Factors influencing HIV disclosure among people living with HIV/AIDS in Nigeria: a systematic review using narrative synthesis and meta-analysis

Adeoye-Agboola, Dorcas; Evans, Hala; Hewson, David; Pappas, Yannis

doi:10.1016/j.puhe.2016.02.021

Cited by 37 publications

(33 citation statements)

References 30 publications

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“…We did not have information on the date of initial HIV diagnosis so we were unable to adjust for length of time living with HIV, which could significantly impact both depressive symptoms and ART initiation. Instead, we used time known to be in a serodiscordant relationship, which may only be an approximate proxy measure given that disclosure is challenging and participants could have delayed disclosing to their partners for a time after diagnosis (49,50). We also did not ascertain history of mental illness and it is unclear if depressive symptoms preceded HIV diagnosis (potentially indicative of longer-term depressive disorder) or if they were a result of recent HIV diagnosis (indicative of adjustment disorder with depressive symptoms).…”

Section: Discussionmentioning

confidence: 99%

Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

et al. 2017

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Background Depression is a known barrier for antiretroviral therapy (ART) adherence, but less is understood about its effects on ART initiation. Methods We followed 1,013 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. Results 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 six months after ART initiation (adjusted odds ratio [aOR] 0.34, 95% CI:0.23–0.51). Discussion 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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Section: Discussionmentioning

confidence: 99%

Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

et al. 2017

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“…Ample research has addressed the clinical and health system challenges of the HIV and TB co-epidemic [7,8], butas Daftary (2012) rightfully pointed out -"the social aspects remain relatively unexplored" [9], especially the potential stigma associated with HIV and TB in a setting confronted with this dual epidemic. Evidencebased knowledge on the double stigma generated by the interlinked nature of both epidemics is urgently needed as both HIV and TB stigma have been individually extensively associated with non-disclosure [10][11][12], delayed health care [13][14][15][16], and ultimately worse (physical and psychological) health outcomes [10,14,[17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers

et al. 2020

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Background: HIV and tuberculosis (TB) are intricably interlinked in South Africa. The social aspects of this coepidemic 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 coepidemic, not only in medical-clinical terms, but also in its social consequences.

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“…Stigma is a discrediting social label that changes the way persons view themselves and the and social exclusion are important reasons for nondisclosure [5].…”

Section: Introductionmentioning

confidence: 99%

Work-related stigma and disclosure: A daily challenge for people living with HIV

Wagener

Opstal

Miedema

et al. 2017

WOR

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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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Factors influencing HIV disclosure among people living with HIV/AIDS in Nigeria: a systematic review using narrative synthesis and meta-analysis

Cited by 37 publications

References 30 publications

Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda

Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers

Work-related stigma and disclosure: A daily challenge for people living with HIV

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