The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo

Maman, Suzanne; Cathcart, Rebecca; Burkhardt, Gillian; Omba, Serge; Behets, Frieda

doi:10.1016/j.socscimed.2008.12.028

Cited by 48 publications

(49 citation statements)

References 32 publications

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“…Thus, efforts are needed to both meet women’s needs for the security and support of care providers with disclosure, and explore men’s preferences for testing and disclosure support, which could include home-based couples testing and assisted disclosure in non-facility settings. Previous literature suggests various support systems have improved HIV disclosure experiences (Maman, Cathcart, Burkhardt, Omba, & Behets, 2009; Rujumba et al, 2012; Shrouff, Mafara, Saint-Sauveur, Taziwa, & Vinoles, 2013; Walcott et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

“How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial

Maeri¹,

Ayadi²,

Getahun³

et al. 2016

AIDS Care

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People living with HIV/AIDS anticipate HIV-related stigma and fear disclosure to intimate partners. Yet, disclosure is critical to reducing HIV transmission and improving care engagement. This qualitative study characterized HIV disclosure experiences and normative beliefs among couples in communities participating in an HIV test-and-treat trial in Kenya and Uganda (Sustainable East Africa Research in Community Health, NCT#01864603). In-depth interviews were conducted with care providers (n = 50), leaders (n = 32) and members (n = 112) of eight communities. Data were analyzed using grounded theoretical approaches and Atlas.ti software. Findings confirmed gender differences in barriers to disclosure: while both men and women feared blame and accusation, women also feared violence and abandonment (“I did not tell my husband because [what if] I tell him and he abandons me at the last moment when I am in labor?”). Positive consequences included partner support for increased care-seeking and adherence (“My husband keeps on reminding me ‘have you taken those drugs?’”) Yet negative consequences included partnership dissolution, blame, and reports of violence (“some men beat their wives just because of that [bringing HIV medications home]”). Among HIV-infected individuals in discordant relationships, men more often reported supportive spouses (“we normally share [HIV-risk-reduction strategies] since I have been infected and she is HIV negative”), than did women (“my husband refused to use condoms and even threatened to marry another wife”). Care providers lent support for HIV-positive women who wanted to engage partners in testing but feared negative consequences: “They engaged the two of us in a session and asked him if we could all test.” Findings demonstrate differing experiences and support needs of women and men living with HIV in eastern Africa, with HIV-positive women in discordant couples particularly vulnerable to negative consequences of disclosure. Efforts to strengthen capacity in health systems for gender-sensitive clinician- or counselor-assisted disclosure should be accelerated within test-and-treat efforts.

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Section: Discussionmentioning

confidence: 99%

“How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial

Maeri¹,

Ayadi²,

Getahun³

et al. 2016

AIDS Care

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“…We need to be aware of these beliefs in order to develop culturally adapted HIV information. Moreover, as religion is an important part of daily life in Kinshasa,11 close collaboration between religious leaders and HIV prevention programmes is necessary to ensure success.…”

Section: Discussionmentioning

confidence: 99%

Misconceptions about HIV infection in Kinshasa (Democratic Republic of Congo): a case–control study on knowledge, attitudes and practices: Table 1

et al. 2014

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“…Braxton, Lang, Sales, Wingood, and DiClemente (2007) also noted in their study that spirituality was strongly associated with positive and optimistic feelings in stressful situations. Paradoxically, some studies have shown that a heavy reliance on spiritual coping therapies may undermine women's efforts in taking realistic steps to solve the underlying problem and could also contribute to delay in seeking institutional support (Maman et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Voices of Strength and Struggle

Zakar

Krämer

2012

J Interpers Violence

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This article documents the coping strategies adopted by women victims of spousal violence in Pakistan. By drawing on 21 in-depth interviews conducted in Lahore and Sialkot (Pakistan), we found that the women tried to cope with violence by using various strategies, both emotion focused (e.g., use of religion, placating the husband, etc.) and problem focused (e.g., seeking support from formal institutions, etc.). The data showed that a majority of the women used emotion-focused strategies, especially spiritual therapies, which somehow reduced the violence and provided them with psychosocial solace. Nonetheless, these strategies incurred some costs, such as the consumption of scarce resources, time, and emotional energy. Our data also showed that few women opted for problem-focused strategies, such as seeking help from formal institutions, as these strategies could lead to overt confrontation with their husbands and may result in divorce, the outcome least desired by most of the Pakistani women. We noted that the coping behavior of Pakistani women was complex, subjective, and nonlinear and that the boundaries between emotion-focused and problem-focused strategies were diffuse and blurred. Although the women never surrendered to violence, they were fully aware of their structural limitations and vulnerabilities. Being mindful of the consequences of their actions, women carefully tailored a combination of strategies which could be helpful in resisting or reducing violence but, at the same time, should not be counterproductive. This article argues that Pakistani women alone cannot effectively resist violence while living under a harshly patriarchal regime, where violence against women is embedded in the social, political, and legal structures of society. There are no quick fixes to change the status quo. The Pakistani government, civil society, and formal institutions must proactively support women in reducing their vulnerabilities and facilitate them in expanding their capabilities to address the real causes of violence against them.

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The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo

Cited by 48 publications

References 32 publications

“How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial

“How can I tell?” Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV “test-and-treat” trial

Misconceptions about HIV infection in Kinshasa (Democratic Republic of Congo): a case–control study on knowledge, attitudes and practices: Table 1

Voices of Strength and Struggle

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