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The impact of fear, secrecy, and stigma on parental disclosure of HIV status to children: a qualitative exploration with HIV positive parents attending an ART clinic
- in South Africa. Glob J Health Sci
"... South Africa is one of the sub Saharan countries where considerable progress in providing antiretroviral treatment (ART) has been made. The increased access to ART contributes to improvements in the prognosis of HIV and parents are more likely to raise their children than ever before. The study exam ..."
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South Africa is one of the sub Saharan countries where considerable progress in providing antiretroviral treatment (ART) has been made. The increased access to ART contributes to improvements in the prognosis of HIV and parents are more likely to raise their children than ever before. The study examined the social context influencing disclosure of parental HIV status to children from the perspectives of fathers and mothers accessing ART from an academic hospital in South Africa. Three focus group interviews were conducted with 26 non-disclosed biological parents of children aged between 7 and 18 years. Their ages ranged between 20-60 years and they cared for a total of 60 children. Parental decision not to disclose their HIV status to children was influenced by the fear of death and dying, the influence of television and media, stigma and discrimination. Parents delayed disclosure of their HIV status to children because children believed that AIDS kills. Parents also feared that the child may not be able to keep the parent’s HIV status secret and might result in the family being subjected to stigma, discrimination, and isolation. Fear of stigma and discrimination were also responsible for the continuous efforts by parents to protect their HIV status from their children, family and neighbours. Parents also delayed disclosure to children because they lacked disclosure skills and needed support for disclosure from health care providers. Healthcare providers are in a unique position to provide such support and guidance and
Kerston P: Community-based research among marginalized HIV populations: Issues of support, resources, and empowerment
- In Interdisciplinary perspectives on Infectious Diseases
"... A research question was posed to us by a local HIV-resource organization interested in exploring the educational and service needs of those unreached. In order to properly address this inquiry, we developed a community-based participatory research by training peer-led volunteers to facilitate focus ..."
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A research question was posed to us by a local HIV-resource organization interested in exploring the educational and service needs of those unreached. In order to properly address this inquiry, we developed a community-based participatory research by training peer-led volunteers to facilitate focus-group discussions within Aboriginal and refugees participants following an interview guide. We gathered Aboriginal people and refugees separated into three focus groups each, enrolling a total of 41 self-identified HIVpositive, 38 males. The discussions were tape recorded upon consent and lasted between 59 and 118 minutes. We analyzed the thematic information collected interactively through constant comparison. The qualitative data leading to categories, codes, and themes formed the basis for the spatial representation of a conceptual mapping. Both groups shared similar struggles in living with HIV and in properly accessing local nonmedical HIV resources and discussed their concerns towards the need for empowerment and support to take control of their health.
Declaration
, 2013
"... I hereby declare that this thesis is my own work and effort and that it has not been submitted anywhere for any award. Where other sources of information have been used, they have been acknowledged. ..."
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I hereby declare that this thesis is my own work and effort and that it has not been submitted anywhere for any award. Where other sources of information have been used, they have been acknowledged.
© The Author(s) 2014 Reprints and permissions:
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American Journal of Men’s Health 1 –8 © The Author(s) 2014
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Dedication
, 2004
"... The Dissertation Committee for Jörg Oestreich Certifies that this is the approved version of the following dissertation: ..."
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The Dissertation Committee for Jörg Oestreich Certifies that this is the approved version of the following dissertation:
RESEARCH ARTICLE Open Access
"... A study of patient attitudes towards decentralisation of HIV care in an urban clinic in ..."
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A study of patient attitudes towards decentralisation of HIV care in an urban clinic in
Correlates of Social Exclusion and Negative Labeling and Devaluation of People Living with HIV/AIDS in Rural Settings: Evidence from a General Household Survey in Zambézia Province, Mozambique
"... Background: Increased HIV/AIDS knowledge and access to antiretroviral treatment (ART) have been hypothesized to decrease HIV stigma. However, stigma persists as a barrier to HIV services uptake. We studied the relationship between stigma, knowledge and attitudes towards HIV and its treatment, and co ..."
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Background: Increased HIV/AIDS knowledge and access to antiretroviral treatment (ART) have been hypothesized to decrease HIV stigma. However, stigma persists as a barrier to HIV services uptake. We studied the relationship between stigma, knowledge and attitudes towards HIV and its treatment, and confidence in the legal system (legal rights certitude). Methods: We analyzed data from a household survey of 3749 randomly sampled female heads of households in 259 enumeration areas across 14 districts of Zambézia Province, Mozambique. The questionnaire included questions about beliefs, attitudes and behavior towards PLWHA, HIV transmission knowledge, treatment-related beliefs, and legal rights certitude. Factor analysis distinguished two stigma constructs: Negative labeling and devaluation (NLD) and social exclusion (SoE). Multivariable linear regression was used to determine the association between stigma, knowledge of HIV/AIDS, treatment-related beliefs, and legal rights certitude, while controlling for variance in socio-demographics. Results: A 4-point increase in knowledge about HIV transmission was associated with more than a 3 unit decrease in NLD and SoE stigma scores (p,0.001). Given HIV transmission knowledge, a 25-point increase in legal rights certitude was associated with a 4.62 unit drop in NLD stigma (p,0.001); we did not detect an association between legal rights certitude and SoE stigma. Knowing at least one HIV positive person was associated with lower SoE (23.17, 95 % CI: 25.78, 20.56); no
HIV/AIDS-Related Stigma and Discrimination in Sub-Saharan Africa: A Review
"... HIV/AIDS-related stigma continues to be a global threat to HIV care, treatment and prevention especially in Sub-Saharan Africa. The aim of this narrative review was to examine the different context of HIV/AIDS-related stigma and discrimination, and its consequence in Sub-Saharan Africa. This review ..."
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HIV/AIDS-related stigma continues to be a global threat to HIV care, treatment and prevention especially in Sub-Saharan Africa. The aim of this narrative review was to examine the different context of HIV/AIDS-related stigma and discrimination, and its consequence in Sub-Saharan Africa. This review is significant as it will inform policy makers on HIV/AIDS to be enable to combat HIV/AIDS-related stigma and discrimination as well as promote the rights of people living with HIV/AIDS. Detailed literature search was done using CINAHL, MEDLINE and EMBASE databases where relevant papers were selected. Also, relevant grey literature such as reports and newspapers were included in the review using the Google search engine. The review revealed that HIV/AIDS-related stigma and discrimination has resulted in loss of jobs and accommodation as well as difficulty in accessing healthcare and education among people living with HIV/AIDS. People living with HIV/AIDS have also suffered stigma and discrimination in the family and at church. Although strenuous efforts has been made to fight against HIV/AIDS-related stigma and discrimination in Sub-Saharan Africa, a lot more needs to be done. There is therefore the need to intensify educating people to see persons living with HIV/AIDS as 'normal' people. Governments should ensure that people living with HIV/AIDS have equal access to education, healthcare, housing and jobs. Also, the rights of people living with HIV/AIDS should be promoted.
