“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
Bibliographic Data
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
Blame · Condom · Domestic violence · Environmental health · Family medicine · Poison control · Political science · Qualitative research · Serodiscordant · Sociology · Spouse · Suicide prevention · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Social Psychology
Understanding the Relationship Between Intimate Partner Violence and HIV Status Disclosure Across Health Care Settings in Eastern and Southern Africa
Supportive couple relationships buffer against the harms of HIV stigma on HIV treatment adherence
Social relationships, mental health, and stigma
Reducing health disparities through understanding the lived experiences of women living with HIV regarding intimate relationship power and reproductive decision‐making
Factors associated with male partner involvement in the prevention of mother-to-child transmission of human immunodeficiency virus in the Gokwe North District, Zimbabwe
Youths' strategies for HIV status disclosure in rural Kenya and Uganda
Condom use among married and cohabiting women and its implications for HIV infection in Mahikeng, South Africa
From “Secret” to “Sensitive Issue”
The Uncounted
I don’t want them to know”
Prevalence of and Risk Factors for Intimate Partner Violence in the First 6 Months Following HIV Diagnosis Among a Population-Based Sample in Rural Uganda
Depression and ART Initiation Among HIV Serodiscordant Couples in Kenya and Uganda
Attitudes Toward Pregnancy Among Women Enrolled in Prevention of Mother-to-Child Transmission of HIV (PMTCT) Services in Moshi, Tanzania
Sexual and Relationship Benefits of a Safer Conception Intervention Among Men with HIV Who Seek to Have Children with Serodifferent Partners in Uganda
Intersectional Stigma and Health of People Living with HIV on ART Who Use Alcohol in Southwestern Uganda
Sex specific differences in HIV status disclosure and care engagement among people living with HIV in rural communities in Kenya and Uganda
Gender and stigma in antiretroviral treatment adherence in Mozambique
Challenges with tracing patients on antiretroviral therapy who are late for clinic appointments in rural South Africa and recommendations for future practice
Household-level factors and ART adherence among people living with HIV in Cape Town, South Africa
“ He accepted me the way I am … most people can’t ”
Antiretroviral therapy adherence among peripartum women with HIV in Kenya
HIV status disclosure patterns and male partner reactions among pregnant women with HIV on lifelong ART in Western Kenya
HIV status disclosure in the era of treat-all
Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya
The role of masculinity in HIV disclosure among adolescent South African boys living with HIV
Caring Masculinities in the Context of HIV Serodiscordant Relationships in Papua New Guinea
Gender and sexuality
Gender differences in HIV disclosure, stigma, and perceptions of health
Living with HIV, disclosure patterns and partnerships a decade after the introduction of HIV programmes in rural South Africa
The social and gender context of HIV disclosure in sub-Saharan Africa
Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia
Facilitating HIV status disclosure for pregnant women and partners in rural Kenya
High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners
Processes and Outcomes of HIV Serostatus Disclosure to Sexual Partners among People Living with HIV in Uganda
High Rates of Relationship Dissolution Among Heterosexual HIV-Serodiscordant Couples in Kenya
Disclosure of HIV Status to Sex Partners Among HIV-Infected Men and Women in Cape Town, South Africa
Facilitating HIV Disclosure Across Diverse Settings
HIV status and union dissolution in Sub-saharan Africa
The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo
Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users
| Unique citing works | 26 |
|---|---|
| Citations per year | 2,89 |
| Citation span | 2017 - 2026 (10) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 25 |