Showing 1 - 13 of 13 Results for "disclosure"

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Increased support is needed for HIV serostatus disclosure, particularly at key times such as delivery, infant weaning, and at the resumption of sexual activity. Studies found that disclosure to partners was low and women reported needing additional support to disclose.
Antenatal Care - Testing and Counseling
1 study
Further interventions are needed that support women safely through the disclosure process. [See also %{s:43}] Studies found that women in some settings experienced increased violence and abandonment following disclosure or feared violence as a result of disclosure. Some HIV-positive women wish to disclose their serostatus but want trained health providers to help them do so.
HIV Testing and Counseling for Women
1 study
Non-discriminatory education sector policies on HIV are needed, with regular reviews, updates and implementation. Practices that require disclosure of HIV status for access to education should be prohibited and confidentiality policies are needed.
Mitigating Risk
1 study
HIV prevention information and confidential services are needed for PWID receiving treatment for substance use. Increased skills training for HIV disclosure to sexual partners is needed. Despite high numbers of PWID who are HIV-positive, no HIV nor drug prevention programs focus on PWID. No national guidelines exist for drug treatment.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Further interventions providing HIV disclosure support are needed, particularly for women facing abandonment, violence, or other adverse events. [See also %{s:43}, %{c:11} and %{s:67}] Studies found many women faced abuse and abandonment upon disclosing their HIV status.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Further interventions are needed to incorporate violence prevention, screening and counseling services into PMTCT testing and counseling. [See also %{s:59}] Studies found high rates of violence, sexual coercion and abuse among HIV-positive pregnant women, particularly when accessing HIV testing or during disclosure.
Antenatal Care - Testing and Counseling
1 study
Interventions are needed to provide women and their partners with a better understanding of the risk of acquiring HIV through sexual practices as well as through injecting drug use (IOM, 2007). Studies found low rates of condom use despite sexual relationships with IDUs, lack of knowledge by IDUs on sexual and reproductive health and lack of access to clean needles. A study also found that many MSM and male intravenous drug users avoid disclosure of their sexual and drug risk behavior along with their HIV status due to stigma and gender norms and that most wives reported violence and little or no condom use. HIV-positive male IDUs want help with disclosure to their wives. Most wives of IDUs reported only a single lifetime sexual partner and only a tiny proportion reported injecting drug use.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Efforts are needed to further research and repeal laws that criminalize HIV non-disclosure, exposure or transmission — including vertical transmission of HIV—, which can discourage people from testing for HIV, and undermine the relationship between patients and physicians and other service providers. Because women are more likely to be tested, legal mandates to disclose HIV-positive serostatus may discourage women from accessing needed services and may lead to increased risk of abandonment and violence (see sections on VAW, HTC, etc).
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Additional strategies are needed to address the cultural, gender and other contextual barriers that influence the behavior or decisions of people living with HIV to engage in unsafe sex. [See also %{c:21}] Studies found that factors such as difficulties negotiating condoms, partner refusal, high unemployment, alcohol use, financial dependency, expectations of childbearing, fear of disclosure, etc., influenced protective behavior.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Programs are needed to reduce violence against women who test HIV-positive and/or are already living with HIV. A study found that HIV-positive women report that they were subjected to violence upon disclosure of their serostatus. Women living with HIV continue to experience violence (Hale and Vazquez, 2011). A study of serodiscordant couples found that intimate partner violence was more frequent in those who were HIV positive (2.7% as compared to 2.2%). Those women who suffered from violence prior to couples testing continued to experience violence (Were et al., 2011).
Addressing Violence Against Women
1 study
Adolescents living with HIV need information and services through adolescent-friendly HIV services on a number of topics, including disclosure, safer sex, contraception, safe motherhood and gender-based violence. Studies found that health providers were unprepared to discuss HIV and contraception with adolescents who acquired HIV through perinatal transmission, despite the fact that significant numbers of these adolescents were already sexually active. Another study found that these adolescents need skills to disclose their serostatus to sexual partner. WHO recommends that perinatally infected adolescents be advised of their positive serostatus by age 6 (WHO, 2013) but there is little guidance on disclosure for adolescents. Facilitated disclosure by parents and providers to adolescents living with HIV may lead to higher retention in HIV care (Arrive et al., 2012). Parents living with HIV whose adolescents may be living with HIV also need assistance to disclose to their adolescents, as parents fear rejection from their children. Positive health dignity and prevention interventions can help people living with HIV lead healthy lives and reduce HIV transmission, but tailored interventions for adolescents and their parents have not been evaluated for effectiveness, although a trial is currently ongoing (Cunningham, 2015; Mofeson and Cotton, 2013). One study found that 29% of young women aged 16 to 24 living with HIV reported being forced to have sex. No validated curriculum that was shown to be effective for reducing unsafe sex among adolescents living with HIV was found, although some manuals have been developed (Parker et al., 2013c; UNESCO and GNP+, 2012).
Increasing Access to Services
1 study
Intensified efforts are needed to increase male and female condom use and reduce multiple partnerships by people who know their HIV-positive status and are not virally suppressed, including young people. Studies found that consistent condom use between discordant couples (or with partners whose serostatus was unknown) was low and, among those on treatment, decreased over time. Lack of condom use was associated with fear of disclosure. People living with HIV as well as couples also believed that treatment with antiretroviral therapy meant that they were either cured of HIV or could no longer transmit the virus and were less likely to disclose their positive serostatus. In some studies, men are more likely to report condom use than women, "given the limited control that women have over the use of the male condom" (Walusaga et al., 2012: 698). Particular attention is also needed to provide condoms to men living with HIV who frequent sex workers, as well as for sex workers themselves to protect themselves (Paz-Bailey et al., 2012). [See %{s:9}]
Staying Healthy and Reducing Transmission
1 study
Research and interventions are needed to better to support people living with HIV with disclosure and reduce stigma so they can adhere to ART and can continue to have a healthy and safer sex life. In-depth interviews with patients in South Africa who were acutely infected found that patients did not retain the information that they are very likely to transmit HIV and that condom use was particularly important, but were focused on identifying who transmitted HIV to them. In addition, patients were still in shock on learning of their HIV status and did not understand how they could be HIV-positive if they tested negative with a rapid HIV test (Wolpaw et al., 2014). Women who were acutely infected in South Africa faced profound "challenges, immediately after HIV diagnosis" (Tomita et al., 2014b: 1118). Focus groups of women living with HIV found that women were concerned that their access to lifelong treatment when becoming pregnant may discourage their men from condom use, as men know that treatment can decrease the risk of transmission.
Staying Healthy and Reducing Transmission
1 study