care should include strategies which take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of social inclusion to mitigate stigma and improve utilisation.

scholarly journals The Lived Experiences of Stigmatization in the Process of HIV Status Disclosure among People Living with HIV in Taiwan

2021 ◽  
Vol 18 (10) ◽  
pp. 5089
Author(s):  
Chia-Hui Yu ◽  
Chu-Yu Huang ◽  
Nai-Ying Ko ◽  
Heng-Hsin Tung ◽  
Hui-Man Huang ◽  
...  
Keyword(s):  
Lived Experiences ◽  
Healthcare Professionals ◽  
Social Stigma ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Structured Interviews ◽  
Two Phases ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one “experiences before disclosure” involved three themes: “Struggles under the pressure of concealing the HIV Status,” “Torn between fear of unemployment/isolation and desire to protect closed ones,” and “Being forced to disclose the HIV status.” Phase two “experiences after disclosure” included three themes: “Receiving special considerations and requirements from school or work,” “Receiving differential treatments in life and when seeking medical care,” and “Stress relief and restart.” Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.

scholarly journals Experience of primary care for people with HIV: a mixed-method analysis

BJGP Open ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. bjgpopen19X101665
Author(s):  
Tanvi Rai ◽  
Jane Bruton ◽  
Meaghan Kall ◽  
Richard Ma ◽  
Erica Pufall ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Mixed Method ◽  
Care Staff ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Framework Analysis ◽  
Complex Needs ◽  
Hiv Status Disclosure ◽  
Method Analysis

BackgroundAdvances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs.AimTo explore the experience of people living with HIV (PLHIV) regarding consulting their GPs.Design & settingA mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV.MethodUnivariate logistic regression was used for quantitative data and framework analysis for qualitative data.ResultsThe survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment.ConclusionThe authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.

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 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

scholarly journals HIV Disclosure and Quality of Life in People Living with HIV/AIDS in Yogyakarta

2020 ◽  
Vol 4 (2) ◽  
pp. 50-58
Author(s):  
Tutur Irfantoro ◽  
Dwi Kartika Rukmi
Keyword(s):  
Quality Of Life ◽  
Hiv Disclosure ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Background: Victory Plus Foundation is a Non-Government Organization that helps the population directly affected by HIV/AIDS in Yogyakarta. Status disclosure’s research on People Living with HIV/AIDS (PLWHA) in Victory Plus Foundation is scarce. Even though the status disclosure is one of HIV spreading prevention, it has two-sided effects, both negative and positive, so its result can affect the quality of life despite PLWHA having tried to find a support system. Therefore, it is essential to know how the quality of life of PLWHA has opened up their status.Purpose: This study aimed to determine the relationship between HIV status disclosure and the quality of life of PLWHA in the Victory Plus Foundation, Yogyakarta.Method: This descriptive-analytic correlation study with a cross-sectional approach was conducted in June-July 2019 on 68 PLWHA at the Victory Plus Foundation. Purposively, samples were asked to fill out a disclosure questionnaire and WHOQOL-BREF. Univariate data presented in descriptions and Chi-Square tested bivariate data.Result: Most of the HIV status disclosure of PLWHA in the Victory Plus foundation was classified into a moderate category (77.9%) and low quality of life (64 %). The bivariate test result found a significant relationship between the HIV status disclosures with the quality of life in general (p = 0.001) with a moderate relationship closeness (r=0.403).Conclusion: Consequently, there is a relationship between the HIV status disclosures with the quality of life of PLWHA in the Victory Plus Foundation in Yogyakarta.

scholarly journals A multi-institutional, cross-sectional study on disclosure of HIV status to sexual partner(s) and associated factors among people living with HIV/AIDS attending selected hospitals in Kigali, Rwanda

2020 ◽  
Vol 7 (2) ◽  
pp. 399
Author(s):  
Moreblessing Chipo Mashora ◽  
Tafadzwa Dzinamarira ◽  
Nicholas Njau Ngomi
Keyword(s):  
Sexual Partner ◽  
Cross Sectional Study ◽  
P Value ◽  
People Living With Hiv ◽  
Local Health ◽  
Hiv Status ◽  
Cross Sectional ◽  
Health Authorities ◽  
Hiv Status Disclosure ◽  
Status Disclosure

Background: In Sub-Saharan Africa, human immunodeficiency virus (HIV) remains a public health problem. There is need for evidence-based interventions to curb new infections. HIV status disclosure, especially to sexual partner(s) remains a critical step towards reducing viral transmission across sexual partners.Methods: A hospital-based cross-sectional study, conducted at HIV clinics of three selected hospitals. Systematic random sampling was employed to sample 384 people living with HIV/AIDS (PLWH). A pre-tested self-administered questionnaire was used to collect data.Results: Of the participants, 66% of the participants reported HIV positive status disclosure, with only 46% of these having disclosed to their sexual partner. Logistic regression analysis identified age (p value 0.035; AOR 0.94), being satisfied with counselling (p value 0.017; AOR 0.24), gender (p value 0.030; AOR 5.51) and education (p value 0.041; AOR 2.14) as factors associated with having disclosed HIV status. Being younger, satisfaction with counselling, being female and having attained at least secondary education were all associated with higher odds of HIV status disclosure.Conclusions: Based on the findings of the current study, it can be concluded that there is need to improve rates of HIV status disclosure among PLWH in Kigali, Rwanda. The current study findings have provided baseline information for the local health authorities, health care providers, policy makers and other scholars working in HIV epidemic control. The local health authorities can use this as a guide to develop a programme aimed to address the issue of non-disclosure of HIV status in Kigali City and hence help control the incessant spread of HIV infection.

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