Why do People Disclose their HIV Status? Qualitative Evidence from a Group of Activist Women in Khayelitsha

Almeleh, Colin

doi:10.1080/02533950608628730

Cited by 17 publications

(16 citation statements)

References 31 publications

(47 reference statements)

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“…While peer advocates are commonly used to increase medication adherence, an advocacy by HIV-infected women is not described in the literature (Almeleh, 2006; Hemsworth & Pizer, 2006; Iwelunmor, Zungu, & Airhihenbuwa).Our data support two general types of advocacy: formal employment as a counselor, or informally through sharing her story and encouraging other women to practice “safe” behaviors. This disclosure of HIV status was related to a self-acceptance of the chronic nature of the disease, itself an important self-management task (Swendeman, et al, 2009).…”

Section: Discussionsupporting

confidence: 59%

The Relationship Between Social Roles and Self-Management Behavior in Women Living with HIV/AIDS

Webel¹,

Higgins²

2012

Women's Health Issues

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Section: Discussionsupporting

confidence: 59%

The Relationship Between Social Roles and Self-Management Behavior in Women Living with HIV/AIDS

Webel¹,

Higgins²

2012

Women's Health Issues

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“…The nature of the interaction between the respondents and PLWHA is, however, not known. As mentioned earlier, Almeleh (2006) found that in Cape Town HIV status disclosure is most common when people are sick and have no choice other than to disclose to potential care-givers and assistants. Consequently, HIV/AIDS is so strongly associated with illness and death that people whose health has been restored by HAART are regarded by some as no longer being HIV positive (Almeleh, 2006).…”

Section: Discussionmentioning

confidence: 93%

“…As mentioned earlier, Almeleh (2006) found that in Cape Town HIV status disclosure is most common when people are sick and have no choice other than to disclose to potential care-givers and assistants. Consequently, HIV/AIDS is so strongly associated with illness and death that people whose health has been restored by HAART are regarded by some as no longer being HIV positive (Almeleh, 2006). Change in instrumental stigma 0.17*** n/a n/a [0.05] n/a n/a Change in symbolic stigma À0.06 n/a n/a [0.06] n/a n/a n 607 608 610 R-squared 0.10 0.12 0.28 Prob > F 0.000 0.000 0.000…”

Section: Discussionmentioning

confidence: 93%

“…However, Almeleh's (2006) finding that PLWHA in South Africa generally do not disclose until they are manifestly sick raises the possibility that the increase in the number of AIDS-sick people, especially among blacks (Actuarial Society of South Africa, 2005), results in more people becoming aware of the negative aspects of HIV, and this could result in the perpetuation of stigma. The South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey in 2005 found some evidence for this with a positive correlation between negative attitudes and close contact to PLWHA (Shisana et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stigma rises despite antiretroviral roll-out: A longitudinal analysis in South Africa

Maughan-Brown

2010

Social Science & Medicine

108

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a b s t r a c tStigma is a recognised problem for effective prevention, treatment, and care of HIV/AIDS. However, few studies have measured changes in the magnitude and character of stigma over time. This paper provides the first quantitative evaluation in Africa of the changing nature of stigma and the potential determinants of these changes. More specifically, it evaluates the dynamic relationship between stigma and (1) increased personal contact with people living with HIV/AIDS and (2) knowing people who died of AIDS. Panel survey data collected in Cape town 2003 and 2006 for 1074 young adults aged 14-22 years were used to evaluate changes in three distinct dimensions of stigma: behavioural intentions towards people living with HIV/AIDS; instrumental stigma; and symbolic stigma. Individual fixed effects regression models are used to evaluate factors that influence stigma over time. Each dimension of stigma increased in the population as a whole, and for all racial and gender sub-groups. Symbolic stigma increased the most, followed by instrumental stigma, while negative behavioural intentions showed a modest increase. Knowing someone who died of AIDS was significantly associated with an increase in instrumental stigma and symbolic stigma, while increased personal contact with people living with HIV/AIDS was not significantly associated with any changes in stigma. Despite interventions, such as public-sector provision of antiretroviral treatment (which some hoped would have reduced stigma), stigma increased among a sample highly targeted with HIV-prevention messages. These findings emphasise that changes in stigma are difficult to predict and thus important to monitor. They also indicate the imperative for renewed efforts to reduce stigma, perhaps through interventions to weaken the association between HIV/AIDS and death, to reduce fear of HIV/AIDS, and to recast HIV as a chronic manageable disease.

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“…Perhaps this is why, when they weighed up the costs and benefits of disclosing, or choosing certain individuals to disclose to and not others, they did so to mitigate these bad reactions, and thus minimise the actual stigma and discrimination that they would receive. Almeleh (2006) found that his study participants weighed up the perceived negative responses towards one's HIV-positive status disclosure with the potential positive support that certain individuals could offer them, and ultimately chose to disclose to persons they trusted, who were of value to them and from whom very little or no negative reactions or outcomes were expected to result from the disclosure.…”

Section: Discussionmentioning

confidence: 99%

To tell or not to tell: Negotiating disclosure for people living with HIV on antiretroviral treatment in a South African setting

Linda¹

2013

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Disclosure of HIV status occurs for a variety of reasons and in various contexts, such as to sexual partners to enable safer sexual choices, to health-care workers to access treatment and care services and to family and community members to gain various forms of support. The reasons for disclosure or non-disclosure are shaped by the relationships, needs and circumstances of people living with HIV (PLHIV) at the time of disclosure. The purpose of this study was to investigate and describe the act and experience of disclosure in order to understand how these experiences of disclosure impact on the lives of PLHIV on antiretroviral (ARV) treatment and influence adherence to treatment. Using a qualitative research design, I conducted an ethnographic study at and through the referral clinic at the Tygerberg Hospital in Cape Town, South Africa. Ninety-three adult patients (75 women) participated in the study, 32 of whom were visited at home to conduct semi-structured in-depth interviews, and 61 of them participated in a cross-sectional study at the referral clinic using researcher-administered questionnaires. A general inductive approach was used to analyse the data. Participants in both arms of the study disclosed mainly to family members, then partners and then to friends and other persons; only five had not disclosed to anyone at all. In deciding to disclose or not, the author began to see how patients negotiated their disclosure. From weighing up other people's reactions, to being concerned about the effect of their disclosure on their disclosure targets, to concealing one's status to evade untoward negative reactions towards themselves. Further, negotiating one's disclosure is not only about to whom or how to disclose, it also means finding good opportunities to disclose or conceiving ways of hiding one's status and/or medication from others in order to enhance access and adherence to their ARV treatment. Perceived rather than actual stigma played an important role in decisions not to disclose. Nonetheless, HIV remains a highly stigmatising disease. The author suggests that both the gains in support and the evasion of negative reactions from the disclosure will continue to drive negotiation of disclosure of one's status in order for patients to access and remain adherent to their treatment. Thus, areas of disclosure and concealment as they influence one's adherence to treatment need to be investigated further to facilitate adherence to treatment.Keywords: stigma, discrimination, social, household, family, partners RésuméLe partage du statut VIH a lieu pour diverses raisons et dans des contextes divers: avec les partenaires sexuels pour permettre des choix à moindre risque, avec les agents de santé pour accéder aux traitements et aux services de soins, et avec des membres de la famille et de la communauté pour obtenir diverses formes de soutien. Les motifs du partage ou du non-partage sont façonnés par les relations, les besoins et les circonstances des personnes vivant avec le VIH (PVVIH) au moment où elle...

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Why do People Disclose their HIV Status? Qualitative Evidence from a Group of Activist Women in Khayelitsha

Abstract: This study explores the bio-psychosocial context of HIV/AIDS in which eleven

Cited by 17 publications

References 31 publications

The Relationship Between Social Roles and Self-Management Behavior in Women Living with HIV/AIDS

The Relationship Between Social Roles and Self-Management Behavior in Women Living with HIV/AIDS

Stigma rises despite antiretroviral roll-out: A longitudinal analysis in South Africa

To tell or not to tell: Negotiating disclosure for people living with HIV on antiretroviral treatment in a South African setting

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