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HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda

BACKGROUND: Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. METHODS:...

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Autores principales: Atuyambe, Lynn Muhimbuura, Ssegujja, Eric, Ssali, Sarah, Tumwine, Christopher, Nekesa, Nicolate, Nannungi, Annette, Ryan, Gery, Wagner, Glenn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076501/
https://www.ncbi.nlm.nih.gov/pubmed/24950958
http://dx.doi.org/10.1186/1472-6963-14-276
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author Atuyambe, Lynn Muhimbuura
Ssegujja, Eric
Ssali, Sarah
Tumwine, Christopher
Nekesa, Nicolate
Nannungi, Annette
Ryan, Gery
Wagner, Glenn
author_facet Atuyambe, Lynn Muhimbuura
Ssegujja, Eric
Ssali, Sarah
Tumwine, Christopher
Nekesa, Nicolate
Nannungi, Annette
Ryan, Gery
Wagner, Glenn
author_sort Atuyambe, Lynn Muhimbuura
collection PubMed
description BACKGROUND: Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. METHODS: Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. RESULTS: Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. CONCLUSIONS: There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies.
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spelling pubmed-40765012014-07-02 HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda Atuyambe, Lynn Muhimbuura Ssegujja, Eric Ssali, Sarah Tumwine, Christopher Nekesa, Nicolate Nannungi, Annette Ryan, Gery Wagner, Glenn BMC Health Serv Res Research Article BACKGROUND: Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services, but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of disclosure among clients attending an urban HIV clinic in Uganda. METHODS: Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were exported to MS Excel and pivot tables, and code counts made to generate statistical data. RESULTS: Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses were supportive including encouragement, advice and support regarding HIV care and treatment. The results show on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive followed by behavioral change and prevention, and then negative responses. Men reported increased care and support when they disclosed to fellow men compared to when women disclosed to women. There was better or not change in relationship when women disclosed to women than when women disclosed to men. CONCLUSIONS: There is overwhelming support to individuals that disclose their HIV status, especially in the long term. Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure support strategies. BioMed Central 2014-06-21 /pmc/articles/PMC4076501/ /pubmed/24950958 http://dx.doi.org/10.1186/1472-6963-14-276 Text en Copyright © 2014 Atuyambe et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Atuyambe, Lynn Muhimbuura
Ssegujja, Eric
Ssali, Sarah
Tumwine, Christopher
Nekesa, Nicolate
Nannungi, Annette
Ryan, Gery
Wagner, Glenn
HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title_full HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title_fullStr HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title_full_unstemmed HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title_short HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
title_sort hiv/aids status disclosure increases support, behavioural change and, hiv prevention in the long term: a case for an urban clinic, kampala, uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076501/
https://www.ncbi.nlm.nih.gov/pubmed/24950958
http://dx.doi.org/10.1186/1472-6963-14-276
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