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Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study

BACKGROUND: HIV disclosure is an important step in delivering the right care to people. However, many people with an HIV positive status choose not to disclose. This considerably complicates the delivery of adequate health care. METHODS: We conducted a grounded theory study to develop a theoretical...

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Autores principales: Thapa, Subash, Hannes, Karin, Buve, Anne, Bhattarai, Shivani, Mathei, Catharina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775526/
https://www.ncbi.nlm.nih.gov/pubmed/29351785
http://dx.doi.org/10.1186/s12889-018-5073-x
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author Thapa, Subash
Hannes, Karin
Buve, Anne
Bhattarai, Shivani
Mathei, Catharina
author_facet Thapa, Subash
Hannes, Karin
Buve, Anne
Bhattarai, Shivani
Mathei, Catharina
author_sort Thapa, Subash
collection PubMed
description BACKGROUND: HIV disclosure is an important step in delivering the right care to people. However, many people with an HIV positive status choose not to disclose. This considerably complicates the delivery of adequate health care. METHODS: We conducted a grounded theory study to develop a theoretical model explaining how local contexts impact on HIV disclosure and what the mechanisms are that determine whether people choose to disclose or not. We conducted in-depth interviews among 23 people living with HIV, 8 health workers and 5 family and community members, and 1 community development worker in Achham, Nepal. Data were analysed using constant-comparative method, performing three levels of open, axial, and selective coding. RESULTS: Our theoretical model illustrates how two dominant systems to control HIV, namely a community self-coping and a public health system, independently or jointly, shape contexts, mechanisms and outcomes for HIV disclosure. CONCLUSION: This theoretical model can be used in understanding processes of HIV disclosure in a community where HIV is concentrated in vulnerable populations and is highly stigmatized, and in determining how public health approaches would lead to reduced stigma levels and increased HIV disclosure rates.
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spelling pubmed-57755262018-01-31 Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study Thapa, Subash Hannes, Karin Buve, Anne Bhattarai, Shivani Mathei, Catharina BMC Public Health Research Article BACKGROUND: HIV disclosure is an important step in delivering the right care to people. However, many people with an HIV positive status choose not to disclose. This considerably complicates the delivery of adequate health care. METHODS: We conducted a grounded theory study to develop a theoretical model explaining how local contexts impact on HIV disclosure and what the mechanisms are that determine whether people choose to disclose or not. We conducted in-depth interviews among 23 people living with HIV, 8 health workers and 5 family and community members, and 1 community development worker in Achham, Nepal. Data were analysed using constant-comparative method, performing three levels of open, axial, and selective coding. RESULTS: Our theoretical model illustrates how two dominant systems to control HIV, namely a community self-coping and a public health system, independently or jointly, shape contexts, mechanisms and outcomes for HIV disclosure. CONCLUSION: This theoretical model can be used in understanding processes of HIV disclosure in a community where HIV is concentrated in vulnerable populations and is highly stigmatized, and in determining how public health approaches would lead to reduced stigma levels and increased HIV disclosure rates. BioMed Central 2018-01-19 /pmc/articles/PMC5775526/ /pubmed/29351785 http://dx.doi.org/10.1186/s12889-018-5073-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Thapa, Subash
Hannes, Karin
Buve, Anne
Bhattarai, Shivani
Mathei, Catharina
Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title_full Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title_fullStr Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title_full_unstemmed Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title_short Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study
title_sort theorizing the complexity of hiv disclosure in vulnerable populations: a grounded theory study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775526/
https://www.ncbi.nlm.nih.gov/pubmed/29351785
http://dx.doi.org/10.1186/s12889-018-5073-x
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