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

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Disclosure amongst discordant couples is a key issue since there is a possibility of separation. Some participants whose partners tested HIV negative had such challenges. When he tested HIV negative, the situation at home changed. He stopped caring for me and as far as he is concerned I no longer matter or exist to him. Although we live together, he has more or less abandoned me. [Female, 30 years, married] Sex and maintenance of relations among discordant couples are also very problematic issues. In most cases among such couples, the sexual act is surrounded with fear and there is mistrust between the partners. A participant, whose wife tested HIV negative, had to stop having sexual relations with her although he has kept looking after her at his home in the village. Eventually he decided to marry an HIV positive woman. Although my wife had been supportive and looked after me while I was sick for along time, we were psychologically affected when she tested HIV negative. She feared to have sexual relations with me so we agreed to stop having sex. Although she has remained in our village home and I provide for her, we have not had any sexual relations for the last ten years. I got married to another woman who is also HIV positive. We live together here in town. [Male, 41 years, married] 4.4. Reasons for disclosure Disclosure of sero-status to a sexual partner though challenging is associated with a number of benefits. The participants who disclosed their serostatus to partners had various reasons they said that enabled them to disclose which include; desire for partner to get treatment, need for partner’s support, prior knowledge of partner’s HIV status, anger and anxiety about the future. 45
4.4.1. Desire for partner to get treatment The desire for the partners to take an HIV test and also begin to access care and treatment services especially ARVs were highlighted as one motivator for disclosure. A number of clients have faith in the HIV treatment and would even go out of their way so as to access medication for themselves and their partners. Three of the participants explained that they disclosed because their partners also needed to go and get treatment. I realised that it would be wrong for me not to tell my wife about my serostatus because she would discover it in the long run and she too needed to get treatment [Male, 42 years, married] TASO’s disclosure counselling emphasizes the importance of prevention of HIV transmission to partners and their need to access testing, care and support services. One participant who wanted her partner to access health services but was hesitant to disclose, enlisted the support of her counsellor. The counsellor had told me that I needed to disclose to my partner and explain the need for us to begin using condoms and his need to access TASO services. I tried to do it alone at first but failed, and then I invited the counsellor home who helped me to tell him [Female, 42 years, married] 4.4.2 Need for Partner’s support ART being a life-long treatment, there is usually need for a drug companion who in most cases is either a spouse or a household member to remind the client to take the medication on time. The fact that the ARVs are free and sometimes delivered to clients’ homes by TASO staff using TASO labelled vehicles, also motivates clients to disclose to partners and other family members. One participant in the FGD said; If I hadn’t revealed my status, I would not have benefitted from the treatment since it required a lot of support and understanding from my spouse. It would have been difficult to hide because the medicine is taken every day and TASO staff had promised to bring it home every two months 46
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 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: I thought he would probably blame m
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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