Giving “Sadness” a Name

Odokonyero, Raymond; Wagner, Glenn; Ngo, Victoria K.; Nakasujja, Noeline; Musisi, Seggane; Akena, Dickens

doi:10.1177/2325957414557265

Cited by 17 publications

(13 citation statements)

References 18 publications

(20 reference statements)

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“…Since its discovery, varying views and opinions have been expressed in different communities concerning HIV. Even though some communities have accepted the science of HIV transmission, treatment, and prevention, many still live in denial with varying levels of stigma, myths, and misconceptions that have caused constant depression among those affected [ 2 , 3 ]. The World Health Organization (WHO) has recommended full access to Antiretroviral therapy (ART) for all in need, but reaching all eligible people with treatment remains a huge global challenge.…”

Section: Introductionmentioning

confidence: 99%

Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Kulane

Owuor

Sematimba

et al. 2017

IJERPH

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Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to families and communities, which creates a risk of self-isolation and ill health. Still, affected individuals have developed resilient mechanisms for managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups, and maintain the utmost optimism about their prognosis.

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Section: Introductionmentioning

confidence: 99%

Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Kulane

Owuor

Sematimba

et al. 2017

IJERPH

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“…2007 ) and one in Canada ( Husbands et al . 2007 ); one was conducted in a middle-income country, South Africa ( Andersen 2012 ); and two were conducted in low-income countries, in Uganda ( Odokonyero et al . 2015 ) and in Tanzania ( Adams et al .…”

Section: Resultsmentioning

confidence: 99%

“…2011 ), one cohort study ( Adams et al . 2012a ), one case-series ( Odokonyero et al . 2015 ), one cross-sectional study ( Wolfe et al .…”

Section: Resultsmentioning

confidence: 99%

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Interventions and approaches to integrating HIV and mental health services: a systematic review

Chuah

Haldane

Cervero-Liceras

et al. 2017

Health Policy and Planning

121

103

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BackgroundThe frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services.MethodsThis review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias.ResultsForty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach.ConclusionThis review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery outcomes when implemented within appropriate contexts. Our review revealed a lack of research in low- and middle- income countries, and was limited to most studies being descriptive. Overall, studies that seek to evaluate and compare integration models in terms of long-term outcomes and cost-effectiveness are needed, particularly at the health system level and in regions with high HIV and AIDS burden.

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“…Even though some communities have accepted the science of HIV transmission, treatment and prevention, many still live in denial with varying levels of stigma, myths and misconceptions that have caused constant depression among those affected (Mkwanazi, Rochat, & Bland, 2015;Odokonyero et al, 2015). The World Health Organization (WHO) has recommended full access to ART for all in need, but reaching all eligible people with treatment remains a huge global challenge.…”

Section: Introductionmentioning

confidence: 99%

Access to HIV Care and Resilience in a Long Term Conflict Setting. A Pilot Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Kulane¹,

Owuor²,

Sematimba³

et al. 2017

Preprint

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Background: Human Immnodeficiency virus (HIV) continues to take a heavy toll on the lives of many people with worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region unexpressed. This pilot qualitative study sought to explore the experiences of people living with diagnosed HIV in Mogadishu and their resilience in access to care and social support. Method: Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving Antiretroviral therapy (ART) from the HIV clinic in Mogadishu. Participants were recruited through drug dispensers at the HIV clinic in Benader Hospital. These were tape recorded, transcribed and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouces or through health care contamination. They were very knowledgable about the realities of HIV, how the medication works, nutritional requirements and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organisations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainity of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechansms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people living with diagnosed HIV in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with diagnosed HIV infection and efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to the families and communities which creates a risk of self isolation and ill health. But affected individuals have developed resilient mechanisms of managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups and maintain utmost optimism about their prognosis.

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Giving “Sadness” a Name

Cited by 17 publications

References 18 publications

Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Interventions and approaches to integrating HIV and mental health services: a systematic review

Access to HIV Care and Resilience in a Long Term Conflict Setting. A Pilot Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

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