Non-disclosure of HIV serostatus to partners among HIV positive pregnant women enrolled on the prevention of mother to child transmission (PMTCT) program at Katutura Antenatal Clinic, Windhoek, Namibia

Shiyoleni, Mirjam Ndapandula (2013-03)

Thesis (MPhil)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: There are no published studies conducted in Namibia describing the experiences of HIV positive women on HIV disclosure. Exploring and understanding factors affecting disclosure among these women is crucial for health care workers and policy makers to devise ways to increase disclosure rate among women. The overall aim of the study was to establish factors contributing to HIV non-disclosure to sexual partners among women enrolled on the PMTCT program at Katutura ANC clinic in order to suggest strategies to increase HIV disclosure rate among women in the communities. The objectives of the study were to identify current level of HIV disclosure among pregnant women, to establish factors contributing to nondisclosure to sexual partners among pregnant women, to determine the proportion of women those have been abused by their sexual partners as a reaction of HIV disclosure and to recommend strategies aimed at increasing HIV disclosure rate among women living with HIV in the communities. The objectives were met by using a correlational research design with a quantitative approach conducted to collect data from 50 HIV positive pregnant women attending follow-up antenatal care at Katutura Antenatal Care Clinic, Windhoek, Namibia in November 2012. A self administered questionnaire which primarily consisted of closed ended questions and a limited number of open-ended questions was used to answer the research question. Ethical approval was sought and obtained from the Ethics Committee of Stellenbosch University. Permission was requested and granted from the Ministry of Health and Social Services (MoHSS) to conduct the study. Study participants who agreed to take part in the study were also given a consent form to sign. Quantitative data was analysed with assistance from a statistician. Analysed data were presented by using frequency tables, pie charts and bar graphs. Cross tabulations were also used to analyse the relationship between HIV disclosure and other variables. Qualitative data collected by the use of open ended questions were analysed by using a thematic approach and trends were assessed. Recommendations were to encourage couples to test together in order to prevent negative outcomes as a result of HIV disclosure to partners. HIV positive women that encounter difficulties in disclosing to partners were encouraged to discuss issues on disclosure to family or community members they trust to assist share their HIV serostatus to their sexual partners. Empowerment of women through education and employment opportunities could also lessen women’s dependence on men for financial support.

AFRIKAANSE OPSOMMING: Daar is geen gepubliseerde studies in Namibië wat die ervarings van MIV-positiewe vroue oor MIV openbaarmaking uitbeeld nie. Verkenning en begrip van faktore wat 'n uitwerking het op die openbaarmaking onder hierdie vroue is van kardinale belang vir gesondheidswerkers en beleidmakers om maniere te bedink om openbaarmaking koers te verhoog onder die vroue. Die algehele doel van die studie was om faktore wat bydra tot MIV nie-openbaarmaking aan seksmaats onder vroue wat op die Voorkoming van Moeder tot Kind MIV-program by die Katutura voorgeboorte kliniek geregistreer is te bewerkstellig om ten einde strategieë voor te stel om MIV-openbaarmaking koers te verhoog onder die vroue en in die gemeenskap. Die doelwitte van die studie was om die huidige vlak van MIV openbaarmaking onder swanger vroue te identifiseer , faktore wat bydra tot nie-openbaarmaking aan seksmaats onder swanger vroue te bevestig, die verhouding van vroue wat mishandel is deur hul seksmaats as gevolg van reaksies terwille van MIV-openbaarmaking te bepaal en strategieë wat gemik is op die verhoging van MIV openbaarmaking koers onder vroue wat met MIV leef in die gemeenskap aan te beveel. Die doelwitte is bereik deur gebruik te maak van 'n korrelatiewe navorsingsontwerp met 'n kwantitatiewe benadering om data in te samel van 50 MIV-positiewe swanger vroue wat vir opvolg voorgeboortesorg by die Katutura Voorgeboorte kliniek, Windhoek, Namibia in November 2012 opgedaag het. 'N self geadministreer vraelys, hoofsaaklik bestaande uit geslote en 'n beperkte oop vrae is gebruik om die navorsingsvraag te beantwoord. Etiese goedkeuring is gevra en verkry van die Etiese Komitee van die Universiteit van Stellenbosch. Toestemming is ook gevra van die Ministerie van Gesondheid en Maatskaplike Dienste (MoHSS) en is toegestaan om die studie uit te voer. Studie deelnemers wat ingestem het om deel te neem in die studie is ook 'n toestemming vorm gegee om te onderteken. Kwantitatiewe data is ontleed met die hulp van 'n statistikus. Ontlede data is met behulp van frekwensie tabelle, sirkeldiagramme en staafgrafieke gedemonstreer. Kruis tabelle is ook gebruik om die verhouding tussen MIV-openbaarmaking en ander veranderlikes te analiseer. Kwalitatiewe data ingesamel deur die gebruik van oop vrae is ontleed deur gebruik te maak van 'n tematiese benadering en tendense is gemeet. Aanbevelings is om paartjies aan te moedig om saam te toets ten einde negatiewe uitkomste te voorkom as gevolg van MIV openbaarmaking daarvan aan die seksmaat. MIV-positiewe vroue wat probleme ondervind met openbaarmaking aan hulle seksmaats is aangemoedig om kwessies oor openbaarmaking met familie of lede van die gemeenskap wat hulle vertrou te bespreek om sodoende hulp te verkry om hul MIV- serostatus met hulle seksmaats te kan bespreek. Bemagtiging van vroue deur middel van opvoeding en werksgeleenthede kan ook vroue se afhanklikheid van die manne vir finansiele ondersteuning verminder.

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