Disclosure of HIV Status: Experiences and Perceptions of Persons Living With HIV/AIDS and Nurses Involved in Their Care in Africa

Greeff, Minrie; Phetlhu, René; Makoae, Lucia N.; Dlamini, Priscilla S.; Holzemer, William L.; Naidoo, Joanne R.; Kohi, Thecla W.; Uys, Leana R.; Chirwa, Maureen

doi:10.1177/1049732307311118

Cited by 178 publications

(235 citation statements)

References 28 publications

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“…These patterns of association suggest that differences in disclosure target and intention may partly explain the previous inconsistent results on disclosure, stigma and social support (Chaudoir et al, 2011;Smith et al, 2008). It confirms previous findings that stigma and social support may play different roles in disclosure decisions to partners, family, friends or broader community (Bairan et al, 2007;Derlega et al, 2002), and that consequences may differ when disclosing to different types of actors (Greeff et al, 2008;Norman et al, 2007).…”

Section: Discussionsupporting

confidence: 80%

“…Indeed, qualitative data show that PLWH opt to disclose mainly to spouse, close family and friends and less to the larger social network (Deribe et al, 2008;Lugalla et al, 2012), and that certain types of actors, e.g. partners and relatives, are sometimes considered mutuallyexclusive choices for disclosure (Antelman et al, 2001, Greeff et al, 2008. Although levels of voluntary disclosure to specific actors are low compared with other populations (Mayfield Arnold et al, 2008), our sample has comparatively higher overall disclosure levels than other studies in the region (Medley et al, 2004).…”

Section: Discussionmentioning

confidence: 58%

“…This assumption might not hold, as several studies, both qualitative and quantitative, indicate that each act of disclosure to a particular type of actor may have different causes and consequences. For example, disclosure to a partner may be intended to prevent HIV transmission and to gain social support in the context of a steady relationship, disclosing to a family member may aim for emotional or financial support, while disclosing to a broader audience may be motivated by a wish to change the perception of PLWH by the community at large (Greeff et al, 2008;Sowell et al, 2003;Stutterheim, Shiripinda et al, 2011;Vu et al, 2012). Hence, other authors chose to analyze disclosure acts to different actor categories separately (Armistead et al, 1999;Tsai et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Dima

Stutterheim

Lyimo

et al. 2014

Social Science & Medicine

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Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent Dima, A.L.; Stutterheim, S.E.; Lyimo, R.; de Bruin, M. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Acknowledgements:The authors appreciatively acknowledge the financial assistance from RVVZ from the Netherlands, the participation of PLWH in our target group, and the cooperation of the management in the ART clinics where we conducted the study. Abstract:Disclosure of HIV status has been the focus of three decades of research, which have revealed its complex relations to many behaviors involved in HIV prevention and treatment, and exposed its central role in managing the HIV epidemic. The causes and consequences of disclosure acts have recently been the subject of several theoretical models. Although it is acknowledged that individual disclosure events are part of a broader process of disclosing one's HIV status to an increasing number of people, this process has received less theoretical attention. In quantitative studies of disclosure, researchers have often implicitly assumed that disclosure is a single unidimensional process appropriately measured via the total number of one's disclosure acts. However, there is also evidence that disclosure may have different causes and consequences depending on the types of actors involved (e.g. family members, friends) and on the presence or absence of the discloser's intention, suggesting that the unidimensionality assumption may not hold. We quantitatively examined the dimensionality of voluntary and involuntary disclosure to different categories of actors, using data collected via structured interviews in the spring of 2010 from 158 people living with HIV in Kilimanjaro, Tanzania. For voluntary disclosure, nonparametric item response analyses identified two multi-category clusters, family and community, and two single-category dimensions, partner and children. Involuntary disclosure consisted of several single-or twocategory dimensions. Correlation analyses between the resulting disclosure dimensions and stigma and social support revealed distinct relationships for each disclosure dimension. Our results suggest that treating disclosure as a unidimensional construct is a simplification of disclosure...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Dima

Stutterheim

Lyimo

et al. 2014

Social Science & Medicine

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“…A limitation of the study was that unfortunately, probably due to stigmatisation, which still exists among South African individuals49,50 and other aspects such as the illness itself and poverty,51 the participants did not visit the local clinic or hospital for follow up and CD 4 cell count determinations. Therefore the sample size of the nadir CD 4 cell count group was very small and those results should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

Is HIV-1 infection associated with endothelial dysfunction in a population of African ancestry in South Africa?

Fourie¹,

Rooyen²,

Pieters³

et al. 2011

CardioVascular Journal of Africa

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The chronic infection status suffered by HIV-infected individuals promotes chronic arterial inflammation and injury, which leads to dysfunction of the endothelium, atherosclerosis and thrombosis. Although HIV-1 subtype C is prevalent in South Africa and accounts for almost a third of the infections worldwide, this subtype differs genetically from HIV-1 subtype B on which the majority of studies have been done. The objective of this study was to assess whether newly identified, never-treated, HIV-1-infected South African participants showed signs of endothelial dysfunction, accelerated atherosclerosis and increased blood coagulation.We compared 300 newly diagnosed (never antiretroviral-treated) HIV-infected participants to 300 age-, gender-, body mass index- and locality-matched uninfected controls. Levels of high-density lipoprotein cholesterol (HDL-C), triglycerides, interleukin-6 (IL-6), C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), fibrinogen and plasminogen activator inhibitor-1 (PAI-1), and carotid radialis pulse wave velocity (cr-PWV) were determined. The HIV-infected participants showed lower HDL-C and higher IL-6, CRP, ICAM-1 and VCAM-1 levels compared to the uninfected controls. No differences in fibrinogen and PAI-1 levels were detected. A continuous positive trend of increasing age with cr-PWV was detected in the HIV-infected group.Our findings suggest inflammatory injury of the endothelium, pointing to endothelial dysfunction of never-treated HIV-1-infected South Africans of African ancestry. Although no indication of a prothrombotic state could be detected, there was an indication of accelerated vascular aging and probable early atherosclerosis in the older HIV-infected participants.

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“…Especially among Africans, the disclosure of a positive HIV status can be often characterized as a double edged sword where disclosure can either promote or enhance physical, social and psychological wellbeing or result in discrimination, stigmatization, rejection, abandonment, loss of employment, emotional and physical abuse especially directed at women and other negative social consequences [9][10][11]. In spite of this, disclosure remains an integral part of prevention and control within the continuum of the HIV care process.…”

Section: Introductionmentioning

confidence: 99%

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Iwu¹,

Duru²,

Diwe³

et al. 2017

J AIDS Clin Res

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Background: The non-disclosure of HIV positive status has most often been accompanied by risky sexual behaviours which is a complex relationship that facilitates the transmission of sexually transmitted diseases such as HIV.Objective: To determine sexual behaviour, levels of sero-status disclose and willingness to disclose; and the socio-demographic determinants of disclosure and willingness to disclose among HIV positive male patients receiving care in hospitals in Imo State, Nigeria. Methods:A cross sectional analytical design using a simple random sampling technique to select 422 HIV male patients attending the adult HIV clinics of two major hospitals. Data was collected using a pretested, semi structured questionnaire. Descriptive statistics were presented using frequencies and summary indices. Chi square statistics were computed to determine significant relationships and binary logistic regression was used to determine predictors of disclosure and willingness to disclose. A p-value of ≤ 0.05 was considered significant. Results:A majority of the respondents were either traders or artisans (54.6%) with a mean age of 32.0 ± 2.0 years. The results revealed that more than one third of the respondents had two or more sexual partners (35.5%), less than one quarter correctly and consistently use condoms (23.3%) and close to one third had not disclosed their HIV positive status (31.7%); of which, less than two fifths are now willing to disclose (37.8%). It was further revealed that married HIV positive male patients who are traders or artisans above the age of 30 years with monthly income levels less than N40,000 ($110) and living in an urban or semi urban area with family members or other people, were significantly more likely to have disclosed their HIV positive status. Similarly, HIV positive male patients who had not disclosed their status, but are artisans aged above 30 years, were significantly more likely to be willing now to disclose their HIV positive status.

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Disclosure of HIV Status: Experiences and Perceptions of Persons Living With HIV/AIDS and Nurses Involved in Their Care in Africa

Cited by 178 publications

References 28 publications

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

Is HIV-1 infection associated with endothelial dysfunction in a population of African ancestry in South Africa?

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

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