Purpose Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. The current study addressed this research gap, and explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Participants and Methods We conducted 12 in-depth interviews with the help of a translated interview guide, and they were audio recorded. Participants were purposively enrolled in the study, which employed a phenomenological qualitative design. The study was conducted at three public health facilities in Mbarara City. The data was analyzed using thematic content analysis. Approval for this research was obtained from the Mbarara University Research Ethics Committee (MUST-REC) and administrative clearance from the city clerk of Mbarara City. Results The mean age of the participants was 38 years old, ranging from 20 to 67 years. An equal number of males (six) and females participated in this study. Most of them had at least secondary level education, and only three had primary education. Half of the participants disclosed their serostatus to partners immediately after testing HIV positive. Key emerging themes as experienced benefits of HIV serostatus disclosure included: 1) social support and care; 2) decisions regarding health, fertility, and child bearing; 3) sharing information on HIV prevention and protection measures; 4) positive living; and 5) ease of HIV serostatus disclosure. The challenges associated with serostatus disclosure were summarized as one theme: misunderstandings in the families of the discordant couples. Conclusion Socially, psychologically and financially HIV positive individuals have benefited from their negative partners. Healthwise, they have been supported, and cared for after disclosing their positive status, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Background Sexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. Methods We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25). Results Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0–14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16–1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26–2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99–2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47–6.21) or no education (AOR = 1.84, 95%CI: 1.21–3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56–7.30) or often (AOR = 12.87, 95%CI: 5.64–29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29–0.92) were less likely to experience sexual violence. Conclusions There is a need to demystify negative culturally-rooted beliefs favouring sexual violence, such as justified beating, as well as increase efforts to promote women’s empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount to addressing male-related issues that expose women to sexual violence.

BackgroundSex work is a global driver of the HIV epidemic, and the risk of acquiring HIV is 13 times higher for female sex workers (FSWs) compared to the general population. The enrollment and retention of FSWs in HIV care is a challenge and has been a major contributing factor to increased new HIV infections.MethodsWe conducted a qualitative study among 30 FSWs and 21 healthcare workers (HCWs) working in antiretroviral therapy (ART) clinics at the selected three primary health facilities in Mbarara City, Southwestern Uganda. The study participants were enrolled by both purposive and snowball sampling techniques. We obtained informed consent from all the participants, and data were collected using in-depth interviews and thematically analyzed.ResultsThree themes emerged as facilitators toward enrollment and retention of FSWs into HIV care, namely, (1) good health living, (2) receptive HCWs and availability of health services, and (3) community outreach services and peer support. The barriers are summarized into four major themes: (1) stigma, community discrimination, and beliefs; (2) social obstacles; (3) adverse effects of ART; and (4) inadequate services at the health facilities.ConclusionFSWs are challenged by unsupportive environments and communities where they live and work, which hinders their enrollment and retention in HIV care. Creating awareness of the utilization of HIV care services and extending such services to hotspot communities could enhance the response of HIV-positive FSWs to ART.

Stigma and discrimination (SAD) remains a major challenge facing HIV/AIDs management in most countries of sub-Saharan Africa. Expert clients can potentially play a role in the fight against SAD. Our study explored the experiences and the role of expert clients in reducing SAD among people living with HIV/AIDs enrolled on care in health facilities in Western Uganda. Participants and Materials:We conducted a phenomenological qualitative study among (12) twelve purposively selected expert clients at four health facilities in Sheema district, Western Uganda. In-depth interviews were conducted using an interview guide. Data were transcribed verbatim, translated to English, manually coded and analysed manually by thematic content. Results: Four themes emerged describing the experiences of expert clients in reducing HIV/AIDs SAD; 1) Feeling of inner satisfaction, 2) Challenging work environment, 3) Acquisition of skills and 4) Disclosure dilemma. The roles of expert clients in reducing HIV-related SAD included 1) Facilitating status disclosure, 2) Identifying and helping clients with stigma/discrimination, 3) Linking patients to the health care system and 4) Promotion of positive living. Conclusion: Expert clients had numerous experiences and play a key role in the fight against SAD. Expert clients should be included as one of the stakeholders in the efforts to reduce or eradicate SAD in the management of HIV/AIDs.

Background Sexual violence against women is a global public health issue with both short and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. Methods We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence, using SPSS (version 25). Results Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0-14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16–1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26–2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99–2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47–6.21) or no education (AOR = 1.84, 95%CI: 1.21–3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56–7.30) or often (AOR = 12.87, 95%CI: 5.64–29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29–0.92) were less likely to experience sexual violence. Conclusions There is a need to demystify negative culturally-rooted beliefs favouring sexual violence such as justified beating as well as increasing efforts to promote women's empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount in addressing male-related issues that expose women to sexual violence.