Do support groups members disclose less to their partners? The dynamics of HIV disclosure in four African countries
Do support groups members disclose less to their partners? The dynamics of HIV disclosure in four African countries
复制标题
DOI：
10.1186/1471-2458-13-589
复制
发表时间：
2013-06-17
影响因子：
4.5
通讯作者：
Obermeyer, Carla Makhlouf
中科院分区：
文献类型：
--
作者：
Hardon, Anita;Gomez, Gabriela B.;Obermeyer, Carla Makhlouf
背景资料：最近在非洲遏制艾滋病毒流行的努力强调通过抗逆转录病毒疗法防止性传播给伙伴。目前战略的一个组成部分是向合作伙伴披露，因此了解其动机将有助于取得最大成果。本研究考察了布基纳法索、肯尼亚、马拉维和乌干达的伴侣披露的比率、动态和后果，特别关注了支持团体和披露中的耻辱感的作用。方法：这项研究采用了混合方法，包括对咨询和检测服务进行的跨部门客户调查、焦点小组以及对布基纳法索、肯尼亚、马拉维和乌干达，在提供HIV检测的医疗机构招募。结果：披露给合作伙伴的比率在国家之间存在差异（32.7% - 92.7%）。马拉维报告的比率最低。披露的原因包括防止艾滋病毒的传播、需要护理和维护关系的完整性。害怕蒙受耻辱是不披露的一个重要原因。妇女报告说，在向伴侣透露情况时，她们的负面反应更多。披露与生活在城市地区，较高的教育水平，是男性，而负相关的成员支持groups.Conclusions：了解的原因披露和承认的支持团体在这个过程中的作用，可以帮助改善目前的预防工作，越来越多地侧重于治疗作为预防的一种方式，以阻止新的感染。支助团体可以帮助传播二级预防信息，向其成员解释抗逆转录病毒治疗对艾滋病毒阳性者及其伴侣有益。家庭检测可以进一步促进伴侣信息披露，因为夫妇可以一起检测，并共同接受咨询。
Background: Recent efforts to curtail the HIV epidemic in Africa have emphasised preventing sexual transmission to partners through antiretroviral therapy. A component of current strategies is disclosure to partners, thus understanding its motivations will help maximise results. This study examines the rates, dynamics and consequences of partner disclosure in Burkina Faso, Kenya, Malawi and Uganda, with special attention to the role of support groups and stigma in disclosure.Methods: The study employs mixed methods, including a cross-sectional client survey of counselling and testing services, focus groups, and in-depth interviews with HIV-positive individuals in stable partnerships in Burkina Faso, Kenya, Malawi and Uganda, recruited at healthcare facilities offering HIV testing.Results: Rates of disclosure to partners varied between countries (32.7% - 92.7%). The lowest rate was reported in Malawi. Reasons for disclosure included preventing the transmission of HIV, the need for care, and upholding the integrity of the relationship. Fear of stigma was an important reason for non-disclosure. Women reported experiencing more negative reactions when disclosing to partners. Disclosure was positively associated with living in urban areas, higher education levels, and being male, while being negatively associated with membership to support groups.Conclusions: Understanding of reasons for disclosure and recognition of the role of support groups in the process can help improve current prevention efforts, that increasingly focus on treatment as prevention as a way to halt new infections. Support groups can help spread secondary prevention messages, by explaining to their members that antiretroviral treatment has benefits for HIV positive individuals and their partners. Home-based testing can further facilitate partner disclosure, as couples can test together and be counselled jointly.