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Nguyen TT, Huong DT, Nguyen LT, Nguyen BD, Giang LM, Lin C. Disclosure of HIV Status in Healthcare Settings: Practices and Considerations among Women Living with HIV/AIDS in Vietnam. J Int Assoc Provid AIDS Care 2024; 23:23259582241277655. [PMID: 39238476 PMCID: PMC11378245 DOI: 10.1177/23259582241277655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE This study investigated women living with HIV/AIDS (WLHA)'s practices and decision-making regarding disclosure of HIV status in healthcare settings in Vietnam. Introduction: Disclosure of HIV status in healthcare settings is under-studied. METHODS We conducted in-depth interviews with 30 WLHA in Hanoi, Vietnam. Thematic analysis was conducted to investigate the patterns, considerations, and consequences of HIV disclosure. Results: Most participants chose a selective disclosure strategy based on the type of procedure and healthcare setting. They considered several factors: concerns about stigma/discrimination, risks of confidentiality breach, relevance to healthcare provision, and altruism towards protecting providers and other patients. Selective disclosure or non-disclosure often prevented participants from accessing comprehensive care. Conclusion: The study underscores the need to prepare WLHA to make informed decisions regarding disclosure and provide them with service navigations and support. It also highlights the necessity of reducing stigma and enhancing confidentiality protection to ensure safe disclosure in healthcare settings.
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Affiliation(s)
- Thu Trang Nguyen
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Dang Thi Huong
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Lynn T Nguyen
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Bich Diep Nguyen
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Le Minh Giang
- Center for Training and Research on Substance Use & HIV, Hanoi Medical University, Hanoi, Vietnam
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Chunqing Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, USA
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Mmotsa TM, Magasana V, Nsibande DF, Buthelezi M, Dassaye R, Rodriguez VJ, Jones DL, Goga AE, Ngandu NK. Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner's HIV status, in six South African districts with a high antenatal HIV burden. BMC Public Health 2023; 23:1988. [PMID: 37828512 PMCID: PMC10571358 DOI: 10.1186/s12889-023-16921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Elimination of vertical HIV Transmission (VHT) and maternal deaths are global health priorities. Male involvement is one of the most important factors that influences women's decisions, including the uptake of Prevention of vertical HIV transmission (P-VHT). We sought to understand not knowing a male partner's HIV status (MPHIVs) amongst women using services to prevent vertical HIV transmission in six South African districts with high antenatal HIV burden. METHODS A mixed-methods cross-sectional study was conducted in six South African districts, and data collected through face-to-face interviews with women and focus group discussions (FGDs) with women or male partners. The quantitative data were analyzed using STATA SE-17.0 and an inductive approach was used for qualitative data analysis. RESULTS Overall, 28.7% of women were unaware of their MPHIVs, while 25.3% and 46.0% knew the MPHIVs was positive or negative, respectively. In multivariable logistic regression, single marital status and unplanned pregnancy increased the odds of not knowing a MPHIVs while a woman's disclosure of her HIV status to the male partner reduced the odds. FDGs highlighted complexities around MPHIVs disclosure, e.g., reluctance to test for HIV and potential interventions including healthcare worker (HCW) assisted HIV disclosure. CONCLUSION User-informed interventions to address MPHIVs non-disclosure amongst women of child-bearing age, particularly those at risk of unstable sexual partners and unplanned pregnancies, should be strengthened.
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Affiliation(s)
- Tshiamo M Mmotsa
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Vuyolwethu Magasana
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Duduzile F Nsibande
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Mbongeleni Buthelezi
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Reshmi Dassaye
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychology (Clinical/Community Division), University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ameena E Goga
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - Nobubelo K Ngandu
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
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Giuliani M, Patini R, Lo Muzio L, Troiano G, Caponio VCA, Adamo D, Conti F, Gallenzi P, Lajolo C. Attitudes and practices of dentists treating HIV+ patients in the era of new antiretroviral therapy: A 12-year update. Heliyon 2023; 9:e18751. [PMID: 37554845 PMCID: PMC10404774 DOI: 10.1016/j.heliyon.2023.e18751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
During the first years of the HIV pandemic, the virus diffusion was responsible for discriminatory behavior from medical and dental care workers towards HIV-infected patients, as described by our research group in 2009. The aim of the current study was to provide an update on the previous data, investigating the presence of discriminatory behaviors, evaluating the level of dentists' knowledge about the virus and proposing strategies to be implemented to avoid professional exposure and cross-infections. This study was a cross-sectional, online, national survey on dentists, members of the main national dental associations (ANDI and AIO). The questionnaire was divided into four major sections, with the same structure as the questionnaire administered in 2009. The differences between groups were analyzed using the software program IBM SPSS Statistic, version 21.0. A total of 1054 dentists filled out the questionnaire completely. Among them 0.04% revealed a discriminatory attitude towards HIV-infected patients. The univariate analysis showed that discrimination towards HIV + patients was statistically associated with personal experiences and the level of fear associated with treating them (p = 0.001) and with the type of dental treatments performed (p = 0.01). This cross-sectional study revealed the persistence of dentists who still discriminate against HIV + patients, and the percentage of these dentists was only slightly lower than that in the previous survey (4.3% in the present survey vs. 4.5%). The survey also depicted other information worthy of consideration, such as a perceived ability to detect HIV + patients based on their appearance, complaints about not having received adequate training for treating HIV + individuals, and a lack of scientific knowledge about the virus. From the evidence reported by the present survey, it can be argued that universities, professional boards, and training institutions must increase their efforts in spreading correct knowledge about HIV among all dental care workers.
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Affiliation(s)
- Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Dentistry - IRCCS “Casa Sollievo della Sofferenza” San Giovanni Rotondo, Foggia, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Daniela Adamo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Head and neck Clinical Section, University of Naples Federico II, Naples, Italy
| | - Francesca Conti
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy
| | - Patrizia Gallenzi
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy
| | - Carlo Lajolo
- Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy
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Ma H, Hu Z, Wang Z, Ma Y, Zhai H, Li J. Development and Validation of a New Comprehensive Assessment Scale of HIV-Related Psychological Distress in China: A Methodological Study. J Assoc Nurses AIDS Care 2023; 34:292-306. [PMID: 37067998 DOI: 10.1097/jnc.0000000000000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
ABSTRACT Instruments evaluating HIV-related psychological distress (HRPD) in people living with HIV may lack sensitivity to capture patients' psychological burden. We developed a comprehensive scale measuring HRPD and evaluated its psychometric properties. A mixed-method study was conducted from July 2021 to April 2022; it involved a literature review, semistructured interviews (n = 15), three rounds of panel discussions, two rounds of Delphi studies (n = 20), a pilot test (n = 20) to generate new scale items, and a cross-sectional survey (n = 659) to evaluate the psychometric properties of the HIV-related psychological distress scale. The scale contains 22 items across 4 subscales (i.e., disease-related distress, treatment adherence distress, identity distress, and disclosure distress). The confirmatory factor analysis revealed high goodness of fit (χ2/df = 2.412, comparative fit index = 0.916, incremental fit index = 0.917, and Tucker‒Lewis index = 0.902), showing that the HIV-related psychological distress scale is a reliable (Cronbach's α = 0.871 overall) and valid scale for evaluating HRPD in China and can be used to dynamically evaluate and monitor HRPD levels during patient follow-up.
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Affiliation(s)
- Haiqi Ma
- Haiqi Ma, MSN, RN, is a Graduate Student, School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Zhiguang Hu, BA, is a General Practitioner, Hongshan Street Community Health Service Center, Huangpu District, Guangzhou, Guangdong, China. Zhongqing Wang, MSN, is a Social Worker, University of Chinese Academy of Sciences Education Foundation, Beijing, China. Yue Ma, MSN, RN, is a Lecturer, School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Huimin Zhai, MSN, RN, is a Professor, School of Nursing, Southern Medical University, Guangzhou, Guangdong, China. Juan Li, MSN, RN, is a Lecturer, School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
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Psychological Distress Increases 30-Fold Among People with HIV in the First Year on ART in Nigeria-a Call for Integrated Mental Health Services. Int J Behav Med 2023; 30:38-48. [PMID: 35226343 PMCID: PMC8883753 DOI: 10.1007/s12529-022-10068-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Few studies have longitudinally assessed psychological distress among people with HIV (PWH) initiating ART in resource-limited settings. METHOD Baseline, 6-month, and 12-month psychological distress were measured in a Nigerian cohort newly initiating therapy; the relationship between baseline factors and psychological distress at 12 months was assessed; and the association between psychological distress at 12 months and care retention or immunologic failure was determined. RESULTS Among 563 patients, median age was 38 years (IQR: 33-46 years), 62% were female, and 51% were married. Psychological distress increased from 3% at baseline to 34% at 12 months. Age (aOR 1.28, 95% CI 1.06-1.56), female sex (aOR 2.89, 95% CI 1.93-4.33), lack of disclosure (aOR 4.32, 95% CI 2.48-7.51), and time on ART (6 months [aOR 6.91, 95% CI 3.14-15.18] and 12 months [aOR 32.63, 95% CI 16.54-64.36]) were associated with psychological distress while being married (OR 0.42, 95% CI 0.30-0.61) was associated with reduced odds. Tweve-month psychological distress was associated with increased risk of immunologic failure (aOR 2.22, 95% CI 1.31-3.82). CONCLUSION The risk of psychological distress increased 30-fold in the first year on therapy in PWH in Nigeria.
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HIV Disclosure Among Sexually Infected People Living with HIV and AIDS in China: Prevalence, Influencing Factors, and Negative Outcomes. AIDS Behav 2022; 27:2411-2429. [PMID: 36580165 DOI: 10.1007/s10461-022-03968-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 12/30/2022]
Abstract
HIV disclosure is crucial for HIV prevention and control, but may also lead to discrimination, insult, and even violence against people living with HIV and AIDS (PLWHAs). In this study, we examined HIV disclosure, its influencing factors, and its association with intimate partner violence (IPV) among 1153 PLWHAs through the sexual route in Jinan, Shandong Province, China. Our results showed that 76.4% (881/1153) PLWHAs had disclosed someone about their HIV infection, the HIV disclosure rates among family members, friends, spouses, and current fixed partners of PLWHAs were 43.5% (501/1153), 47.9% (552/1153), 56.8% (129/227), and 43.2% (336/777), respectively. HIV disclosure was affected by socio-demographics, disease characteristics, and psycho-social factors and varied among family members, close friends, spouses, and current fixed sexual partners. Age ≤ 33 years (aOR 1.79, 95% CI 1.27-2.53), heterosexual infection route (aOR 1.52, 95% CI 1.06-2.17), HIV diagnosis time > 36 months (aOR 1.84, 95% CI 1.30-2.59), with other chronic diseases (aOR 1.87, 95% CI 1.34-2.61), lower self-stigma (aOR 4.03-4.36, 95% CI 1.98-8.74), higher social support (aOR 1.71-1.73, 95% CI 1.03-2.83), no depression (aOR 1.54, 95% CI 1.12-2.11), and no suicidal ideation (aOR 1.79, 95% CI 1.28-2.50) were all independently associated with increased likelihood of HIV disclosure. HIV disclosure was associated with an increased risk of IPV among current fixed sexual partners (aOR 1.87, 95% CI 1.38-2.54) and spouses (aOR 2.54, 95% CI 1.41-4.56). Our findings suggest that the HIV disclosure rate of PLWHAs is still low and is affected by multiple factors. There is an urgent need to design targeted and comprehensive interventions to improve HIV disclosure. IPV prevention should also be incorporated into the intervention system of HIV disclosure to ensure adequate and continuous support for PLWHAs.
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Osei EA, Oti-Boadi E, Agyeman-Yeboah J, Hennor E, Ofosuwaa B, Agyeiwaa J, Elikplem R. Psychosocial experiences of patients diagnosed with COVID-19 at a teaching hospital in Ghana. SAGE Open Med 2022; 10:20503121221144859. [PMID: 36561148 PMCID: PMC9768531 DOI: 10.1177/20503121221144859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives The number of people affected with COVID-19 keeps rising globally resulting in increasing fear and anxiety among patients and their families. However, literature on the psychosocial experiences of these patients with COVID-19 in Africa is limited. Hence, this research explored the psychosocial experiences of patients infected with COVID-19 and undergoing treatment. Methods The study employed a qualitative phenomenological approach. The sampling technique chosen for this study was purposive with a sample size of 34 determined by data saturation. Participants were selected from Korle-Bu Teaching Hospital, Ghana, and were interviewed face-face using a semi-structured interview guide. Data were analyzed using Interpretive Phenomenological Analysis. Results Two main themes and seven sub-themes were generated from this study. The two themes included emotional burden of COVID-19 patients and effects of COVID-19 on patients and relatives. Sub-themes formulated under the emotional burden were reactions to COVID-19 diagnosis, suicidal thoughts, and sadness by fear of the unknown. Social restriction/isolation, stigmatization and disclosure, effect of COVID-19, and positive attitudes of staff emerged under the effect of COVID-19 on patients and relatives. Conclusion Even though the recovery rate of COVID-19 has improved since the introduction of the COVID-19 vaccine, there is generally a global surge with respect to the incidence of the condition and an increasing number of patients on admission. Most interventions are targeted at the prevention of the disease than the effect of the psychosocial experience on the quality of life of the individuals affected which is equally essential. It is therefore recommended that current studies focus on improving the quality of life of those affected.
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Affiliation(s)
- Evans Appiah Osei
- Department of Midwifery, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana,Evans Appiah Osei, Department of Midwifery, School of Nursing and Midwifery, Valley View University, Box DT 595, Oyibi 00233, Ghana.
| | - Ezekiel Oti-Boadi
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | | | - Emilia Hennor
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | - Bertha Ofosuwaa
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | - Joyce Agyeiwaa
- Department of Midwifery, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
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Peng W, Song X, Zhang C, Chen Y, Zhou Q, Välimäki MA, Li X. The proportion of HIV disclosure to sexual partners among people diagnosed with HIV in China: A systematic review and meta-analysis. Front Public Health 2022; 10:1004869. [PMID: 36324439 PMCID: PMC9620859 DOI: 10.3389/fpubh.2022.1004869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/30/2022] [Indexed: 01/27/2023] Open
Abstract
Background Sexual behavior is one of the main routes of HIV/AIDS spread. HIV disclosure to sexual partners has been confirmed to be an important strategy for HIV/AIDS prevention and control. We conducted a systematic review and meta-analysis to pool proportions and characteristics of HIV disclosure to sexual partners among people diagnosed with HIV in China. Methods We searched eight databases and extracted the data on HIV disclosure to partners. Heterogeneity of the data was tested with I 2. Published bias subjectively and objectively analyzed through the funnel plot and Egger's regression test. Subgroup analyses were performed to explore the variation in the proportion by sexual partnership types (unclassified, regular, casual sexual partners), whether being men who have sex with men (MSM), and when to diagnose. The sources of heterogeneity were analyzed. Sensitivity analysis was carried out to evaluate the stability of the results. Results Out of 3,698 studies, 44 were included in the review; 11 targeted on MSM. The pooled proportion of HIV disclosure to sexual partners was 65% (95% CI: 56%-75%; 34 studies). Sub-group analyses indicated the proportions of HIV disclosure to regular, casual and unclassified sexual partners were 63% (95% CI: 45%-81%; 31 studies), 20% (95% CI: 8%-33%; nine studies), and 66% (95% CI: 59%-73%; 14 studies), respectively. Fifty-seven percent (95% CI: 45%-69%; three studies) disclosed on the day of diagnosis, 62% (95% CI: 42%-82%; four studies) disclosed within 1 month, and 39% (95% CI: 2%-77%; four studies) disclosed 1 month later. Among MSM, the disclosure to regular male partners, regular female sexual partners, spouses, and casual partner were 47% (95% CI: 29%-65%; six studies), 49% (95% CI: 33%-65%; three studies), 48% (95% CI: 18%-78%; seven studies), and 34% (95% CI: 19%-49%; four studies), respectively. Conclusions The disclosure prevalence of people diagnosed with HIV to sexual partners still need improving in China, and it varies among partner types, key populations, and time being diagnosed. HIV disclosure strategies and procedures need to be developed more detailed and tailored based on the pain points of disclosure status, so as to ultimately prevent HIV transmission through sexual contact. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022291631, identifier: CRD42022291631.
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Affiliation(s)
- Wenwen Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Xiaohan Song
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Yuqing Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Qidi Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China
| | - Maritta Anneli Välimäki
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China,Department of Nursing Science, University of Turku, Turku, Finland,*Correspondence: Xianhong Li
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China,Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation (A JBI Affiliated Group), Changsha, Hunan Province, China,Maritta Anneli Välimäki
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Tegegne AS, Zeru MA. Evaluation of the interventions on HIV case management and its association with cART adherence and disclosure of the disease status among HIV-positive adults under treatment. Sci Rep 2022; 12:13729. [PMID: 35962025 PMCID: PMC9374750 DOI: 10.1038/s41598-022-17905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
The rate of prevalence of HIV among adults has been increasing in sub-Saharan African countries over the last decade. The objective of this study was to evaluate the interventions on HIV case management based on cART adherence and disclosure of HIV disease status among HIV-positive adults under treatment. A retrospective cohort longitudinal data was conducted on 792 randomly selected patients in the study area. Engagement of HIV-positive persons into care and achieving treatment outcomes such as the disclosure of HIV status and cART adherence were fundamental for HIV prevention strategy. The two response variables under the current investigation were evaluation of intervention on HIV case management interims cART adherence and disclosure of HIV status. Binary logistic regression was conducted for separate models. Among the predictors, age of patients (AOR = 1.020, 95% CI (1.016, 1.191); p value = 0.005), the number of follow-up (AOR = 1.014, 95% CI (1.023, 1.030); p value < 0.0001). CD4 cell count (AOR = 0.981; 95% CI (0.765, 0.971), p value < 0.01), Marital status (AOR = 1.013; 95% CI (1.002, 1.015), p value = 0.006), female patients (AOR = 1.014; 95% CI (1.001, 1.121), p value < 0.007), rural (AOR = 0.982; 95% CI (0.665, 0.998), p value = 0.004), non-educated adult patients (AOR = 0.950, 95% CI (0.92. 0.98). p value = 0.003), Non-existence of social violence (AOR = 1.012, 95% CI (1.008, 1.234), p value < 0.01), adult with non-opportunistic diseases (AOR = 1.021, 95% CI (1.002. 1.042). p value = 0.001) significantly affected the two response variables jointly. Interventions on HIV case management lead to an efficient continuum of successful treatment outcomes like disclosure of HIV status and cART adherence. Hence, HIV case management intervention and the two results had a positive association. HIV case management intervention should be given to younger patients, rural residents, and non-educated patients to disclose the disease status and to have a long life with the virus. Health-related education should be conducted for the community in general and for patients in particular on how HIV is transferred from an infected person to an uninfected one. This helps to reduce the stigma of patients and to deliver social support to patients.
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Affiliation(s)
| | - Melkamu A Zeru
- Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia
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Prevalence for the Disclosure of HIV Status to Sexual Partners and Its Determinants among Adults under cART in Amhara Region, Northwest Ethiopia. J Trop Med 2022; 2022:9941380. [PMID: 35846071 PMCID: PMC9283073 DOI: 10.1155/2022/9941380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Globally, the transmission of HIV from one individual to another causes 1.8 million new infections each year, 36.7 million people living with HIV, and one million people died from HIV-related illnesses. The objective of this study was to determine the prevalence of the disclosure of HIV status to sexual partners and its determinants among adults under cART in the Amhara Region, northwest Ethiopia. Methods A retrospective study design was conducted on 792 randomly selected samples. The study was conducted in the Amhara Region, from 2015 to 2020. A binary logistic regression modeling was used for data analysis. The data were collected using a stratified random sampling technique where the residential areas were considered strata. Data were collected by trained health practitioners in the ART section in Felege Hiwot Teaching and Specialized Hospital. The hospital is a referral in which many patients from different districts and zonal hospitals in the region are referred to this hospital. Results The rate of disclosure of HIV status to sexual partners in this study was 21%, which is very low compared to the average rate of disclosure in developing countries. Among the predictors, age of patients (AOR = 1.02, 95% CI:(1.001,1.120); p-value = 0.004); number of baseline CD4 cell count (AOR = 0.980; 95% CI: (0.764, 0.991); p-value<0.01); number of hospital visits (AOR = 1.01; 95% CI: (1.001, 1.034); p-value < 0.01); marital status (living with partner) (AOR = 1.01; 95% CI: (1.003, 1.112); p-value = 0.006); female HIV-positive adults (AOR = 1.01; 95% CI: (1.001, 1.021); p-value = 0.007); rural residence (AOR = 0.98; 95% CI: (0.96, 0.99); p-value = 0.004); non-educated adult patients (AOR = 0.950, 95% CI: (0.92. 0.98); p-value = 0.003); cART non-adherent adult patients (AOR = 0.940, 95% CI: (0.61. 0.97); p-value < 0.001); non-opportunistic infectious diseases (AOR = 1.062, 95% CI: (1.049. 1.191); p-value = 0.002); and non-existence of social violence (AOR = 1.012, 95% CI: (1.008, 1.); p-value < 0.01) significantly affected the variable of interest. Of these, the number of CD4 cell count, male HIV-positive adults, rural residence, and existence of social violence negatively affected the variable of interest. Conclusions Some groups of HIV patients did not disclose their level of HIV status to their sexual partners. Health-related education is recommended for patients who did not disclose their HIV status to sexual partners. This helps to reduce the transmission of HIV from infected individuals to noninfected ones and from mother-to-child HIV transmission.
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Parcesepe AM, Remch M, Dzudie A, Ajeh R, Nash D, Anastos K, Yotebieng M, Adedimeji A, Pefura-Yone E, Lancaster K. Depressive Symptoms, Gender, Disclosure, and HIV Care Stage Among People Living with HIV in Cameroon. AIDS Behav 2022; 26:651-661. [PMID: 34403021 PMCID: PMC8915538 DOI: 10.1007/s10461-021-03425-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
Depression is associated with suboptimal HIV care outcomes. Little is known about the extent to which the prevalence of depressive symptoms varies across the HIV care continuum. Also, the relationship among gender, HIV disclosure, HIV care stage, and depressive symptoms in PLWH remains poorly understood. We analyzed cross-sectional data from 12,507 PLWH at enrollment in International epidemiology Databases to Evaluate AIDS (IeDEA) Cameroon between 2016 and 2020. Recent depressive symptoms were assessed using the Patient Health Questionnaire-2 (PHQ-2). A score of three or greater on the PHQ-2 was considered indicative of likely major depressive disorder. We estimated the prevalence of depressive symptoms across three stages of HIV care: those not yet on antiretroviral therapy (ART), recent ART initiators (ART initiation ≤ 30 days prior), and ART users (ART initiation > 30 days prior). Adjusted prevalence differences (aPD) of depressive symptoms were estimated comparing recent ART initiators and ART users. Disclosure and gender were examined as effect measure modifiers of the relationship between HIV care stage and depressive symptoms. The prevalence of depressive symptoms was 11.9%, 22.0%, and 8.7% among PLWH not yet on ART, recent ART initiators, and ART users, respectively. ART users had significantly lower prevalence of depressive symptoms compared to recent ART initiators (aPD - 0.09 [95% CI - 0.11, - 0.08]). Neither gender nor HIV disclosure modified the effect measure of the relationship between HIV care stage and depressive symptoms. Depressive symptoms were commonly reported among this group of PLWH and were associated with recent ART initiation. Integration of screening and treatment of depression into HIV care should be prioritized and may be particularly relevant for PLWH initiating ART.
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Affiliation(s)
- Angela M Parcesepe
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB# 7445, Chapel Hill, NC, 27599, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Molly Remch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anastase Dzudie
- Clinical Research Education Networking and Consultancy, Yaounde, Cameroon
| | - Rogers Ajeh
- Clinical Research Education Networking and Consultancy, Yaounde, Cameroon
| | - Denis Nash
- Institute of Implementation Science in Population Health, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Kathryn Anastos
- Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marcel Yotebieng
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adebola Adedimeji
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Kathryn Lancaster
- Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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12
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Ogundijo DA, Tas AA, Onarinde BA. Factors influencing the perception and decision‐making process of consumers on the choice of healthier foods in the United Kingdom: a systematic review using narrative synthesis. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel A. Ogundijo
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
| | - Ayten A. Tas
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
| | - Bukola A. Onarinde
- National Centre for Food Manufacturing University of Lincoln Holbeach PE12 7LD UK
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13
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Chi Y, Huang D, Lindgren T, Goldsamt L, Zhou J, Ren Y, Zhang L, Li X. The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China. AIDS Care 2022; 34:127-134. [PMID: 35000522 DOI: 10.1080/09540121.2021.2008859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Disclosure of HIV status can encourage spouses of people diagnosed with HIV to prioritize HIV prevention. However, few studies have reported the HIV disclosure status of married men who have sex with men (MSM) and their female spouses. The purpose of this study was to describe the prevalence of HIV disclosure, and whether it was associated with spouses' HIV testing uptake and unprotected vaginal intercourse within marriage for MSM living with HIV (HIV + MSM) in China. A cross-sectional study was conducted in three Chinese cities. Of 309 participants, only 31.1% of men had disclosed their HIV status to spouses. About 80% of participants reported that their spouses had been tested for HIV. A small proportion of men (9.1%) had unprotected sex with their spouse after HIV diagnosis. Multivariate analyses indicated HIV disclosure was positively associated with HIV testing uptake of spouses, but there was no significant association between HIV disclosure and unprotected marital sexual behaviors for HIV + MSM. The findings indicated that HIV disclosure to spouses is uncommon among married HIV + MSM in China, and HIV disclosure is associated with increased uptake of HIV testing among spouses of MSM, but it does not decrease the unprotected sexual behaviors in marriage.
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Affiliation(s)
| | - Daoping Huang
- Changde Center for Diseases Prevention and Control, Changde, Hunan, China
| | - Teri Lindgren
- University of California, San Francisco, California, USA
| | - Lloyd Goldsamt
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Jing Zhou
- Xiangya Hospital of Centre-south University, Changsha, Hunan, China
| | - Yong Ren
- Wuxi Fifth People's Hospital, Wuxi, Jiangsu, China
| | - Lin Zhang
- Shanghai Public Health Clinical Research Center, Shanghai, China
| | - Xianhong Li
- Xiangya Nursing School of Central South University, Changsha, Hunan, China
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14
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Hempel S, Ferguson L, Bolshakova M, Yagyu S, Fu N, Motala A, Gruskin S. Frameworks, measures, and interventions for HIV-related internalised stigma and stigma in healthcare and laws and policies: systematic review protocol. BMJ Open 2021; 11:e053608. [PMID: 34887280 PMCID: PMC8663079 DOI: 10.1136/bmjopen-2021-053608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION There is strong global commitment to eliminate HIV-related stigma. Wide variation exists in frameworks and measures, and many strategies to prevent, reduce or mitigate stigma have been proposed but critical factors determining success or failure remain elusive. METHODS AND ANALYSIS Building on existing knowledge syntheses, we designed a systematic review to identify frameworks, measures and intervention evaluations aiming to address internalised stigma, stigma and discrimination in healthcare, and stigma and discrimination at the legal or policy level. The review addresses four key questions (KQ): KQ1: Which conceptual frameworks have been proposed to assess internal stigma, stigma and discrimination experienced in healthcare settings, and stigma and discrimination entrenched in national laws and policies? KQ2: Which measures of stigma have been proposed and what are their descriptive properties? KQ3: Which interventions have been evaluated that aimed to reduce these types of stigma and discrimination or mitigate their adverse effects and what are the effectiveness and unintended consequences? KQ4: What common 'critical factors for success or failure' can be identified across interventions that have been evaluated? We will search PubMed, PsycINFO, Web of Science, Universal Human Rights Index, HeinOnline, PAIS, HIV Legal Network, CDSR, Campbell Collaboration, PROSPERO and Open Science Framework. Critical appraisal will assess the source, processes and consensus finding for frameworks; COnsensus-based Standards for the selection of health Measurement Instruments criteria for measures; and risk of bias for interventions. Quality of evidence grading will apply . A gap analysis will provide targeted recommendations for future research. We will establish a compendium of frameworks, a comprehensive catalogue of available measures, and a synthesis of intervention characteristics to advance the science of HIV-related stigma. PROSPERO REGISTRATION NUMBER CRD42021249348.
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Affiliation(s)
- Susanne Hempel
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, USA
| | - Maria Bolshakova
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Sachi Yagyu
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Ning Fu
- Department of Economics, Shanghai University of Finance and Economics, Shanghai, China
| | - Aneesa Motala
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Sofia Gruskin
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, California, USA
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15
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Attal BA, Al-Rowaishan KM, Akeel AA, AlAmmar FK. HIV stigma in the teaching hospitals in Sana'a, Yemen: a conflict and low-resource setting. BMC Public Health 2021; 21:1793. [PMID: 34610815 PMCID: PMC8493713 DOI: 10.1186/s12889-021-11845-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV stigma undermines a person's wellbeing and quality of life and hinders HIV control efforts. This study examined the extent and drivers of HIV stigma in the teaching hospitals in Sana'a City, Yemen. The country has low HIV prevalence (4000 (2000-11,000) per 100,000) and limited HIV control funds, worsened by a long conflict and an economic crisis. METHODS We conducted a cross-sectional study of 320 Yemeni health professionals in all the four teaching hospitals in Sana'a City. Data were collected anonymously, using an adapted self-completed Arabic version of the Health Policy Project HIV Stigma tool. The questionnaire covered the respondents' background, the stigmatising practices, and potential personal and professional drivers of stigma. RESULTS The majority of the participants were: females (68%), 20-39 years old (85%), nurses (84%), and holding a nursing diploma (69%) or a bachelor's degree (27%). None of the hospitals had institutional policies against HIV stigma, and 93% of the participants believed the current infection control measures were inadequate. Less than half of the participants provided care for people living with HIV (PLHIV) (45%), had received HIV training (33%), and were confident that their HIV knowledge was adequate (23%). The majority indicated a preference to test patients for HIV prior to surgical procedures (77%) and disclose positive HIV results to others (99%) without prior knowledge or consent. All the participants had exhibited a form of HIV-related stigmatization, such as avoiding physical contact with PLHIV (87%) or wearing gloves throughout the consultation (96.5%). These practices were significantly correlated with the fear of infection, high perceived risk of infection, and poor work environment (p < 0.05). CONCLUSION PLHIV face widespread stigmatizing behaviour in the teaching hospitals in Sana'a City, consistent with the higher level of stigma in low HIV prevalence countries and its links to the fear of infection, poor HIV knowledge, and limited funding for HIV control. Stigma reduction interventions are required at institutional and individual levels. In addition, anti-discrimination policies and structural adjustments are needed, in combination with training on HIV and universal precautions, and action to tackle negative attitudes towards PLHIV and key populations.
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Affiliation(s)
- Bothaina Ahmed Attal
- Faculty of Medicine and Health Sciences, Sana'a University, The Sixty St., Sana'a, Yemen. .,Affiliated researcher at the Centre for Business Research, Cambridge Judge Business School, Cambridge, UK.
| | | | | | - Fawziah Kassim AlAmmar
- Educational and Psychological Sciences Department, Faculty of Education, Art and Applied Sciences, Amran University, Amran, Yemen
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16
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Naidoo S, Ferreira L, Subramaney U, Paruk S. An HIV Narrative of Female Inmates With a Lifetime History of Mental Illness in Durban, South Africa. Front Psychiatry 2021; 12:637387. [PMID: 34512406 PMCID: PMC8424036 DOI: 10.3389/fpsyt.2021.637387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/27/2021] [Indexed: 02/02/2023] Open
Abstract
Introduction: South Africa (SA) has one of the highest prevalence rates of Human Immuno-deficiency Virus (HIV) globally, with women carrying a larger burden of the disease. Furthermore, female inmates have higher rates of HIV compared to their male counterparts, with an over-representation of mental illnesses among female inmates as well. Additionally, mental illnesses are highly prevalent in people living with HIV, with HIV and mental illness sharing a complex bidirectional relationship. This study, which forms part of a larger two-phased, mixed-methods study, describes the experiences of contracting and living with/being affected by HIV, among female inmates with a lifetime history of mental illness, in a South African setting. Method: This study was conducted at a correctional centre in Durban, KwaZulu-Natal, SA. Fourteen adult (18 years and older) female inmates, were purposively selected to participate in individual, in-depth semi-structured interviews. Participants had a lifetime history of mental illness, trauma and were either living with HIV, or affected by HIV. Women from diverse cultural backgrounds, who were fluent in English, were selected. This manuscript focuses on the description of the HIV component of the qualitative interviews only. Thematic analysis was used to analyse the data. Results: Themes related to contracting HIV included intimate partner betrayal, gender differences regarding sexual behaviour, fear associated with HIV and the importance of pre- and post-test HIV counselling. Themes related to living with/being affected by HIV included the challenges women experienced in their home community, which contrasted with their experience of living with HIV in the prison community, and the importance of accepting an HIV positive life. Conclusion: HIV is prevalent in the female inmate population at this correctional centre in SA. This study emphasises that whilst incarcerated, attempts should be made to educate, train, support and manage HIV in this population, thereby helping to curb the epidemic. Further research should aim at exploring such strategies. The study also underscores the importance of the continued need for HIV education in order to eradicate associated stigma and discrimination which are still prevalent in SA.
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Affiliation(s)
- Samantha Naidoo
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Liezel Ferreira
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ugasvaree Subramaney
- Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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17
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Madiba S, Ralebona E, Lowane M. Perceived Stigma as a Contextual Barrier to Early Uptake of HIV Testing, Treatment Initiation, and Disclosure; the Case of Patients Admitted with AIDS-Related Illness in a Rural Hospital in South Africa. Healthcare (Basel) 2021; 9:healthcare9080962. [PMID: 34442099 PMCID: PMC8395026 DOI: 10.3390/healthcare9080962] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
We explored the extent to which perceived HIV-related stigma influences the disclosure and concealment of HIV status to family among adult patients hospitalised for AIDS-related illness, and described reports of negative responses and enacted stigma following disclosure. We conducted interviews with a purposeful sample of 28 adult patients in a rural South African hospital. Data analysis was deductive and inductive and followed the thematic approach. We found evidence of delayed HIV diagnosis and initiation of treatment. There was delayed and selective disclosure as well as concealment of the HIV-positive status. The disclosure was delayed for months or even years. During that time, there was active concealment of the HIV status to avoid stigma from family, friends, and community. When disclosure occurred, there was selective disclosure to close family members who would keep the secret and respond favorably. Although the participants disclosed mostly to close family, some of their post-disclosure experiences included incidents of enacted stigma and discrimination. The fear of perceived stigma and self-stigma influenced the active concealment of their HIV status from others. Continuous concealment of one's HIV status and delayed disclosure limit the opportunities for support and care. There is a need to take into consideration the interaction between HIV-related stigma and disclosure to develop disclosure-counselling strategies in primary health care settings.
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Affiliation(s)
- Sphiwe Madiba
- Department of Environmental and Occupational Health, School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa;
- Correspondence:
| | - Evelyn Ralebona
- Department of Environmental and Occupational Health, School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa;
| | - Mygirl Lowane
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0001, South Africa;
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18
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Yalew M, Adane B, Kefale B, Damtie Y, Tadesse SE, Molla A. The effect of counseling, antiretroviral therapy and relationship on disclosing HIV positive status to sexual partner among adult HIV patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0249887. [PMID: 33886583 PMCID: PMC8061922 DOI: 10.1371/journal.pone.0249887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human Immunodeficiency Virus (HIV) is continued as a major public health problem, especially in developing countries. Therefore, this study aimed to estimate the effect of counseling, antiretroviral therapy (ART) and relationship on disclosing HIV positive status to sexual partner among adult HIV patients in Ethiopia. METHODS The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was used during this review. The study included both published and unpublished studies which were conducted in Ethiopia until the end of 2019. Different electronic databases (PubMed, Cochrane library, CINAHL, Global Health, HINARI and Google scholar) were searched. Data were extracted in Microsoft Excel sheet and STATA/SE 14 was used to meta-analysis. I2 and Egger test statistics were used to test heterogeneity and publication bias respectively. RESULTS Twenty-two articles with 8,873 adult HIV infected peoples were included in this systematic review and meta-analysis. The pooled magnitude of disclosing HIV status to sexual partner was 74.63% [95% CI: (67.79, 81.47)]. Counseled [AOR = 4.96, 95% CI: (2.87, 8.55)], ART initiated [AOR = 4.78, 95% CI: (3.84, 5.94)] and who had a smooth relationship before HIV testing [AOR = 6.82, 95% CI: (3.49, 13.33)] were significantly associated with disclosing HIV status to sexual partner. CONCLUSIONS Disclosing HIV positive status to sexual partner in Ethiopia was low as the government invested in partner notification. Counseling, ART initiation and smooth relationship before HIV testing were significantly associated with disclosing HIV status to sexual partner. The government needs to strengthen pre and post HIV test counseling even after treatment started to increase disclosing status. REGISTRATION The protocol of this systematic review and meta-analysis was registered in the PROSPERO with a specific registration number: CRD42020161276; https://clinicaltrials.gov/.
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Affiliation(s)
- Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Asressie Molla
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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19
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Goodwin T, Gregson S, Maswera R, Moorhouse L, Nyamukapa C. Understanding the determinants and consequences of HIV status disclosure in Manicaland, Zimbabwe: cross-sectional and prospective analyses. AIDS Care 2021; 33:1577-1594. [PMID: 33813969 DOI: 10.1080/09540121.2021.1883507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Few longitudinal studies have measured trends and effects of disclosure over ART scale-up in general-population samples. We investigated levels, determinants and outcomes of disclosure to relatives and partners in a large general-population cohort in Zimbabwe. Trends in disclosure levels from 2003 to 2013 were analysed, and multivariable logistic regression was used to identify determinants. Longitudinal analyses were conducted testing associations between disclosure and prevention/treatment-related outcomes. Disclosure to anyone increased from 79% to 100% in men and from 63% to 98% in women from 2003 to 2008; but declined to 89% in both sexes in 2012-2013. More women than men disclosed to relatives (67.8% versus 44.4%; p < 0.001) but fewer women disclosed to partners (85.3% versus 95.0%; p < 0.001). In 2012-2013,secondary/higher education, being single, and experience of stigma were associated with disclosure to relatives in both sexes. Partner characteristics and HIV-group attendance were associated with disclosure to partners for women. Reactions to disclosure were generally supportive but less so for females than males disclosing to partners (92.0% versus 97.4%). Partner disclosure was weakly associated (p < 0.08) with having had a CD4 count or taken ART at follow-up in females. To conclude, this study shows disclosure is vital to HIV prevention and treatment, and programmes to facilitate disclosure should be re-invigorated.
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Affiliation(s)
| | - Simon Gregson
- Imperial College London, London, UK.,Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | | | - Constance Nyamukapa
- Imperial College London, London, UK.,Biomedical Research and Training Institute, Harare, Zimbabwe
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20
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Sun W, Zhou Y, Chen WT, Huang F, Sun M, Shen L, Gao Y, Zhang Q, Ma S, Shiu C, Zhang L, Lu H. Disclosure experience among COVID-19-confirmed patients in China: A qualitative study. J Clin Nurs 2021; 30:783-792. [PMID: 33349988 PMCID: PMC9205648 DOI: 10.1111/jocn.15616] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
AIM To understand COVID patients' experiences of and perspectives on disclosure of their illness and to explore and describe the factors affecting disclosure decisions among COVID patients in China. BACKGROUND Disease disclosure is a critical component of prevention and control of a virus outbreak, and this is especially true during the COVID-19 pandemic. Understanding COVID patients' experiences and perspectives on disclosure could play a vital role in COVID management. DESIGN A qualitative study. METHODS A semi-structured interview guide was used to conduct qualitative in-depth interviews from April to June 2020. All the interviews were audio-recorded and transcribed, and then, a thematic analysis was conducted. The Standards for Reporting Qualitative Research (SRQR) were applied to this study. RESULTS A total of 26 COVID-confirmed patients were recruited for the in-depth interviews. Four themes emerged from the thematic analysis on disclosure: persons disclosed to, reasons for disclosure, reasons for nondisclosure and impact of disclosure. The participants disclosed their COVID diagnosis to different groups, including family, close friends, community members and workplace contacts. The main reasons for disclosure included the following: government policy, social responsibility, gaining support and fear of being blamed for nondisclosure. However, some participants decided not to disclose to some groups for fear of facing stigma and discrimination or to protect family members from discrimination. Despite the potential benefits of obtaining support after disclosure, many participants did experience stigma and discrimination, privacy exposure, psychological distress and social isolation. CONCLUSIONS An individual's decision as to whether to disclose their COVID-positive status is affected by many factors. To prevent the spread of COVID-19 and reduce the potential risks of disclosure, such as discrimination and privacy exposure, a balanced intervention should be designed to protect COVID patients and to secure any contact tracing. Therefore, the chances of discrimination could be decreased and patients' confidentiality could be protected. RELEVANCE TO CLINICAL PRACTICE As the number of COVID patients increases, disclosure of an individual's infectious status is encouraged by health departments. Despite the potential benefits of disclosure, discrimination and privacy exposure should not be ignored. A disclosure protocol is necessary to ensure patients' privacy regarding their COVID status.
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Affiliation(s)
- Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Ying Zhou
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Meiyan Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lei Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yan Gao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qing Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Siyue Ma
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Chengshi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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21
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Masiano S, Machine E, Mphande M, Markham C, Tembo T, Chitani M, Mkandawire A, Mazenga A, Ahmed S, Kim M. Video-Based Intervention for Improving Maternal Retention and Adherence to HIV Treatment: Patient Perspectives and Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041737. [PMID: 33579047 PMCID: PMC7916796 DOI: 10.3390/ijerph18041737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 11/24/2022]
Abstract
VITAL Start is a video-based intervention aimed to improve maternal retention in HIV care and adherence to antiretroviral therapy (ART) in Malawi. We explored the experiences of pregnant women living with HIV (PWLHIV) not yet on ART who received VITAL Start before ART initiation to assess the intervention’s acceptability, feasibility, fidelity of delivery, and perceived impact. Between February and September 2019, we conducted semi-structured interviews with a convenience sample of 34 PWLHIV within one month of receiving VITAL Start. The participants reported that VITAL Start was acceptable and feasible and had good fidelity of delivery. They also reported that the video had a positive impact on their lives, encouraging them to disclose their HIV status to their sexual partners who, in turn, supported them to adhere to ART. The participants suggested using a similar intervention to provide health-related education/counseling to people with long term conditions. Our findings suggest that video-based interventions may be an acceptable, feasible approach to optimizing ART retention and adherence amongst PWLHIV, and they can be delivered with high fidelity. Further exploration of the utility of low cost, scalable, video-based interventions to address health counseling gaps in sub-Saharan Africa is warranted.
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Affiliation(s)
- Steven Masiano
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
- Correspondence: (S.M.); (M.K.)
| | - Edwin Machine
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Mtisunge Mphande
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Christine Markham
- Center for Health Promotion and Preventive Research, Department of Health Promotion and Behavioral Sciences, The University of Texas, Houston, TX 77030, USA;
| | - Tapiwa Tembo
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Mike Chitani
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Angella Mkandawire
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Alick Mazenga
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
| | - Saeed Ahmed
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
- Section of Retrovirology and Global Health, Baylor College of Medicine, Houston, TX 77030, USA
| | - Maria Kim
- Baylor College of Medicine Children’s Foundation Malawi, PBAG B397, Lilongwe, Malawi; (E.M.); (M.M.) (T.T.); (M.C.); (A.M.); (A.M.); (S.A.)
- Section of Retrovirology and Global Health, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: (S.M.); (M.K.)
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22
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Yang Y, Wang W, Kelifa MO, Li J, Yao X, Li S, Yan H. HIV Disclosure Patterns and Psychosocial Correlates Among People Living with HIV in Nanjing, China: A Latent Class Analysis. AIDS Res Hum Retroviruses 2020; 36:220-226. [PMID: 31793328 DOI: 10.1089/aid.2019.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Little is known about the patterns of HIV disclosure and the predictors of such group memberships. Therefore, our study aimed to explore the relationship between HIV disclosure patterns and psychosocial factors. From July to August 2016, totally 466 people living with HIV (PLWH) were recruited from a tertiary hospital. Latent class analysis was performed to ascertain HIV disclosure patterns, and multinomial logistic regression was used to examine predictors of HIV disclosure patterns. Four classes were identified and characterized as the systematic disclosure (11.2%), systematic concealment (39.5%), disclosure to spouse (29.0%), and disclosure to parents (20.4%). Relative to the systematic concealment class, respondents of the systematic disclosure and disclosure to spouse classes were more likely to report a high level of social support (adjusted odds ratio (aOR) = 1.112, 95% CI = 1.039-1.189; aOR = 1.144, 95% CI = 1.084-1.208). PLWH in the disclosure to spouse class tended to have increased perceived stigma (aOR = 1.040, 95% CI = 1.008-1.073). These findings provide practical implications for effective intervention targeting the different subgroups. Urgent attention should be paid to perceived stigma and social support to encourage PLWH to disclose their HIV status.
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Affiliation(s)
- Yinmei Yang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | | | - Jingjing Li
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Tucker, Georgia
| | - Xing Yao
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, China
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23
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Wouters E, Sommerland N, Masquillier C, Rau A, Engelbrecht M, Van Rensburg AJ, Kigozi G, Ponnet K, Van Damme W. Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers. BMC Infect Dis 2020; 20:106. [PMID: 32028895 PMCID: PMC7006097 DOI: 10.1186/s12879-020-4816-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this co-epidemic remain relatively unexplored. More specifically, no research has quantitatively explored the double stigma associated with HIV and TB in this context, and more specifically the impact of the co-epidemic on [1] the stigmatisation of TB and [2] the TB stigma mangement strategy of covering (i.e. the use of TB as a cover for having HIV). The current study aims to address this research gap by disentangling the complex mechanisms related to HIV-TB stigma. METHODS Using Structural Equation Modelling (SEM), data of 882 health care workers (HCWs) in the Free State province, South Africa, are analysed to investigate the link between the stigmatization of HIV and TB and the stigma management by those affected. The current study focuses on health care workers (HCWs), as both TB and HIV have a severe impact on this professional group. RESULTS The results demonstrate that the perceived link between the epidemics is significantly associated with double HIV-TB stigmatization. Furthermore, the link between the illnesses and the double stigma are driving the stigmatization of TB. Finally, the link between HIV and TB as well as the stigmatization of both diseases by colleagues are associated with an increased use of covering as a stigma management strategy. CONCLUSIONS This is the first quantitative study disentagling the mediating role of double stigma in the context of the co-epidemic as well as the impact of the co-epidemic on the social connotations of TB. The results stress the need for an integrated approach in the fight against HIV and TB recognizing the intertwined nature of the co-epidemic, not only in medical-clinical terms, but also in its social consequences. TRIAL REGISTRATION South African National Clinical Trials Register, registration ID: DOH-27-1115-5204. Prospectively registered on 26 August 2015.
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Affiliation(s)
- Edwin Wouters
- Department of Sociology and Centre for Population, Family and Health, University of Antwerp, Sint-Jacobstraat 2, BE-2000, Antwerp, Belgium.
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa.
| | - Nina Sommerland
- Department of Sociology and Centre for Population, Family and Health, University of Antwerp, Sint-Jacobstraat 2, BE-2000, Antwerp, Belgium
| | - Caroline Masquillier
- Department of Sociology and Centre for Population, Family and Health, University of Antwerp, Sint-Jacobstraat 2, BE-2000, Antwerp, Belgium
| | - Asta Rau
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa
| | - Michelle Engelbrecht
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa
| | | | - Gladys Kigozi
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa
| | - Koen Ponnet
- Department of Communication Sciences, Media, Innovation and Communication Technologies, Ghent University, Ghent, Belgium
| | - Wim Van Damme
- International Health Policy, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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24
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Barnidge E, Krupsky K, LaBarge G, Arthur J. Food Insecurity Screening in Pediatric Clinical Settings: A Caregivers’ Perspective. Matern Child Health J 2019; 24:101-109. [DOI: 10.1007/s10995-019-02785-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Wagener MN, van Opstal SEM, Miedema HS, van Gorp ECM, Roelofs PDDM. Work-related stigma and disclosure: A daily challenge for people living with HIV. Work 2018; 58:537-548. [PMID: 29254135 DOI: 10.3233/wor-172650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Stigma and disclosure are important work-related issues for people living with HIV (PLWH). To gain better understanding and improve the position of PLWH in the labor market, further insight in these issues is needed. OBJECTIVE This study reviews the scientific evidence related to work-related stigma and disclosure. METHODS A sensitive literature search was performed in the databases of Medline, Embase, Cochrane Library, Cinahl and Psychinfo for articles published between 1996 and 2016. All studies on PLWH in western countries and investigating disclosure or stigma in relation to work were included. RESULTS Of the 866 identified studies, 19 met the inclusion criteria: 4 addressed both disclosure and stigma (2 quantitative), 9 addressed only disclosure (4 quantitative) and 7 studies addressed only stigma (4 quantitative). CONCLUSION This review provides a unique overview of the research on work-related disclosure and stigma, which will enable health care providers to support PWLH to make well-considered decisions. However, the available literature was heterogeneous and in most studies the topics of our interest were secondary outcomes and provided only basic insight.
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Affiliation(s)
- M N Wagener
- Centre of Expertise Innovations in Care, Rotterdam University of Applied Science, The Netherlands
| | - S E M van Opstal
- Centre of Expertise Innovations in Care, Rotterdam University of Applied Science, The Netherlands
| | - H S Miedema
- Centre of Expertise Innovations in Care, Rotterdam University of Applied Science, The Netherlands
| | - E C M van Gorp
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - P D D M Roelofs
- Centre of Expertise Innovations in Care, Rotterdam University of Applied Science, The Netherlands
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26
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Adefemi S, Abayomi M, Adekanye A, Mohammed Y. Prevalence, Pattern and Predictors of Disclosure among HIV Positive Clients of FMC Bida Art Clinic. JOURNAL OF MEDICAL SCIENCES 2018. [DOI: 10.3923/jms.2018.172.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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27
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Hino S, Grodensky C, Rutstein SE, Golin C, Smith MK, Christmas L, Miller W, Phiri S, Massa C, Kamanga G, Pettifor A. HIV status disclosure during acute HIV infection in Malawi. PLoS One 2018; 13:e0201265. [PMID: 30048496 PMCID: PMC6062079 DOI: 10.1371/journal.pone.0201265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/13/2018] [Indexed: 01/05/2023] Open
Abstract
Diagnosis of acute HIV infection (AHI) presents an opportunity to prevent HIV transmission during a highly infectious period. Disclosure is important during AHI as a means to facilitate safer sex practices and notify partners, particularly as those with AHI may be better able to identify the source of their infection because of the recency of HIV acquisition. However, little is known about disclosure during AHI. We conducted 40 semi-structured interviews with Malawians diagnosed with AHI (24 men; 21 married). Most participants reported disclosing to a sexual partner within a month of diagnosis, and knew or had a strong suspicion about the source of their infection. Participants often assumed their source had knowingly infected them, contributing to anger and feeling that disclosure is futile if the source already knew their HIV status. Assisted partner notification, individual and couples counseling, and couples HIV testing may facilitate disclosure during AHI. CLINICAL TRIAL REGISTRATION NUMBER NCT01450189.
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Affiliation(s)
- Sayaka Hino
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
| | - Catherine Grodensky
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Sarah E. Rutstein
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
- Department of Health Policy and Management, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Carol Golin
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
- * E-mail:
| | - M. Kumi Smith
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
| | - Lawrenson Christmas
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - William Miller
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
| | | | - Cecilia Massa
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Gift Kamanga
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Audrey Pettifor
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
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28
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Abstract
Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. We followed 1013 HIV-infected individuals participating in the Partners Demonstration Project, an open-label study of integrated pre-exposure prophylaxis (PrEP) and ART delivery for HIV serodiscordant couples in Kenya and Uganda. Associations between depression, measured annually with the Hopkins Symptoms Checklist-Depression (HSCL-D), and ART initiation were assessed with Cox proportional hazards regression. At enrollment, 162 participants (16.0%) reported symptoms consistent with probable depression, defined by a HSCL-D mean score >1.75, and this proportion decreased during study follow-up (6.7 and 3.6% at 12- and 24-months, respectively; p value < 0.001). Greater depressive symptom severity was associated with a greater likelihood of ART initiation overall (adjusted hazard ratio [aHR] 1.32, 95% CI 1.01-1.73) and among participants with CD4 count ≤ 350 cells/µl (aHR 1.30, 95% CI 1.01-1.67). Depression decreased 6 months after ART initiation (adjusted odds ratio [aOR] 0.34, 95% CI 0.23-0.51). Among East African HIV-infected persons in HIV serodiscordant couples, depression was not a barrier to ART initiation. ART initiation was associated with improved depressive symptoms in this setting.
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29
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Smith C, Cook R, Rohleder P. 'When it comes to HIV, that's when you find out the genuinity of that love': The experience of disclosing a HIV+ status to an intimate partner. J Health Psychol 2017; 24:1011-1022. [PMID: 28810431 DOI: 10.1177/1359105317691588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Despite a medical discourse of the 'normalisation' of HIV, it remains a highly stigmatising condition and makes the issue of disclosing one's HIV status particularly complex. This article reports on the experience of 18 people living with HIV in the United Kingdom of disclosing their HIV+ status in arguably their most important relationship, their intimate partnership. Five main themes arose: disclosure as the battlefield, preparing psychologically to disclose, disclosure as a test of the partner's love, disclosure as an opportunity for the partner to know them more deeply and the renegotiation of the relationship narrative.
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30
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Lan CW, Li L, Lin C, Feng N, Ji G. Community Disclosure by People Living With HIV in Rural China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:287-298. [PMID: 27427924 PMCID: PMC5069966 DOI: 10.1521/aeap.2016.28.4.287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The decision to disclose HIV serostatus is a complex and a challenging task because of potential stigma, blame, and fear associated with HIV infection. Despite continued research on HIV disclosure, literature on HIV disclosure to community is still scarce. The purpose of the study is to describe patterns of HIV status disclosure to community members in a sample of HIV-infected men and women in rural China. This study used the baseline data of a randomized controlled intervention trial for HIV-affected families in China. The data was collected between late 2011 to early 2013. In addition to demographic and HIV-related clinical characteristics, we collected the extent of HIV disclosure to members within the community. We first calculated descriptive statistics and frequencies to describe the demographics of the sample. We then compared the extents of HIV disclosure to different community members. We performed chi-square tests to determine whether the demographic and socioeconomic variables were associated with the extent of HIV disclosure to community. A total of 522 PLH were included in the study. The results show that age and family income are associated with the extent of disclosure of HIV status to members within the community, including neighbor, village leaders, people in the village, and coworkers. More disclosures were found among older age groups. People with less family income tend to disclose more to the community than those with higher family income. There is a need to explore the association of HIV disclosure to the community to help realize the public health and personal implications of disclosure. Our results underscore the potential benefits of age and socioeconomic status-specific interventions in the efforts to dispel barriers to HIV status disclosure to the community.
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Affiliation(s)
- Chiao-Wen Lan
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, California
| | | | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, California
| | - Nan Feng
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, California
| | - Guoping Ji
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
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