Social context of disclosing HIV test results in Tanzania

Lugalla, Joe; Yoder, Stanley; Sigalla, Huruma Luhuvilo; Madihi, Charles

doi:10.1080/13691058.2011.615413

Cited by 39 publications

(44 citation statements)

References 16 publications

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“…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). This may be explained by the longer time elapsed since diagnosis, as likelihood of disclosure increases with time (Antelman et al, 2001;Lugalla et al, 2012). While previous research offered information on selected disclosure aspects, our method adds a more precise description of the likelihood and interdependence of disclosure to various actors and thus allows a structural view on disclosure processes.…”

Section: Discussionmentioning

confidence: 57%

“…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.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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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“…In this area, we see special emphasis placed on disclosure to sexual partners, medical injunctions (treatment literacy and adherence) and child desire. Indeed, as described by Lugalla, Madihi, Sigalla, Mrutu and Yoder (2008), HIV post-test counsellors spend time explaining how to live with the virus, where to go for help or support, whom to see for medical care, ways to maintain good health, and they urge their clients to tell someone else about their test results. In Burkina Faso, progress has been made to prevent mother-to-child HIV transmission and to enrol children living with HIV on ART.…”

Section: Introductionmentioning

confidence: 99%

Parental HIV disclosure in Burkina Faso: Experiences and challenges in the era of HAART

Tiendrebéogo¹,

Hejoaka²,

Belem³

et al. 2013

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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“…Disclosure is considered critical because (1) it allows individuals to garner social support for preventive actions; (2) disclosing to sexual partners helps prevent HIV transmission; and (3) it facilitates access social or medical services (i.e. Lugalla, Madihi, Sigalla, Mrutu & Yoder 2008). Disclosure may also help counter HIV stigma and allows individuals and couples to make informed reproductive health choices (Medley, Garcia-Moreno, McGill & Maman 2004;Skogmar, Shakely, Lans, Danell, Andersson, Tshandu, et al 2006).…”

Section: Introductionmentioning

confidence: 99%

The duty to disclose in Kenyan health facilities: a qualitative investigation of HIV disclosure in everyday practice

Moyer¹,

Igonya²,

Both³

et al. 2013

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Disclosure of HIV status is routinely promoted as a public health measure to prevent transmission and enhance treatment adherence support. While studies show a range of positive and negative outcomes associated with disclosure, it has also been documented that disclosing is a challenging and ongoing process. This article aims to describe the role of health-care workers in Central and Nairobi provinces in Kenya in facilitating disclosure in the contexts of voluntary counselling and testing and provider-initiated testing and counselling and includes a discussion on how participants perceive and experience disclosure as a result. We draw on in-depth qualitative research carried out in 2008-2009 among people living with HIV (PLHIV) and the health workers who provide care to them. Our findings suggest that in everyday practice, there are three models of disclosure at work: (1) voluntary-consented disclosure, in alignment with international guidelines; (2) involuntary, non-consensual disclosure, which may be either intentional or accidental; and (3) obligatory disclosure, which occurs when PLHIV are forced to disclose to access services at health facilities. Health-care workers were often caught between the three models and struggled with the competing demands of promoting prevention, adherence, and confidentiality. Findings indicate that as national and global policies shift to normalize HIV testing as routine in a range of clinical settings, greater effort must be made to define suitable best practices that balance the human rights and the public health perspectives in relation to disclosure.Keywords: HIV/AIDS, Kenya, disclosure, consent, confidentiality, HIV support groups RésuméLe partage du statut VIH+ est systématiquement présenté comme une mesure de santé publique visant à prévenir la transmission du VIH et à améliorer l'appui à l'observance du traitement. Des études ont mis au jour une variété d'effets positifs et négatifs du partage; il a aussi été montré que l'annonce du statut VIH est un processus difficile et étalé dans le temps. Cet article vise à décrire le rôle joué par le personnel de santé pour faciliter le partage par les personnes atteintes, dans le cadre du conseil et dépistage volontaire et du dépistage et conseil à l'initiative du soignant, dans les provinces du Centre et de Nairobi au Kenya. Il discute aussi la manière dont les participants perçoivent et vivent le partage. Nous nous appuyons sur une recherche qualitative approfondie réalisée en 2008-2009 auprès de personnes vivant avec le VIH et des professionnels de santé qui leur fournissent des soins. Nos résultats suggèrent que, dans la pratique quotidienne, il existe trois modèles de partage du statut VIH : 1) la divulgation volontaire et consentie, suivant les directives internationales, 2) le partage involontaire, non-consensuel, qui peut être intentionnel ou accidentel, et 3) le partage obligatoire, lorsque les PVVIH sont tenues de divulguer leur statut pour accéder à des services dans les établissements de santé. Les agents de s...

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Social context of disclosing HIV test results in Tanzania

Cited by 39 publications

References 16 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

Parental HIV disclosure in Burkina Faso: Experiences and challenges in the era of HAART

The duty to disclose in Kenyan health facilities: a qualitative investigation of HIV disclosure in everyday practice

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