scholarly journals Coping Mechanisms of Previously Diagnosed and New HIV-Discordant, Heterosexual Couples Enrolled in a Pilot HIV Self-Testing Intervention Trial in Central Uganda

2021 ◽  
Vol 3 ◽  
Author(s):  
Joseph K. B. Matovu ◽  
Rose Kisa ◽  
Angela M. Malek ◽  
Caroline Vrana-Diaz ◽  
Semei Christopher Mukama ◽  
...  
Keyword(s):  
Social Support ◽  
Male Partner ◽  
Coping Mechanisms ◽  
Hiv Positive ◽  
Heterosexual Couples ◽  
Intervention Trial ◽  
Main Trial ◽  
Self Testing ◽  
Discordant Couples ◽  
Professional Counselling

Introduction: Learning that a couple has HIV-discordant results can create tensions in the relationship including separation. We explored the coping mechanisms of HIV-discordant, heterosexual couples enrolled in an HIV self-testing (HIVST) intervention trial in Central Uganda.Materials and Methods: This qualitative study was nested within a pilot HIVST intervention trial targeting pregnant women and their male partners in central Uganda. In-depth interviews were conducted with 18 individuals from 13 HIV-discordant couples between July and September 2018; 18 months after the end of the main trial. Data were collected on the couples' initial reactions after learning about their HIV-discordant status, mechanisms adopted by couples to cope with HIV-discordance, and suggestions on how couples in similar situations can be supported. Interviews were transcribed verbatim and analysed manually following a thematic framework approach.Findings: Of the 13 HIV-discordant couples, the female partner was HIV-positive (M–F+) in seven, while the male partner was HIV-positive (F–M+) in six. The mean (±SD) age of the participants was 32.6 (±6.4) years and participants had stayed together for an average of 5.5 (±3.6) years. Fourteen participants from nine couples already knew about their HIV-discordant status by the time they participated in the HIVST trial. After learning about their HIV-discordant status, most individuals (15) thought of abandoning their relationship; three (3) thought of committing suicide. To cope with HIV-discordance, some couples reported that they sought professional counselling support from healthcare providers, and this was particularly true for couples that were already aware of their HIV-discordant status by the time they participated in the HIVST trial. However, new couples that learnt about their HIV-discordant status after participating in the trial reported that they sought psycho-social support from friends or relatives. In the majority of cases, couples reported that they reduced the frequency of sex or abstained from sex. Some couples temporarily separated from their partners, while a few others resorted to using condoms to reduce HIV infection risk.Conclusion: Couples used a variety of approaches to cope with HIV-discordance. Study findings underscore the importance of ongoing professional counselling and psycho-social support in helping couples to cope with HIV-discordance.

Correlates of HIV-Positive Fathers’ Involvement in Prevention of Motherto- child Transmission Programs in Northern Nigeria

2020 ◽  
Vol 18 (6) ◽  
pp. 443-457
Author(s):  
Zubairu Iliyasu ◽  
Hadiza S. Galadanci ◽  
Bashir Muhammad ◽  
Fatima Z. Yadudu ◽  
Aminatu A. Kwaku ◽  
...  
Keyword(s):  
Condom Use ◽  
Hiv Transmission ◽  
Male Partner ◽  
Tertiary Hospital ◽  
Consistent Condom ◽  
Hiv Positive ◽  
Northern Nigeria ◽  
Male Partners ◽  
Logistic Regression Models ◽  
Paternal Education

Background: The involvement of men in the prevention of mother-to-child HIV transmission (PMTCT) programs could accelerate the elimination of vertical transmission. Yet, little research has focused on HIV-positive male partners. This study determined predictors of male partners’ PMTCT knowledge and involvement in a tertiary hospital in northern Nigeria. Methods: A clinic-based sample of 401 HIV-positive male partners of women who delivered within 12 months prior were interviewed using structured questionnaires. PMTCT knowledge and involvement scores were computed. Adjusted odd ratios (AOR) for predictors were derived from multivariate logistic regression models. Results: The proportion of respondents with adequate PMTCT knowledge was 40.9%. Less than half (43.6%) of the respondents participated in PMTCT, with median involvement score of 2.00 (interquartile range, IQR = 0, 5.0). One quarter of respondents (25.7%, n =103) reported >1 sex partners, 10.5% consistently used condoms, and 20.7% had disclosed to all partners. Father’s involvement in PMTCT was predicted by paternal education (AOR = 0.30; 95% Confidence Interval (CI): 0.12-0.77, no formal vs. post-secondary), HIV-positive child (AOR = 3.85; 95%CI: 1.41-10.54, yes vs. no), treatment duration (AOR = 4.17; 95%CI: 1.67-10.41, ≤1 vs. ≥10 years), disclosure to partner(s) (AOR = 1.21; 95%CI: 1.15-3.52, ‘disclosed to all’ vs. ‘not disclosed’), condom use (AOR = 5.81; 95%CI: 3.07-11.0, always vs. never), and PMTCT knowledge (AOR = 0.62; 95%CI: 0.31-0.92, inadequate versus adequate). Conclusion: The involvement of fathers in HIV PMTCT programs was low and predicted by paternal education, HIVpositive child, duration of antiretroviral treatment, disclosure to partner, consistent condom use, and level of PMTCT knowledge. Our findings will inform the development of policies to increase male partner involvement in PMTCT in Nigeria.

Peer assisted HIV self-testing increases positivity rates among key populations in Burundi: descriptive analysis of routine programmatic data (Preprint)

2020 ◽  
Author(s):  
Tiffany Lillie ◽  
Dorica Boyee ◽  
Gloriose Kamariza ◽  
Alphonse Nkunzimana ◽  
Dismas Gashobotse ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Descriptive Analysis ◽  
Case Finding ◽  
Hiv Positive ◽  
Key Populations ◽  
Standard Testing ◽  
Art Initiation ◽  
Treatment Standard ◽  
Self Testing

BACKGROUND In Burundi, given the low testing numbers among key populations, peer assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people (TG) to provide another testing option. HIVST was provided by existing peer outreach workers (POWs) who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics or in facilities. OBJECTIVE The objective was to improve access to HIV testing to underserved KP members, increase HIV positivity rates, and link those who were confirmed HIV positive with life-saving treatment for epidemic control. METHODS A descriptive analysis of routine programmatic data was conducted from a nine-month implementation period (June 2018-March 2019) of peer assisted HIVST among FSWs, MSM, and TG in six provinces where the USAID- and PEPFAR-funded LINKAGES Burundi project worked. Chi-squared tests were used to compare case-finding rates among individuals tested through HIVST versus standard testing. RESULTS A total of 2,198 HIVST test kits were administered (1,791 FSWs, 363 MSM, 44 TG). Three hundred and sixty-six people (17%) were reactive to HIV screening (296 FSWs, 60 MSM, 10 TG); 314 (14%) were confirmed HIV positive (257 FSWs, 47 MSM, 10 TG); and 301 (96%) (251 FSWs, 40 MSM, 10 TG) of those confirmed were initiated on treatment. HIV case-finding rates were significantly higher with HIVST compared to standard testing for FSW and MSM but not TG: FSWs (14% vs. 9%, P < .001); MSM (13% vs. 4%, P < .001); and TG (23% vs. 17%, P > .10). ART initiation rates were significantly lower for MSM confirmed HIV positive through HIVST than through standard testing (85% vs. 99%, P < .001) but not among FSWs or TG (FSWs: 98% vs. 97%, P > .10; TG: 100% vs. 100%). CONCLUSIONS The results demonstrate the potential effectiveness of HIVST in identifying individuals who are living with HIV.

Genital abnormalities, hormonal contraception, and HIV transmission risk in Rwandan serodifferent couples

2021 ◽  
Author(s):  
Kristin M Wall ◽  
Etienne Karita ◽  
Julien Nyombayire ◽  
Rosine Ingabire ◽  
Jeannine Mukamuyango ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Hormonal Contraception ◽  
Male Partner ◽  
Female Partner ◽  
Transmission Risk ◽  
Hiv Positive ◽  
Genital Ulceration ◽  
Factors Associated ◽  
Contraception Use ◽  
Hiv Acquisition

Abstract Background We explored the role of genital abnormalities and hormonal contraception in HIV transmission among heterosexual serodifferent couples in Rwanda. Methods From 2002-2011, non-antiretroviral treatment using HIV serodifferent couples were followed and sociodemographic and clinical data were collected, family planning provided, and HIV-negative partners retested. Couples were assessed for genital ulcers; non-ulcerative genital sexually transmitted infection (STI) including gonorrhea, chlamydia, and trichomoniasis; and non-STI vaginal infections including bacterial vaginosis and candida. Multivariable models evaluated associations between covariates and HIV transmission genetically linked to the index partner. Results Among 877 couples where the man was HIV-positive, 37 linked transmissions occurred. Factors associated with women’s HIV acquisition included female partner genital ulceration (adjusted hazard ratio [aHR]=14.1) and male partner non-ulcerative STI (aHR=8.6). Among 955 couples where the woman was HIV-positive, 46 linked transmissions occurred. Factors associated with men’s HIV acquisition included female partner non-ulcerative STI (aHR=4.4), non-STI vaginal dysbiosis (aHR=7.1), and male partner genital ulceration (aHR=2.6). Hormonal contraception use was not associated with HIV transmission or acquisition. Conclusions Our findings underscore the need for integrating HIV services with care for genital abnormalities. Barriers (e.g., cost for training, demand creation, advocacy, client education; provider time; clinic space) to joint HIV/STI testing need to be considered and addressed.

scholarly journals Influence of boarding secondary school environment on HIV positive students in South Western Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raymond Bernard Kihumuro ◽  
David Jolly Muganzi ◽  
Elton George Wandira ◽  
Racheal Alinaiswe ◽  
Jovitah Joselyne Nanyunja ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Secondary School ◽  
Secondary Schools ◽  
School Environment ◽  
Coping Mechanisms ◽  
Hiv Positive ◽  
Key Informants ◽  
Immunodeficiency Virus ◽  
Negative Coping ◽  
Depth Interviews

Abstract Background The number of human immunodeficiency virus (HIV) positive adolescents in secondary school has increased over the years. Little is known on how the students cope to the pressures and demands of their academic and health lives in the boarding secondary schools. This study explored the factors surrounding their anti-retroviral therapy adherence as well as their experiences. Methods We did a qualitative study that employed in-depth interviews amongst purposively selected 19 HIV positive adolescent students in boarding secondary school and seven key informants. Key informants were members of boarding secondary school staff directly taking care of the adolescents living with human immune virus and had spent at least two academic terms in that school. The study participants were recruited from four health facilities in Bushenyi district, southwestern Uganda, and key informants from five boarding secondary schools in Bushenyi. These were engaged in in-depth interviews using an interview guide. Data was transcribed, coded and the content analyzed thematically. Results Adolescents living with human immunodeficiency virus in boarding secondary school face challenges similar to adolescents outside boarding school settings. However, some challenges are unique to them. Students faced numerous barriers which made it difficult to adhere to their medication. Stigmatization in its different forms was also a major challenge amongst students. Willingness disclosure of serostatus was beneficial to the students since it guaranteed support while at school; facilitating adherence and better living. However, students were uneasy to disclose their status. Some students adopted negative coping mechanisms such as telling lies, escaping from school, and class to access medication. Conclusions Adolescents in boarding secondary schools face similar challenges as compared to their counterparts with some being unique to them. Few school mechanisms help these students to cope while at school. Limited disclosure has proven useful but some adolescents have opted not to disclose their status and hence used negative coping mechanisms. These challenges need to be addressed and a safe environment to encourage limited disclosure should be made.

scholarly journals Acceptability of index partner HIV self-testing among HIV-positive clients in Malawi: A mixed methods analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0235008
Author(s):  
O. Agatha Offorjebe ◽  
Risa M. Hoffman ◽  
Frackson Shaba ◽  
Kelvin Balakasi ◽  
Dvora Joseph Davey ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Positive ◽  
Self Testing

Lack of Medical Support in HIV Infection and Unstable Mood States

1997 ◽  
Vol 81 (2) ◽  
pp. 635-639
Author(s):  
Motoko Hayashi ◽  
Isao Fukunishi
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Hiv Infection ◽  
Mood Disorders ◽  
Early Stage ◽  
Mood States ◽  
Hiv Positive ◽  
Medical Support ◽  
Hiv Patients

This study examined what kinds of social support are related to mood states in a sample of 50 HIV-positive patients without AIDS (46 men and 4 women; M age 36.5 yr., SD = 9.8). In the early stage of HIV infection, HIV patients without AIDS may be prone to depressive symptoms although none of these HIV-positive patients' symptoms fulfilled the DSM-III-R Mood Disorders including Major Depression. The depressive symptoms were not significantly related to lack of ordinary social support such as friends and family but were significantly associated with dissatisfaction with HIV/AIDS-related medical support

Social support among different HIV positive risk groups

1998 ◽  
Vol 13 (S4) ◽  
pp. 240s-240s
Author(s):  
P. Soler ◽  
C. Martin ◽  
M.D. Carretero ◽  
M. Soler-Viñolo ◽  
M. Soler-Arrebola
Keyword(s):  
Social Support ◽  
Risk Groups ◽  
Hiv Positive
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