Disclosure of Hiv status to sexual partners among people who ...

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female clients due to ART. Despite the apparent changes, many clients are not yet open about their resumption of sexual activity and intention to conceive. Prevention of infection and re-infection is one of the most aspects addressed during counselling in TASO. Emphasis is placed on safe sex through condom use , avoiding multiple partners, discordance, disclosure, treatment of STIs, and family planning. Counselling of TASO clients on ART includes providing information on the advantages and disadvantages of having sex with HIV positive or HIV negative partners and the most likely outcomes of their choices that include possibility of contracting other strains of HIV and STIs and development of resistance by a partner who is not taking ARVs. TASO therefore emphasizes the importance of clients disclosing their sero-status to their primary and secondary sexual partners. Disclosure in TASO entails clients being counselled on benefits of disclosure and making plans on who to disclose to, how and when. Counsellors may support clients who find difficulties, to disclose their sero-status to sexual partners as an essential component of behavioural risk reduction plans. Table 3 shows the number of sessions conducted during the 4 th quarter, 2008 and areas focused on during the counselling such as adherence to ART, disclosure, discordance, family planning and other aspects. Furthermore, the organization introduced home-based counselling and testing (HBHCT) for family members of clients as an effort to increase awareness of HIV status among clients’ partners and to improve disclosure of HIV sero- status (TASO, 2006). As a strategy to promote adherence, partner disclosure is a prerequisite to enrolment on ART. If individuals require support to disclose, counsellors are usually available to help them. In spite of these efforts made by the organization, only 12% of 2,071 sexually active clients in Mulago centre had disclosed by the end of 2006. Moreover, in 2006, 222 out of the 2071 sexually active clients reported a pregnancy (TASO, 2007). Non disclosure before conception may increase the chances of mother-to–child HIV transmission if the mother does not get advice on how to reduce the risk. In addition, the 2006 report showed evidence of high discordance rate to be 60% among TASO sexually active clients whose partners were tested during HBHCT visits. By October 2006, 7
Mulago centre had registered 270 discordant couples. While there is no guarantee that disclosure will result in safer sex or that a failure to disclose will result in unprotected sex (Crepaz & Marks, 2002) disclosure of serostatus in this context is important so that partners can make informed decisions about their sexual activities. Table 1.TASO Mulago: Cumulative Number of Clients enrolled on ART from 2004 to 2007 900 800 700 600 500 400 300 200 100 0 CUMMULATIVE NUMBER OF CLIENTS ENROLLED ON ART PER YEAR [2004-2007], N = 2583, 693M, 1890F 84 279 263 Male Female 762 2004 2005 2006 2007 125 327 221 522 8
Page 1 and 2: DISCLOSURE OF HIV STATUS TO SEXUAL
Page 3 and 4: ABBREVIATIONS AND ACRONYMS AIDS - A
Page 5 and 6: While strategies like HBHCT and cou
Page 7 and 8: ACKNOWLEDGEMENTS I am grateful to t
Page 9 and 10: 4.5.2 Fear of abandonment .........
Page 11 and 12: partners, behavioural dis-inhibitio
Page 13 and 14: engage in preventive behaviours as
Page 15: opportunistic infections and ART, i
Page 19 and 20: 1.6 Problem Statement With the evid
Page 21 and 22: 2.2 Benefits of HIV Status Disclosu
Page 23 and 24: approaches including suggesting tha
Page 25 and 26: that people selectively disclose in
Page 27 and 28: Length of time after testing Women
Page 29 and 30: clients who are on antiretroviral t
Page 31 and 32: Stigma and discrimination The stigm
Page 33 and 34: 2001) had fear of the partners’re
Page 35 and 36: gender based violence as well as du
Page 37 and 38: & Ezzy, 2005). This was relevant fo
Page 39 and 40: the personal experiences but also g
Page 41 and 42: participants was raised to the grou
Page 43 and 44: methods besides the data recorded,
Page 45 and 46: CHAPTER 4: RESULTS 4.1 Description
Page 47 and 48: The other common reason for taking
Page 49 and 50: Although most of the participants w
Page 51 and 52: 4.3.2 Timing of disclosure Disclosu
Page 53 and 54: I thought he would probably blame m
Page 55 and 56: 4.4.1. Desire for partner to get tr
Page 57 and 58: In the FGD a female participant who
Page 59 and 60: Some men particularly are afraid to
Page 61 and 62: Some male participants commented th
Page 63 and 64: so that she too could come and they
Page 65 and 66: [Female, 36 years, has a steady par
Page 67 and 68:
[Female, 42 years, married] Even th
Page 69 and 70:
consequences of disclosure among se
Page 71 and 72:
esults (Maman et al., 2003; Kassaye
Page 73 and 74:
fear of stigma and discrimination.
Page 75 and 76:
them and emulate the good examples.
Page 77 and 78:
• Couples should be encouraged to
Page 79 and 80:
Brou, H., Djohan, G., Becquet, R. A
Page 81 and 82:
Greene, K., Derlega, V. J., Yep, G.
Page 83 and 84:
Kitzinger, J. (1994). The Methodolo
Page 85 and 86:
Mugenyi, K., Kabasinguzi, R., & Ali
Page 87 and 88:
Prevention with Positives Committee
Page 89 and 90:
Annual Report, 2007. Kampala, Ugand
Page 91 and 92:
choose not to. The research is tryi
Page 93 and 94:
Appendix 2 UNIVERSITY OF THE WESTER
Page 95 and 96:
A3. Date of interview: ____________
Page 97 and 98:
A2. Interviewee Identification Numb
Page 99:
The counsellors at the different TA
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