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Worku WZ, Azale T, Ayele TA, Mekonnen DK. Women's voices: the lived experience of HIV-positive women in the postpartum period at the University of Gondar comprehensive specialized referral hospital, Ethiopia: a phenomenological study. BMC Womens Health 2023; 23:325. [PMID: 37344854 DOI: 10.1186/s12905-023-02470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Pregnancy and the postpartum period are incredibly challenging for women living with the Human Immune Deficiency Virus (HIV) due to the multidimensional influence of HIV infection. These women experience the challenges of navigating pregnancy and motherhood while living with HIV. It is poorly understood how women living with HIV (WLWH) experience pregnancy and postpartum. Therefore, the current study aimed to explore the lived experience of pregnancy and postpartum among women living with HIV. METHODS A phenomenological qualitative study design was employed. A semi-structured, interview guide was used to conduct in-depth interviews with HIV-positive postpartum women from April to May 2022. All interviews were recorded using a voice recorder and note was taken. The collected data were transcribed and translated into English for analysis. Inductive thematic analysis was applied to analyze the data. RESULTS Six main themes about the lived experience of women living with HIV were identified: (1) Fear and distress related to maternal and child Health, (2) HIV status self-disclosure dilemma, (3) Courage and commitment of HIV-positive women to prevent HIV, (4) Challenges faced and coping mechanisms used by HIV-positive women, (5) Health care providers and HIV-positive women interaction, and (6) Solution from their voices. CONCLUSION HIV infection also has a multidimensional impact on women's life during pregnancy and postpartum. The findings of this study improve our understanding of the lived experience of HIV-positive women while pregnant and in the postpartum period. These women's descriptions showed that they have been experiencing various challenges that are not often addressed in antenatal clinics, such as distress and uncertainties related to vertical transmission of HIV. These women need specialized support and all-encompassing care to have a healthy pregnancy and postpartum period. Moreover, it is essential to understand the circumstances of women's lives, their relationships with others, and their decision-making processes. Healthcare professionals and other responsible bodies working with women living with HIV should encourage and support these mothers to appraise and maintain their commitment to protecting their children from acquiring HIV infection and maintaining their Health to the maximum to raise their children.
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Affiliation(s)
- Workie Zemene Worku
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Pralat R, Anderson J, Burns F, Yarrow E, Barber TJ. Discussing parenthood with gay men diagnosed with HIV: a qualitative study of patient and healthcare practitioner perspectives. BMC Public Health 2021; 21:2300. [PMID: 34923967 PMCID: PMC8684690 DOI: 10.1186/s12889-021-12285-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate. METHODS Qualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20-45, who did not have children, and 16 HIV clinicians. A thematic analysis identified potential reasons why parenthood was rarely discussed with gay men in HIV care. RESULTS Two sets of ideas contributed to a lack of conversations about parenthood: clinicians' ideas about what matters to gay men and men's ideas about what it means to be HIV-positive. Both sets of ideas largely excluded having children, with patients and practitioners similarly unlikely to raise the topic of parenthood in the clinic. Contrary to what clinician commonly assumed, many men expressed interest in receiving more information, highlighting the importance of reassuring people upon diagnosis that it is possible to become parents while living with HIV. CONCLUSIONS Parenting desires and intentions were rarely discussed with men in HIV care. Our findings illuminate the potentially beneficial effects of emphasising that having children is a possibility at diagnosis, regardless of patients' gender or sexuality. Conveying this information seems meaningful, not only to men who want to become parents in the future but also to others, as it appears to alleviate fears about mortality and ill health.
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Affiliation(s)
- Robert Pralat
- Department of Sociology, University of Cambridge, 16 Mill Lane, Cambridge, CB2 1SB, UK.
| | - Jane Anderson
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - Elizabeth Yarrow
- Centre for Gender Studies, University of Cambridge, Cambridge, UK
| | - Tristan J Barber
- Institute for Global Health, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
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Wiginton JM, Maksut JL, Murray SM, Augustinavicius JL, Kall M, Delpech V, Baral SD. Brief report: HIV-related healthcare stigma/discrimination and unmet needs among persons living with HIV in England and Wales. Prev Med Rep 2021; 24:101580. [DOI: 10.1016/j.pmedr.2021.101580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 11/25/2022] Open
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My Whole World Changed: A Qualitative Exploration of the Coping Experiences of Transgender Women After an HIV Diagnosis. J Assoc Nurses AIDS Care 2020; 31:654-668. [PMID: 33060378 DOI: 10.1097/jnc.0000000000000200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this study was to generate a theoretical stage model that describes transgender women's coping strategies and responses after a new HIV diagnosis. The sample included 18 transgender women living with HIV in a large metropolitan city in central Indiana. Semi-structured interviews were conducted, digitally recorded, transcribed verbatim, and analyzed using grounded theory methods. Participants commonly described the experience of being newly diagnosed with HIV as, having the world change. Four stages through which attempts at coping occurred were identified: having the world come crashing down; shutting out the world; living in a dark world; and reconstructing the world. This model advances our understanding of the social and behavioral factors that influence how transgender women cope with a new HIV diagnosis and how their coping responses influence entry and engagement in the HIV care continuum.
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Payán DD, Derose KP, Fulcar MA, Farías H, Palar K. "It Was as Though My Spirit Left, Like They Killed Me": The Disruptive Impact of an HIV-Positive Diagnosis among Women in the Dominican Republic. J Int Assoc Provid AIDS Care 2020; 18:2325958219849042. [PMID: 31109213 PMCID: PMC6748475 DOI: 10.1177/2325958219849042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
An HIV diagnosis may be associated with severe emotional and psychological distress,
which can contribute to delays in care or poor self-management. Few studies have explored
the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in
low-resource settings. We conducted in-depth interviews with 30 women living with HIV in
the Dominican Republic. Interviews were audio-recorded, transcribed, and analyzed using
the biographical disruption framework. Three disruption phases emerged (impacts of a
diagnosis, postdiagnosis turning points, and integration). Nearly all respondents
described the news as deeply distressful and feelings of depression and loss of self-worth
were common. Several reported struggling with the decision to disclose—worrying about
stigma. Postdiagnosis turning points consisted of a focus on survival and motherhood;
social support (family members, friends, HIV community) promoted integration. The findings
suggest a need for psychological resources and social support interventions to mitigate
the negative impacts of an HIV diagnosis.
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Affiliation(s)
- Denise Diaz Payán
- 1 Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, CA, USA.,2 RAND Corporation, Santa Monica, CA, USA
| | | | - María Altagracia Fulcar
- 3 United Nations World Food Programme, Dominican Republic Country Office, Santo Domingo, Dominican Republic
| | - Hugo Farías
- 4 United Nations World Food Programme, Regional Office for Latin America and the Caribbean, Panamá, Dominican Republic
| | - Kartika Palar
- 5 School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Taylor TN, DeHovitz J, Hirshfield S. Intersectional Stigma and Multi-Level Barriers to HIV Testing Among Foreign-Born Black Men From the Caribbean. Front Public Health 2020; 7:373. [PMID: 31998675 PMCID: PMC6965168 DOI: 10.3389/fpubh.2019.00373] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 11/21/2019] [Indexed: 01/08/2023] Open
Abstract
Testing is the entry point into the HIV care continuum that includes linkage to and retention in prevention services, and adherence to prevention strategies, including repeat HIV testing. Despite US policy approaches to expand HIV testing to diverse clinical care and community settings, disparities in HIV testing among Black populations persist. Foreign-born (FB) Black persons from the Caribbean have higher annual rates of HIV diagnosis and a higher percentage of late-stage HIV diagnosis, compared with US-born Black persons; and most HIV infections among FB Blacks are among men. In this article, we provide an overview of HIV testing barriers among FB Black men who engage in HIV risk-taking behaviors (e.g., condomless sex with male and/or female partners of unknown HIV serostatus). Barriers to HIV testing for both FB and US-born Black men, include HIV stigma (anticipated, perceived, internalized), low perceived HIV risk, medical or government mistrust, and perceived low access to testing resources. We examine beliefs about masculinity and gender roles that may perpetuate heteronormative stereotypes associated with perceptions of low HIV risk and barriers to HIV testing. We also discuss the impact of recent immigration policies on accessing HIV testing and treatment services and how intersectional stigmas and structural forms of oppression, such as racism, prejudice against select immigrant groups, and homophobia that may further amplify barriers to HIV testing among FB Black men. Finally, we review comprehensive prevention approaches, and suggest innovative approaches, that may improve the uptake of HIV testing among FB Black men.
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Affiliation(s)
- Tonya N. Taylor
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Abstract
AbstractCognitive behaviour therapy (CBT) as a treatment for schizophrenia and psychotic-related disorders has been shown to have significantly greater drop-out rates in clients of black and minority ethnic (BME) groups. This has resulted in poor outcomes in treatments. Our recent qualitative study thus aimed to develop culturally sensitive CBT for BME clients. The study consisted of individual in-depth 1:1 interviews with patients with a diagnosis of schizophrenia, schizo-affective, delusional disorders or psychosis (n = 15) and focus groups with lay members (n = 52), CBT therapists (n = 22) and mental health practitioners (n = 25) on a data set of 114 participants. Several themes emerged relating to therapist awareness on culturally derived behaviours, beliefs and attitudes that can influence client response and participation in therapy. The current paper aims to explore one of these themes in greater detail, i.e. client-initiated therapist self-disclosure (TSD). Using thematic analysis, the paper highlights key elements of TSD and how this could impact on therapist’s reactions towards TSD, the therapeutic alliance and ultimately, the outcomes of therapy. The findings appear to show that TSD has significant relevance in psychological practice today. Some BME client groups appear to test therapists through initiating TSD. It is not the content of TSD they are testing per se, but how the therapist responds. Consequently, this requires therapists’ cognisance and sensitive responses in a manner that will nurture trust and promote rapport. Further investigation in this area is suggested with a recommendation for guidelines to be created for clinicians and training.Key learning aims(1)To develop a dialogue and practice with confidence when addressing issues of self-disclosure with diverse populations.(2)To appreciate the impact therapist self-disclosure has in early stages of engagement, in particular when working with patients from BME communities.(3)To understand the impact and role of self-disclosure as initiated by patients.(4)To increase therapist awareness on cultural differences in self-disclosure and develop ways to address this in therapy.(5)To challenge therapists to adapt psychological therapies to diverse cultures and be cognisant that ‘one size does not fit all’.
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Sayan M, Hınçal E, Şanlıdağ T, Kaymakamzade B, Sa’ad FT, Baba IA. Dynamics of HIV/AIDS in Turkey from 1985 to 2016. ACTA ACUST UNITED AC 2017; 52:711-723. [PMID: 32214507 PMCID: PMC7088870 DOI: 10.1007/s11135-017-0648-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this paper, we formulated a mathematical model that studies the dynamics of HIV/AIDS in Turkey from 1985 to 2016. We find two equilibrium points, disease free equilibrium and endemic equilibrium. Global stability analysis of the equilibria was conducted using Lyapunov function which depends on the basic reproduction ratio R0. If R0 < 1, the disease free equilibrium point is globally asymptotically stable, and if R0 ≥ 1 the endemic equilibrium point is globally asymptotically stable. We computed and predicted the basic reproduction ratios across all the years. It was found out that there were flaws in the exact values of R0 which is related to the poor registration system of HIV/AIDS in Turkey. Hence, there is need for the government to improve the system in order to cover the actual cases of the disease. The increase of the basic reproduction ratio over the years also shows the need for the relevant authorities to adopt appropriate control measures in combating the disease.
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Affiliation(s)
- Murat Sayan
- PCR Unit, Clinical Laboratory, Faculty of Medicine, Kocaeli University, Izmit, Kocaeli Turkey
| | - Evren Hınçal
- Department of Mathematics, Near East University, Nicosia, Northern Cyprus Turkey
| | - Tamer Şanlıdağ
- Department of Medical Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
- Research Center of Experimental Health Sciences, Near East University, Nicosia, Northern Cyprus Turkey
| | - Bilgen Kaymakamzade
- Department of Mathematics, Near East University, Nicosia, Northern Cyprus Turkey
| | - Farouk Tijjani Sa’ad
- Department of Mathematics, Near East University, Nicosia, Northern Cyprus Turkey
| | - Isa Abdullahi Baba
- Department of Mathematics, Near East University, Nicosia, Northern Cyprus Turkey
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Behlau M, Madazio G, Oliveira G. Functional dysphonia: strategies to improve patient outcomes. PATIENT-RELATED OUTCOME MEASURES 2015; 6:243-53. [PMID: 26664248 PMCID: PMC4671799 DOI: 10.2147/prom.s68631] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient’s perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient’s recovery. An international multicentric effort, involving a large population of voice-disordered patients with no physical pathology, could produce enough data for achieving a consensus regarding this complex problem.
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Affiliation(s)
- Mara Behlau
- Voice Department, Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Glaucya Madazio
- Voice Department, Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Gisele Oliveira
- Voice Department, Centro de Estudos da Voz - CEV, São Paulo, Brazil
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Highton S, Finn MD. HIV positive men as fathers: Accounts of displacement, ir/responsibility and paternal emergence. Health (London) 2015; 20:291-307. [PMID: 25908642 DOI: 10.1177/1363459315583157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
It is now apparent that socio-cultural constructions of masculinity variously impact men's experiences of their HIV positive status, yet how being a father can feature in this mix remains under-researched. This study employed in-depth semi-structured interviews and Foucauldian-informed discourse analysis to explore the accounts of six self-identifying heterosexual fathers (four Black African migrants, two White European) who had been living with HIV from 5 to 24 years. While the HIV-related literature calls for the need to subvert 'traditional' expressions of masculinity as a means of promoting HIV prevention and HIV health, we argue that the lived experience for HIV positive men as fathers is more socially, discursively and thus more psychologically nuanced. We illustrate this by highlighting ways in which HIV positive men as fathers are not simply making sense of themselves as a HIV positive man for whom the modern (new) man and father positions are useful strategies for adapting to HIV and combating associated stigma. Discourses of modern and patriarchal fatherhoods, a gender-specific discourse of irresponsibility and the neoliberal conflation of heath and self-responsibility are also at work in the sense-making frames that HIV positive men, who are also fathers, can variously deploy. Our analysis shows how this discursive mix can underpin possibilities of often conflicted meaning and identity when living as a man and father with HIV in the United Kingdom, and specifically how discourses of fatherhood and HIV 'positive' health can complicate these men's expressions and inhabitations of masculinity.
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Kose S, Mandiracioglu A, Mermut G, Kaptan F, Ozbel Y. The Social and Health Problems of People Living with HIV/AIDS in Izmir, Turkey. Eurasian J Med 2015; 44:32-9. [PMID: 25610202 DOI: 10.5152/eajm.2012.07] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 10/27/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members. MATERIALS AND METHODS Three large state hospitals in the metropolitan area of Izmir participated in the study. Six focus groups were conducted with people infected with HIV (n=32) and their family members (n=11). Participants were asked to fill out a questionnaire to assess their HIV/AIDS knowledge and to convey how the stigma had affected them. RESULTS The most important problems identified were society and work-related social problems and access to health services. The patients and their family members stated that education was needed to correct misconceptions about HIV and to help them cope with related problems. We found that patients and their family members were sensitive about disclosure. CONCLUSION We determined the education, counseling and support needs of HIV-infected patients and their families. Additionally, we found that health personnel who monitor the patients should make more efforts on patients' education and counselling.
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Affiliation(s)
- Sukran Kose
- Clinic of Infectious Diseases, Ministry of Health Tepecik Hospital, Izmir, Turkey
| | - Aliye Mandiracioglu
- Department of Public Health, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gulsen Mermut
- Clinic of Infectious Diseases, Ministry of Health Bozyaka Hospital, Izmir, Turkey
| | - Figen Kaptan
- Clinic of Infectious Diseases, Ministry of Health Ataturk Hospital, Izmir, Turkey
| | - Yusuf Ozbel
- Department of Parasitology, Faculty of Medicine, Ege University, Izmir, Turkey
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Walcott MM, Ehiri J, Kempf MC, Funkhouser E, Bakhoya M, Aung M, Zhang K, Jolly PE. Gender Norms and Family Planning Practices Among Men in Western Jamaica. Am J Mens Health 2014; 9:307-16. [PMID: 25077729 DOI: 10.1177/1557988314543792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to identify the association between gender norms and family planning practices among men in Western Jamaica. A cross-sectional survey of 549 men aged 19 to 54 years attending or visiting four government-operated hospitals was conducted in 2011. Logistic regression models were used to identify factors associated with taking steps to prevent unwanted pregnancy, intention to have a large family size (three or more children), and fathering children with multiple women. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated from the models. Reduced odds for taking steps to prevent unwanted pregnancy among men with moderate (AOR = 0.5; 95% CI = 0.3-0.8) and high (AOR = 0.3; 95% CI = 0.1-0.6) support for inequitable gender norms was observed. Desiring large family size was associated with moderate (AOR = 2.0; 95% CI = 1.3-2.5) and high (AOR = 2.6; 95% CI = 1.5-4.3) support for macho scores. For men with two or more children (41%), there were increased odds of fathering children with multiple women among those who had moderate (AOR = 2.1; 95% CI = 1.0-4.4) and high (AOR = 2.4; 95% CI = 1.1-5.6) support for masculinity norms. Support for inequitable gender norms was associated with reduced odds of taking steps to prevent unwanted pregnancy, while support for masculinity norms was associated with desiring a large family size and fathering children with multiple women. These findings highlight the importance of including men and gender norms in family planning programs in Jamaica.
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Affiliation(s)
| | | | | | | | | | - Maung Aung
- Cornwall Regional Hospital, St James, Jamaica
| | - Kui Zhang
- University of Alabama at Birmingham, AL, USA
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Walcott MM, Jolly PE, Ehiri JE, Funkhouser E, Kempf MC, Hickman D, Aung M, Zhang K. Factors associated with the acceptability of male circumcision among men in Jamaica. PLoS One 2013; 8:e75074. [PMID: 24066164 PMCID: PMC3774608 DOI: 10.1371/journal.pone.0075074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 08/10/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To determine the prevalence of male circumcision (MC) among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year) and older sons (1-17 years). METHODS A cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated from the models. RESULTS Fourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9), believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2), and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8). Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self. CONCLUSION Providing men with information about MC increased acceptance of MC for self, infants (<17 years) and sons (1-17 years). Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.
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Affiliation(s)
- Melonie M. Walcott
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Pauline E. Jolly
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
| | - John E. Ehiri
- Division of Health Promotion Sciences, University of Arizona, Tucson, Arizona, United States of America
| | - Ellen Funkhouser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Mirjam C. Kempf
- Department of Family/Child Health and Caregiving and Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Deborah Hickman
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Maung Aung
- Epidemiology Unit, Western Regional Health Authority, Jamaica
| | - Kui Zhang
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Cain R, Jackson R, Prentice T, Collins E, Mill J, Barlow K. The experience of HIV diagnosis among Aboriginal people living with HIV/AIDS and depression. QUALITATIVE HEALTH RESEARCH 2013; 23:815-824. [PMID: 23539094 DOI: 10.1177/1049732313482525] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this article, we consider how the broad context of Aboriginal people's lives can shape their experience and understanding of their HIV diagnosis. We conducted interviews across Canada with 72 Aboriginal people living with HIV who also reported feelings of depression. Consistent with what has been found in previous studies, participants responded to their HIV diagnosis with shock, disbelief, and often anger. Prior depression, drug and alcohol use, multiple losses, stigma, and social isolation also shaped how participants experienced their diagnosis. We consider how the history of colonization of Aboriginal communities in Canada relates to the experience of HIV diagnosis, and end with a discussion of the service implications of our findings.
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Affiliation(s)
- Roy Cain
- School of Social Work (KTH-312), McMaster University, Hamilton, Ontario, Canada.
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Wekesa E, Coast E. Living with HIV postdiagnosis: a qualitative study of the experiences of Nairobi slum residents. BMJ Open 2013; 3:e002399. [PMID: 23645922 PMCID: PMC3646186 DOI: 10.1136/bmjopen-2012-002399] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 02/18/2013] [Accepted: 03/25/2013] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To characterise the experiences of heterosexual men and women living with HIV postdiagnosis and explain these experiences in relation to their identity and sexuality. DESIGN Qualitative study using in-depth interviews and a theoretically informed biographic disruption theory. SETTING Interviews were conducted in two Nairobi slums (Kenya). PARTICIPANTS 41 HIV-infected heterosexual men and women aged 18 years or older. RESULTS People living with HIV have divergent experiences surrounding HIV diagnosis. Postdiagnosis, there are multiple phases of identity transition, including status (non-)disclosure, and attempts at identity repair and normalcy. For some people, this process involves a transition to a new self-identity, incorporating both HIV and antiretroviral treatment (ART) into their lives. For others, it involves a partial transition, with some aspects of their prediagnosis identity persisting, and for others it involves a rejection of HIV identity. Those people who were able to incorporate HIV/AIDS in their identity, without it being disruptive to their biography, were pursuing safer sexual and reproductive lives. By contrast, those people with a more continuous biography continued to reflect their prediagnosis identity and sexual behaviour. CONCLUSIONS People living with HIV/AIDS (PLWHA) had to rework their sense of identity following diagnosis in the context of living in a slum setting. Men and women living with HIV in slums are poorly supported by health systems and services as they attempt to cope with a diagnosis of HIV. Given the availability of ART, health services and professionals need to support the rights of PLWHA to be sexually active if they want to and achieve their fertility goals, while minimising HIV transmission risk.
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Affiliation(s)
- Eliud Wekesa
- London School of Economics—Social Policy, London, UK
| | - Ernestina Coast
- Population Council, Reproductive Health Program, Nairobi, Kenya
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16
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Anderson M, Asnani M. "You just have to live with it": coping with sickle cell disease in Jamaica. QUALITATIVE HEALTH RESEARCH 2013; 23:655-64. [PMID: 23459927 DOI: 10.1177/1049732313480048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Research has shown that living with sickle cell disease (SCD) can be a considerable challenge. Unfortunately, although it is Jamaica's most common genetic disorder, to date, no qualitative research has been conducted on Jamaicans' experiences of SCD. We conducted thematic analysis on transcripts of in-depth semistructured interviews with 30 patients and found two interlinked themes bound up in life with SCD: loss and control. Faced with important losses, respondents used cognitive and behavioral coping strategies to reestablish control over their response to SCD, others' responses to SCD, and SCD's physical manifestations. Although the adaptive nature of some of these strategies is debatable, many facilitate management of the illness. Health care practitioners should encourage positive coping strategies and have nonjudgmental discussions with patients about (potentially) negative ones. They should also share information with nonspecialist doctors and nurses to reduce stigmatization around the illness. More exploration of this underresearched topic is needed.
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Affiliation(s)
- Moji Anderson
- Department of Sociology, Psychology and Social Work, University of the West Indies, Kingston, Jamaica.
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17
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Ribeiro Nobre N, Kylmä J, Kirsi T. "I Live Quite a Good Balanced Life": A Pilot Study on the Life Experiences of Ageing Individuals Living with HIV. Nurs Res Pract 2012; 2012:128108. [PMID: 22761996 PMCID: PMC3385662 DOI: 10.1155/2012/128108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/08/2012] [Indexed: 11/17/2022] Open
Abstract
An ageing population is accompanied by an increased number of older adults living with HIV. So far, our knowledge regarding the life experiences of older adults living with HIV is still poor and under researched. The purpose of this study is to present new knowledge by interviewing nine Finnish HIV-positive individuals of 50 years of age and older. The data were analysed by inductive content analysis. Living with HIV is shaped by unique personal life experiences. These experiences played an important role on how the interviewees assessed their lives and their future as HIV positive individuals. Most of the participants reacted negatively to their HIV-positive diagnosis. However, throughout time they had found meaning in their lives and had developed a degree of positive attitude towards life and future which was articulated in terms of a good overall balanced life. Since caring is the tenor of the nursing profession, nurses should be able to identify and implement methods for assessing how successfully older adults living with HIV age and intervene in an informed way whenever needed.
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Affiliation(s)
- Nuno Ribeiro Nobre
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
| | - Jari Kylmä
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
| | - Tapio Kirsi
- School of Health Sciences, Public Health, University of Tampere, 33014 Tampere, Finland
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18
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Stutterheim SE, Bos AE, Shiripinda I, de Bruin M, Pryor JB, Schaalma HP. HIV-related stigma in African and Afro-Caribbean communities in the Netherlands: Manifestations, consequences and coping. Psychol Health 2012; 27:395-411. [DOI: 10.1080/08870446.2011.585426] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Harding R, Liu L, Catalan J, Sherr L. What is the evidence for effectiveness of interventions to enhance coping among people living with HIV disease? A systematic review. PSYCHOL HEALTH MED 2011; 16:564-87. [DOI: 10.1080/13548506.2011.580352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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Kako PM, Stevens PE, Karani AK. Where will this illness take me? Reactions to HIV diagnosis from women living with HIV in Kenya. Health Care Women Int 2011; 32:278-99. [PMID: 21409662 DOI: 10.1080/07399332.2010.530727] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of our study was to develop an in-depth understanding of the reactions of 40 urban and rural HIV-infected Kenyan women to HIV diagnosis. We employed narrative inquiry principles to guide this qualitative cross-sectional study. We conducted individual in-depth interviews using open-ended questions in April and May 2006. In this article we focus on women's reactions to HIV diagnosis, under which four subthemes emerged: immediate intense emotions; keeping HIV status secret; acceptance of HIV diagnosis; and finding liberation in disclosure. We offer important implications for health care professionals serving women in sub-Saharan Africa from the findings of our study.
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Affiliation(s)
- Peninnah M Kako
- College of Nursing, University of Wisconsin-Milwaukee, 53201, USA.
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21
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Ghose T, Swendeman DT, George SM. The role of brothels in reducing HIV risk in Sonagachi, India. QUALITATIVE HEALTH RESEARCH 2011; 21:587-600. [PMID: 21266706 DOI: 10.1177/1049732310395328] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
High rates of empowerment, HIV-related knowledge, and condom use among sex workers in Sonagachi, India have been attributed to a community-led intervention called the Sonagachi HIV/AIDS Intervention Program (SHIP). In this research we examined the crucial role of brothels in the success of the intervention. In-depth, semistructured interviews were conducted with 55 participants of SHIP. The results indicate that brothels help sex workers reduce HIV risk by (a) serving as targeted sites for SHIP's HIV intervention efforts, (b) being operated by madams (women managers of brothels) who participate in SHIP's intervention efforts and promote healthy regimes, (c) structuring the economic transactions and sexual performances related to sex work, thus standardizing sex-related behavior, and (d) promoting community empowerment among brothel residents. Implications of these results are discussed for future efforts to replicate SHIP's success in other sex work communities.
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Affiliation(s)
- Toorjo Ghose
- University of Pennsylvania, Philadelphia, PA, USA.
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22
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Anderson M, Elam G, Gerver S, Solarin I, Fenton K, Easterbrook P. “It took a piece of me”: initial responses to a positive HIV diagnosis by Caribbean people in the UK. AIDS Care 2010; 22:1493-8. [DOI: 10.1080/09540121.2010.482125] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Moji Anderson
- a Department of Sociology, Psychology and Social Work , University of the West Indies , Mona , Kingston , Jamaica
| | - Gillian Elam
- b Centre for Sexual Health and HIV Research , University College London , London , UK
| | - Sarah Gerver
- c Department of Infectious Disease Epidemiology , Imperial College London , London , UK
| | - Ijeoma Solarin
- d Reproductive Health Research Unit , University of Witswatersrand , Johannesburg , South Africa
| | - Kevin Fenton
- e National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
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