scholarly journals Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 253 ◽  
Author(s):  
Khensane Mengwai ◽  
Sphiwe Madiba ◽  
Perpetua Modjadji
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Partner Violence ◽  
Hiv Transmission ◽  
Sexual Partners ◽  
Hiv Treatment ◽  
Hiv Diagnosis ◽  
Cross Sectional Survey ◽  
Access To Treatment ◽  
Cross Sectional

The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first 6 months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods This was a cross-sectional study conducted between January to May 2018, on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice. Results The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. E Exclusive breastfeeding’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women (adjusted odds ratio [AOR] 1.66, 95% Confidence Interval [CI] 1.08–2.56) and those with grade 12 or less level of education (AOR 2.76, 95% CI 1.02–7.49) had a higher likelihood of practising EBF for 6 months since birth while mothers who consumed alcohol (AOR 0.54, 95% CI 0.34–0.85) were less likely to practice EBF for 6 months. Conclusions The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background: Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods: This was a cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice.Results: The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. EBF’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women [adjusted odds ratio (AOR) = 1.66, 95% Confidence Interval CI), 1.08-2.56] and those with grade 12 or less level of education (AOR =2.76, 95% CI, 1.02-7.49) had a higher likelihood of practising EBF for six months since birth while mothers who consumed alcohol (AOR = 0.54, 95% CI, 0.34-0.85) were less likely to practice EBF for six months. Conclusions: The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals Gender Differences in Denial-Acceptance Duration Based on Kübler-Ross Cycle After HIV Diagnosis

2021 ◽  
Vol 31 (3) ◽  
pp. 168
Author(s):  
Niniek Budiarti Burhan ◽  
Muhammad Reza Febriliant
Keyword(s):  
Gender Differences ◽  
Median Duration ◽  
Hiv Treatment ◽  
P Value ◽  
Test Results ◽  
Hiv Diagnosis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Routine Treatment ◽  
Male Subjects

<p class="Englishversionofabstract">Patients who have been diagnosed with HIV often suffer from sadness and grief that, in turn, affect the adherence to HIV treatment. This study aimed to examine gender differences in the denial-acceptance duration based on the Kübler-Ross cycle in patients after diagnosed with HIV. A cross-sectional survey was conducted on 63 adult HIV patients aged 19-60 years who received routine treatment at the HIV/VCT outpatient department of Saiful Anwar General Hospital Malang. Subjects were interviewed using the Acceptance of Disease and Impairments Questionnaire (ADIQ). Gender differences in denial-acceptance duration after diagnosed with HIV were analyzed using the unpaired T-test. Results were statistically significant if p value &lt;0.05. The median duration of denial-acceptance in male subjects was 16 weeks with the shortest duration of 1 week and the longest duration of 144 weeks, while the median duration of female subjects was 12 weeks with the shortest duration of 1 week and the longest duration of 240 weeks. There are no gender differences in the denial-acceptance duration (p value = 0.629). In conclusion, there are no gender differences in denial-acceptance duration based on the Kübler-Ross cycle after diagnosed with HIV.</p>

scholarly journals The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Nutritional Status ◽  
Health Facilities ◽  
The Body ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.

scholarly journals Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti

2020 ◽  
Vol 19 ◽  
pp. 232595822095263
Author(s):  
Megan K. Ramaiya ◽  
Elizabeth Haight ◽  
Jane M. Simoni ◽  
Jean Marcxime Chéry ◽  
Witson Dervis ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Treatment ◽  
Provider Communication ◽  
Art Adherence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Behavioral Skills ◽  
Adherence Support ◽  
Hiv Positive Adults ◽  
Patient Provider Communication

While Haiti has scaled up use of antiretroviral therapy (ART), current studies suggest sub-optimal adherence threatens long-term viral suppression in this understudied setting. Patient-provider communication (PPC) and information, motivation, and behavioral skills (IMB) have been implicated in ART adherence globally. However, no studies have examined their relevance in Haiti. The present mixed-methods study utilized cross-sectional survey data from 128 ART-initiating patients at 2 large HIV treatment sites in Haiti, as well as observational data from 12 clinic visits, to document associations between adherence-related PPC and IMB. Multivariate regression analyses suggested that PPC is associated with IMB constructs. At the bivariate level, more effective PPC was associated with higher levels of adherence-related information and motivation, but not behavioral skills. Observational findings indicate infrequent and non-collaborative adherence support. Taken together, findings lay the groundwork for additional research in the area of PPC, IMB, and ART adherence in Haiti.

Determinants of Gender Disparities in Scaling Up the First 90 Towards the UNAIDS 90-90-90 Targets in South Africa: Findings From the 2017 Household-based National Cross-sectional Survey

2020 ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Tertiary Education ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Cascade

Abstract Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa.Methods: The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender.Results: Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p<0.001). Both females aged 25 to 49 years [aOR=3.20 (95% CI: 1.35–7.57), p=0.008], and 50 years and older [aOR=3.19 (95% CI: 1.04–9.76), p=0.042] and males aged 25 to 49 years [aOR=3.00 (95% CI: 1.13–7.97), p=0.028], and 50 years and older [aOR=7.25 (95% CI: 2.07–25.36), p=0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR=75.24 (95% CI: 9.07–624.26), p<0.001] compared to those with no education or with primary level education. Females with secondary [aOR=3.28 (95% CI: 1.20–8.99), p=0.021] and matric [aOR=4.35 (95% CI: 1.54–12.37), p=0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education.Conclusion: Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.

scholarly journals Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2021 ◽  
Author(s):  
Daniel Ter Goon ◽  
Anthony Idowu Ajayi ◽  
Oladele Vincent Adeniyi
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Exclusive Breastfeeding ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practice

Abstract Background: Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa. Methods: This was a cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice.Results: The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. EBF’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women [adjusted odds ratio (AOR) = 1.66, 95% Confidence Interval CI), 1.08-2.56] and those with grade 12 or less level of education (AOR =2.76, 95% CI, 1.02-7.49) had a higher likelihood of practising EBF for six months since birth while mothers who consumed alcohol (AOR = 0.54, 95% CI, 0.34-0.85) were less likely to practice EBF for six months. Conclusions: The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

scholarly journals Fear of stigma, beliefs, and knowledge about HIV are barriers to early access to HIV testing and disclosure for perinatally infected children and adolescents in rural communities in South Africa

2017 ◽  
Vol 59 (3) ◽  
pp. 37
Author(s):  
Sphiwe Madiba ◽  
Mathildah Mokgatle
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Hiv Testing ◽  
Health Care Facilities ◽  
Hiv Status ◽  
Hiv Diagnosis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mpumalanga Province ◽  
Perinatally Infected

Background: The majority of HIV-infected children in resource-limited countries are not aware of their HIV status because of the various reasons responsible for the delay in seeking HIV testing for children. The aim of the study was to determine the prevalence and barriers to testing and disclosing the HIV status of children aged between 5 and 18 years. Methods: This was a cross-sectional survey involving 405 caregivers of HIV perinatally infected children receiving anti-retroviral treatment (ART) in primary health care facilities in a rural district of Mpumalanga province in South Africa. Results: The prevalence of disclosure was 27%, and disclosure was done to promote adherence (26%) or because it was the child’s right to know his/her status (43%). Children’s age was significantly associated with disclosure (AOR = 2.81, p < 0.000, CI 1.64–4.81). Concerns that children were too young and would not understand the implications of HIV diagnosis (74.5%) or would not keep the diagnosis secret (7%) were reasons for non-disclosure. Over half of the caregivers intended to disclose status when the child was aged between 12 and 15 years. In response to children’s questions about medication, caregivers substituted HIV with other less stigmatising conditions (32%). Conclusion: The prevalence of disclosure was low and delayed till the child was above 10 years of age. The main barrier to disclosure was fear of stigma, or fears of the child telling others about their HIV status with consequences of stigma. The need for guidelines to provide caregivers with disclosure skills, to overcome the barriers that prevent disclosure, is crucial. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1329489

scholarly journals Determinants of gender disparities in scaling up the first 90 towards the UNAIDS 90–90–90 targets in South Africa: findings from the 2017 household-based national cross-sectional survey

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
S. Jooste ◽  
M. Mabaso ◽  
M. Taylor ◽  
A. North ◽  
Y. L. Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Tertiary Education ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Level ◽  
Treatment Cascade

Abstract Background The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa. Methods The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender. Results Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p < 0.001). Both females aged 25 to 49 years [aOR = 3.20 (95% CI 1.35–7.57), p = 0.008], and 50 years and older [aOR = 3.19 (95% CI 1.04–9.76), p = 0.042] and males aged 25 to 49 years [aOR = 3.00 (95% CI 1.13–7.97), p = 0.028], and 50 years and older [aOR = 7.25 (95% CI 2.07–25.36), p = 0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR = 75.24 (95% CI 9.07–624.26), p < 0.001] compared to those with no education or with primary level education. Females with secondary [aOR = 3.28 (95% CI 1.20–8.99), p = 0.021] and matric [aOR = 4.35 (95% CI 1.54–12.37), p = 0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education. Conclusion Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.

scholarly journals Factors associated with the practice of exclusive breastfeeding for six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa

2020 ◽  
Author(s):  
PROF DANIEL TER GOON ◽  
Anthony Idowu Ajayi ◽  
OLADELE VINCENT ADENIYI
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Factors Associated ◽  
Sub Saharan ◽  
Context Specific

Abstract Background: Exclusive breast feeding (EBF) is associated with reduction of post-natal HIV transmission and optimal infant growth. Given that the factors influencing EBF are multi-factorial and context-specific, we examined the prevalence and factors associated with EBF practice in the first six months among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa. Methods: This was a prospective cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. EBF was defined as infant feeding with breast milk only. We collected relevant socio-demographic, lifestyle and maternal information by interview. Bivariate and multivariate logistic regression analyses were fitted to determine the factors associated with EBF practice.Results: EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%) and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08-2.56) and those with grade 12 or less level of education (AOR =2.76, 95% CI: 1.02-7.49) had a higher likelihood of practising EBF for six months while mothers who consumed alcohol (AOR = 0.54, 95% CI: 0.34-0.85) were less likely to practice EBF for six months. Conclusions: Sub-optimal rate of EBF in this study is comparable with the national (31.6%), sub-Saharan Africa (36%) and WHO global (35%) rates. Advocacy campaign on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

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