Factors influencing HIV status disclosure

Klopper, Ceridwyn Elza (2011-12)

Thesis (MCur)--Stellenbosch University, 2011.

Thesis

ENGLISH ABSTRACT: Understanding the incidence and prevalence of HIV/AIDS is important in addressing the ongoing epidemic. Understanding which factors influence the rate of transmission of the virus is critical in attempting to contain and ultimately eradicate the disease. Determining which factors influence a person’s decision to disclose his/her positive status to others, particularly the sexual partner, is essential in understanding this complex process and thereby improving disclosure rates. The aim of the study was to investigate which factors influence the disclosure of someone’s HIV positive status. The objectives were to determine whether aspects such as socio-demographic factors, stigma and discrimination, religion, culture, fear of abandonment and rejection as well as knowledge of the disease influences disclosure rates. These objectives were met through an in-depth descriptive correlational research design with a quantitative approach. The target population (N = 1200/100%) consisted of all the HIV infected clients who attended a Community Health Clinic (CHC) for HIV management in the Cape Metropolitan area. The convenience sampling method was used to select the sample of participants (n = 150/12.5%) who met the criteria and voluntarily agreed to participate in the study. A self-administered questionnaire was used consisting of mainly closed-ended questions, with a limited number of open-ended questions. Ethics approval for the study was obtained from the Health Research Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Permission was obtained from the City of Cape Town: City Health, to conduct the research. Informed consent was obtained from each participant. Reliability and validity were supported by a pilot study which was conducted on (n=15/10%) of participants at this CHC to assure the feasibility of the study. The data was analysed with the support of a statistician and was presented with histograms and frequency tables. Statistical associations were determined between the various variables. The qualitative data obtained from the open-ended questions were grouped in trends and analysed thematically and then these trends were quantified. The results show that there are numerous factors which influenced HIV status disclosure. The fear of stigmatisation was identified as a factor which influences HIV disclosure to others, especially among the male participants. The results revealed that this was the major reason for delayed or non-disclosure, as well as the fear of rejection and blame. The results showed that awareness of the sexual partner’s HIV status remained relatively low (n = 64/43%), with awareness of the partner’s status highest among married participants. The recommendations were to assure that HIV positive individuals have access to support groups and are given an opportunity to attend multiple counselling sessions. Community based initiatives are needed to reduce stigmatisation of individuals with HIV and to improve access to social support systems. It was concluded that disclosure is a multifaceted process and one particular factor does not necessarily influence disclosure of a HIV positive status but most often a combination of factors.

AFRIKAANSE OPSOMMING: Dit is belangrik om die verspreiding en voorkoms van MIV/VIGS te verstaan om die gesprek rondom die voortdurende epidemie aan te roer. Kennis van watter faktore die snelheid beïnvloed waarteen die virus oorgedra word, is krities in ’n poging om dit onder beheer te hou en uiteindelik uit te wis. Om te bepaal watter faktore ’n mens se besluit beïnvloed om jou positiewe status van MIV aan andere bekend te maak, veral aan ’n seksuele maat, is dit belangrik om die kompleksiteit van die proses te begryp en sodoende die pas van bekendmaking te verbeter. Die doel van die studie is om te bepaal watter faktore beïnvloed die bekendmaking van ’n MIV positiewe status. Die doelwitte is om vas te stel of aspekte soos sosio-demografiese faktore, stigma en diskriminasie, godsdiens, kultuur, vrees vir verlating en verwerping en kennis van die siekte, die insidensie van bekendmaking beïnvloed. ’n Beskrywende korrelatiewe navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep (N=1200/100%) het bestaan uit al die MIV geïnfekteerde persone wat ’n Gemeenskapgesondheidskliniek vir die bestuur van MIV in die Kaapse Metropolitaanse area besoek het. Die gerieflikheidssteekproef metode is gebruik om die steekproef van deelnemers (n=150/12.5%) te kies wat vrywillig ingestem het om aan die kriteria vir die studie te voldoen. ’n Self-geadministreerde vraelys was gebruik wat hoofsaaklik uit geslote vrae met ’n beperkte aantal ope vrae bestaan. Etiese goedkeuring vir die studie is verkry van die Gesondheidsnavorsing se Etiese Komitee by die Fakulteit van Gesondheidswetenskappe, Universiteit van Stellenbosch. Toestemming is verkry van die stad Kaapstad: Stad Gesondheid, om die navorsing uit te voer. Ingeligte toestemming is van die deelnemers verkry. Betroubaarheid en geldigheid is ondersteun deur ’n loodsstudie wat op (n=15/10%) van die deelnemers beoefen is by die Gemeenskapsgesondheidkliniek om die uitvoerbaarheid van die studie te verseker.Die data is geanaliseer met die ondersteuning van ’n statistikus en is deur histogramme en frekwensie-tabelle voorgestel. Statistiese assosiasies is vasgestel tussen die verskeie veranderlikes. Die kwalitatiewe data is geneem vanuit ope vrae wat gegroepeer is in neigings en tematies geanaliseer is en die neigings is hierna gekwantifiseer. Die uitslae bewys dat daar heelwat faktore is wat die bekendmaking van MIV statusstatus beïnvloed. Die vrees vir stigmatisering is geïdentifiseer as ’n faktor met betrekking tot die bekendmaking van MIV aan andere, veral onder die manlike deelnemers. Die uitslae bewys dat dit die hoofrede vir terughoudendheid of nie-bekendmaking van die siekte is, asook die vrees vir ververwerping en blaam. Die resultate bewys dat die bewustheid van die seksuele maat se MIV statusstatus relatief laag bly (n=64/43%) met bewustheid van die maat se status die hoogste onder getroude deelnemers. Die aanbevelings is om te verseker dat MIV positiewe individue toegang het tot ondersteuningsgroepe en dat hulle geleentheid gegee word om veelvuldige voorligtingsessies by te woon. Gemeenskapgebaseerde inisiatiewe is nodig om stigmatisering van individue met MIV te verminder en vir die verbetering van toegang tot maatskaplike ondersteuningsisteme. Ter samevatting kan die gevolgtrekking gemaak word, dat; die bekend making van MIV positiewe status word nie noodwendig beïnvloed deur ʼn spesifieke faktor of meervlakkige besluitnemings proses nie, maar eerder deur ʼn kombinasie van faktore.

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