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

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Duration of relationship and type of partner Hays (1993) expressed that telling sexual partners about HIV infection is relatively more difficult among patients who feel vulnerable to rejection, especially by partners with whom HIV-positive patients have not established a relatively permanent relationship. A study in Tanzania found that being in a cohabiting relationship, shorter duration of relationship, not knowing someone with HIV, and lower income were negatively associated with disclosure (Antelman et al., 2001). In Uganda, Human Rights Watch (2003) reported about HIV-positive women in cohabiting relationships who had hidden their sero-status for fear of being accused of adultery and blamed for the illness. Most of the studies cited focused on women. However, a qualitative study among HIV infected men who have sex with men (MSM) in USA that aimed at understanding better the factors that impact decision making process regarding HIV disclosure identified rejection, issues of confidentiality, possible missed partner’s HIV status and type of sexual partner as barriers to disclosure (Driskell, Salomon, Mayer, Capistrant & Safren, 2008). Whereas the findings in the studies above raise pertinent issues related to disclosure, they cannot be generalised to people of different gender and age and other social settings; and most of these studies do not indicate how these fears affect disclosure after an intervention to reduce fear. Women may have the above fears due to already existing socio-cultural and gender biases including gender based violence. However, a major strength is that they were carried out in different sites and countries and represent variations of cultural norms. Studies on the factors that influence decisions to disclose HIV status that are conducted among sexual partners that receive ART care are needed.. 2.7 Summary The above literature reiew reveals that disclosure of HIV status to sexual partners is a process.The facilitators of disclosure discussed include: knowledge of partner’s status, duration of relationship, type of relationship, clinical stage of the disease, social support, ethical responsibility, gender, and prior discussion about HIV testing .Whereas barriers to disclosure include: stigma and discrimination,gender and power relations and fear of 25
gender based violence as well as duration of the relationship.The above findings show that the idea of trust and security in the relationship; the knowledge that a positive serostatus is not the end of life ; the need to protect one’s partner from infection as well as consideration of other personal benefits of disclosure facilitate disclosure. While risks of adverse outcomes of disclosure such as abandonment and violence hinder disclosure. Strategies to support disclosure and decisions to disclose to sexual partners should critically weigh these issues in the context of HIV risk reduction . 26
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 and 16: opportunistic infections and ART, i
Page 17 and 18: Mulago centre had registered 270 di
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: 2001) had fear of the partners’re
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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