Effect of Disclosure and Social Support on Change in Childbearing Intentions among People Diagnosed With Hiv
Abstract
Majority of PLWHA remain sexually active, reproduction among PLWHA are clinical and concerned more on transmission prevention rather than childbearing plans and intentions. There are limited data on childbearing intentions of PLWHA, especially when comparing those whose sexual partners and/or significant others are aware of their HIV status. The study used Information-Motivation- Behavioural Skills Model and Theory of Planned Behaviour in analysing relationship between disclosure and change in sexual behaviour/childbearing intentions among known HIV patients.
A cross sectional study of PLWHA attending care and treatment centre was conducted using both quantitative and qualitative methods of data collection. Selected subsamples of the survey respondents participated in in-depth interviews and 13 were interviewed. Descriptive statistics were calculated to determine rate of disclosure and other outcomes.
Respondents were between the ages of 20-49,belonged to one religious group or the other,a large percentage (56.7%) had secondary education, majority; 90.9% revealed their HIV status to at least one person whereas 50.6% disclosed to their sexual partners. Female respondents disclosed to sexual partners than males (64.2% versus 37.2%, respectively). Doctors/health professionals gave the overall greatest source of support. Only 24.7% reporting abstinence in 12 months while only 20 (9.4%) changed their reproductive intentions after disclosure.
Majority reported receiving more social support after disclosure, disclosure was related to changes in sexual behaviour but not related to childbearing intentions. The study suggests that counsellors and Healthcare providers should provide accurate reproductive health information to guide PLWHA in making informed choices regarding their reproductive goals.
References
Ajeromi-Ifelodun Local Government Health Reports 2010, 2013
Ajzen, I., and Thomas, J. M. 1986 Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology 22 (5):453-474.
Akani, C. I. and Erhabor, O. 2006. Rate pattern and Barriers of HIV Serostatus Disclosure in a Resource –limited Setting in the Niger Delta of Nigeria. Tropical Doctor, 36(2): 87-89.
Allen, C. F., Y. Simon, J. E, and Simeon, D.T. 2010. Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean. AIDS Care 22 (11):1386-1394.
Amoran, O. E. 2012 Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in Ogun State, Nigeria. Niger J Clin Pract 2012;15:385-90
Anderson, J., and Doyal, L. 2004. Women from Africa living with HIV in London: a descriptive study. AIDS Care 16 (1):95 - 105.
Barnett, Tony, and Whiteside A.. 2006. AIDS in the Twenty-First Century: Disease and Globalization. Second Edition ed. New York: Palgrave Macmillan
Bartos, M., and McDonald, K. 2000. HIV as identity, experience or career. AIDS Care 12 (3):299-306.
Baumgartner, Lisa M. 2007. The Incorporation of the HIV/AIDS Identity Into the Self Over Time. Qualitative Health Research 17 (7):919-931.
Bunnell, R.E., Mermin, J.H, De Cock, K.M. 2006. HIV prevention for a threatened continent. Implementing positive prevention in Africa. Journal of American Medical Association; 296(7):855-858.
Bury, Michael. 1982. Chronic illness as biographical disruption. Sociology of Health & Illness 4 (2):167-182.
Caldwell, J. C., Caldwell, P and Quiggin, P. 1989. The Social Context of AIDS in sub-Saharan Africa. Population and Development Review 15 (2):185-234.
Carricaburu, D. and Pierret J. 1995. From biographical disruption to biographical reinforcement: the case of HIV-positive men. Sociology of Health & Illness 17 (1):65-88.
Chama, C., Morrupa, J. and Gashau, W. 2007. Sex and reproduction among HIV- infected people in Maiduguri, Nigeria. Journal of Obstetrics & Gynaecology 27 (8):812-815.
Chaudoir, S. R., Fisher, J.D and Simoni, J. 2011. Understanding HIV disclosure: A review and application of the Disclosure Processes Model. Social Science and Medicine 72 (10):1618-1629.
Cooper, Diane, Jane Harries, Landon Myer, Phyllis Orner, and Hillary Bracken. 2007. "Life is still going on": Reproductive intentions among HIV-positive women and men in South Africa. Social Science & Medicine 65 (2):274-283.
Cooper, Diane, Jennifer Moodley, Virginia Zweigenthal, Linda-Gail Bekker, Iqbal Shah, and Landon Myer. 2009. Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services. AIDS and Behavior 13 (supplement 1):38-46.
Courtenay-Quirk, Cari, Jun Zhang, and Richard Wolitski. 2009. Intentional Abstinence Among Homeless and Unstably Housed Persons Living with HIV/AIDS. AIDS and Behavior 13 (6):1119-1128.
Crepaz, N. and Marks, G. 2002. Towards an understanding of sexual risk behaviour in people living with HIV: A review of social, psychological and medical findings. AIDS, 16:135-159
Daniel O.J and Oladapo O.T 2011: Self- disclosure of HIV sero-status to sexual partner in Nigeria
Darak, Shrinivas, Fanny Janssen, and Inge Hutter. 2011. Fertility among HIV-infected Indian women: the biological effect and its implications. Journal of Biosocial Science 43 (01):19-29.
Deribe K, Woldemichael K, Wondafrash M, Haile A, Amberbir A. (2008) Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia. BMC Public Health. 8:81.
Eliud Wekesa, Ernestina Coast (2014) Fertility Desires among Men and Women Living with HIV/AIDS in Nairobi Slums: A Mixed Methods Study. PLoS One. 2014; 9(8): e106292.
Kazuyo Machiyama, Joyce N. Mumah, Michael Mutua, John Cleland (2019) Childbearing desires and behaviour: a prospective assessment in Nairobi slumsBMC Pregnancy Childbirth. 2019; 19: 100. doi: 10.1186/s12884-019-2245-3
PMCID: PMC6437922
Evans, Catrin, and Helen Lambert. 2007. The limits of behaviour change theory: Condom use and contexts of HIV risk in the Kolkata sex industry. Culture, Health & Sexuality 10 (1):27-41.
Fisher, J. D., W. A. Fisher, K. R. Amico, and J. J. Harman. 2006. An information- motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology 25 (4):462-473.
Fisher, Jeffrey D., and William A. Fisher. 1992. Changing AIDS-risk behavior. Psychological Bulletin 111 (3):455-474.
Gielen, Andrea, Linda Fogarty, Patricia O'Campo, Jean Anderson, Jean Keller, and Ruth Faden. 2000. Women living with HIV: Disclosure, violence, and social support. Journal of Urban Health 77 (3):480-491.
Green L,W and Kreuter M.W 1991 Health promotion planning, an educational and
Greenberg, J. 2000. The impact of disclosure of mixed HIV Status of support, relationship satisfaction and psychological Distress for male mixed status couples. Accessed from www.informaworld.com/index.
Gregson, Simon, To Zhuwau, Joshua Ndlovu, and Constance Nyamukapa. 2002. Methods to Reduce Social Desirability Bias in Sex Surveys in Low- Development Settings: Experience in Zimbabwe. Sexually Transmitted Diseases 29 (10):568-575.
Hosegood, Victoria. 2009. The demographic impact of HIV and AIDS across the family and household life-cycle: implications for efforts to strengthen families in sub-Saharan Africa. AIDS Care 21 (sup1):13-21.
Ivankova, Nataliya V., John W. Creswell, and Sheldon L. Stick. 2006. Using Mixed- Methods Sequential Explanatory Design: From Theory to Practice. Field Methods 18 (1):3-20.
Izugbara, Chimaraoke O., and Eliud Wekesa. 2011. Beliefs and practices about antiretroviral medication: a study of poor urban Kenyans living with HIV/AIDS. Sociology of Health & Illness 33 (6):869-883.
Kalipeni, Ezekiel, Joseph Oppong, and Assata Zerai. 2007. HIV/AIDS, gender, agency and empowerment issues in Africa. Social Science & Medicine 64 (5):1015- 1018.
Kennedy, C., K. O'Reilly, A. Medley, and M. Sweat. 2007. The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care 19 (6):707 - 720.
Kralik, Debbie. 2002. The quest for ordinariness: transition experienced by midlife women living Lekas, Helen-Maria, Karolynn Siegel, and Jason Leider. 2011. Felt and Enacted Stigma Among HIV/HCV-Coinfected Adults: The Impact of Stigma Layering. Qualitative Health Research with chronic illness. Journal of Advanced Nursing 39 (2):146- 154.
Maclachlan, Ellen W. 2007. Factors that Influence Risk Behaviour in HIV Infected Women Receiving Antiretroviral Therapy in Kampala and Masaka, Uganda. PhD Thesis, Public Health, Oregon State University, Oregon.
Mathews C, Coetzee N, Zwarenstein M, Lombard C, Guttmacher S, Oxman A, et al. (2002)A systematic review of strategies for partner notification for sexually transmitted diseases including HIV/AIDS. Int J STD AIDS 13:285-300.
Mbizvo, M. T., and M. T. Bassett. 1996. Reproductive health and AIDS prevention in sub-Saharan Africa: the case for increased male participation. Health Policy and Planning 11 (1):84-92.
Mill, Judy E., and John K. Anarfi. 2002. HIV risk environment for Ghanaian women: challenges to prevention. Social Science & Medicine 54 (3):325-337.
Njogu, W., and T.C. Martin. 2005. The persisting gap between HIV/AIDS knowledge and risk prevention among Kenyan youth. Genus 62 (2):135-168.
Paxton, S. 2002. The paradox of public HIV disclosure: Psychological and Socio-medical Aspects of AIDS/HIV. AIDS Care 14 (4):559-567.
Russell, Steven, and Janet Seeley. 2010. The transition to living with HIV as a chronic condition in rural Uganda: Working to create order and control when on antiretroviral therapy. Social Science & Medicine 70 (3):375-382.
Salami, K.A, Fadeyi, A, Ogunmodede, J.A. and Desalu O.O 2011 Status Disclosure among People Living With HIV/AIDS in Ilorin, Nigeria. West African Journal of Medicine Vol 30, No 5
Sarna, A., S. M. F. Luchters, S. Geibel, S. Kaai, P. Munyao, K. S. Shikely, K. Mandaliya, J. van Dam, and M. Temmerman. 2008. Sexual risk behaviour and HAART: a comparative study of HIV-infected persons on HAART and on preventive therapy in Kenya. International Journal of STD and AIDS 19 (2):85- 89.
Segurado A.C, Paiva V. 2007. Rights of HIV positive people to sexual and reproductive health: parenthood.Reprod Health Matters. May;15(29 Suppl):27-45.
Smith, Daniel Jordan, and Benjamin C. Mbakwem. 2010. Antiretroviral therapy and reproductive life projects: Mitigating the stigma of AIDS in Nigeria. Social Science & Medicine 71 (2):345-352.
Ssali, S. N., L. Atuyambe, C. Tumwine, E. Segujja, N. Nekesa, A. Nannungi, G. Ryan, and G. Wagner. 2010. Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care and STDs 24 (10):675-681.
Stillwaggon, E. 2002. HIV/AIDS in Africa: Fertile Terrain. Journal of Development Studies 38 (6):1 - 22.
Stillwaggon, E. 2006. AIDS and the Ecology of Poverty. New York: Oxford University Press.
UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic'
Varga, Christine A. 2003. How Gender Roles Influence Sexual and Reproductive Health Among South African Adolescents. Studies in Family Planning 34 (3):160-172.
Ajzen, I., and Thomas, J. M. 1986 Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology 22 (5):453-474.
Akani, C. I. and Erhabor, O. 2006. Rate pattern and Barriers of HIV Serostatus Disclosure in a Resource –limited Setting in the Niger Delta of Nigeria. Tropical Doctor, 36(2): 87-89.
Allen, C. F., Y. Simon, J. E, and Simeon, D.T. 2010. Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean. AIDS Care 22 (11):1386-1394.
Amoran, O. E. 2012 Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in Ogun State, Nigeria. Niger J Clin Pract 2012;15:385-90
Anderson, J., and Doyal, L. 2004. Women from Africa living with HIV in London: a descriptive study. AIDS Care 16 (1):95 - 105.
Barnett, Tony, and Whiteside A.. 2006. AIDS in the Twenty-First Century: Disease and Globalization. Second Edition ed. New York: Palgrave Macmillan
Bartos, M., and McDonald, K. 2000. HIV as identity, experience or career. AIDS Care 12 (3):299-306.
Baumgartner, Lisa M. 2007. The Incorporation of the HIV/AIDS Identity Into the Self Over Time. Qualitative Health Research 17 (7):919-931.
Bunnell, R.E., Mermin, J.H, De Cock, K.M. 2006. HIV prevention for a threatened continent. Implementing positive prevention in Africa. Journal of American Medical Association; 296(7):855-858.
Bury, Michael. 1982. Chronic illness as biographical disruption. Sociology of Health & Illness 4 (2):167-182.
Caldwell, J. C., Caldwell, P and Quiggin, P. 1989. The Social Context of AIDS in sub-Saharan Africa. Population and Development Review 15 (2):185-234.
Carricaburu, D. and Pierret J. 1995. From biographical disruption to biographical reinforcement: the case of HIV-positive men. Sociology of Health & Illness 17 (1):65-88.
Chama, C., Morrupa, J. and Gashau, W. 2007. Sex and reproduction among HIV- infected people in Maiduguri, Nigeria. Journal of Obstetrics & Gynaecology 27 (8):812-815.
Chaudoir, S. R., Fisher, J.D and Simoni, J. 2011. Understanding HIV disclosure: A review and application of the Disclosure Processes Model. Social Science and Medicine 72 (10):1618-1629.
Cooper, Diane, Jane Harries, Landon Myer, Phyllis Orner, and Hillary Bracken. 2007. "Life is still going on": Reproductive intentions among HIV-positive women and men in South Africa. Social Science & Medicine 65 (2):274-283.
Cooper, Diane, Jennifer Moodley, Virginia Zweigenthal, Linda-Gail Bekker, Iqbal Shah, and Landon Myer. 2009. Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa: Implications for Integrating Reproductive Health and HIV Care Services. AIDS and Behavior 13 (supplement 1):38-46.
Courtenay-Quirk, Cari, Jun Zhang, and Richard Wolitski. 2009. Intentional Abstinence Among Homeless and Unstably Housed Persons Living with HIV/AIDS. AIDS and Behavior 13 (6):1119-1128.
Crepaz, N. and Marks, G. 2002. Towards an understanding of sexual risk behaviour in people living with HIV: A review of social, psychological and medical findings. AIDS, 16:135-159
Daniel O.J and Oladapo O.T 2011: Self- disclosure of HIV sero-status to sexual partner in Nigeria
Darak, Shrinivas, Fanny Janssen, and Inge Hutter. 2011. Fertility among HIV-infected Indian women: the biological effect and its implications. Journal of Biosocial Science 43 (01):19-29.
Deribe K, Woldemichael K, Wondafrash M, Haile A, Amberbir A. (2008) Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia. BMC Public Health. 8:81.
Eliud Wekesa, Ernestina Coast (2014) Fertility Desires among Men and Women Living with HIV/AIDS in Nairobi Slums: A Mixed Methods Study. PLoS One. 2014; 9(8): e106292.
Kazuyo Machiyama, Joyce N. Mumah, Michael Mutua, John Cleland (2019) Childbearing desires and behaviour: a prospective assessment in Nairobi slumsBMC Pregnancy Childbirth. 2019; 19: 100. doi: 10.1186/s12884-019-2245-3
PMCID: PMC6437922
Evans, Catrin, and Helen Lambert. 2007. The limits of behaviour change theory: Condom use and contexts of HIV risk in the Kolkata sex industry. Culture, Health & Sexuality 10 (1):27-41.
Fisher, J. D., W. A. Fisher, K. R. Amico, and J. J. Harman. 2006. An information- motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology 25 (4):462-473.
Fisher, Jeffrey D., and William A. Fisher. 1992. Changing AIDS-risk behavior. Psychological Bulletin 111 (3):455-474.
Gielen, Andrea, Linda Fogarty, Patricia O'Campo, Jean Anderson, Jean Keller, and Ruth Faden. 2000. Women living with HIV: Disclosure, violence, and social support. Journal of Urban Health 77 (3):480-491.
Green L,W and Kreuter M.W 1991 Health promotion planning, an educational and
Greenberg, J. 2000. The impact of disclosure of mixed HIV Status of support, relationship satisfaction and psychological Distress for male mixed status couples. Accessed from www.informaworld.com/index.
Gregson, Simon, To Zhuwau, Joshua Ndlovu, and Constance Nyamukapa. 2002. Methods to Reduce Social Desirability Bias in Sex Surveys in Low- Development Settings: Experience in Zimbabwe. Sexually Transmitted Diseases 29 (10):568-575.
Hosegood, Victoria. 2009. The demographic impact of HIV and AIDS across the family and household life-cycle: implications for efforts to strengthen families in sub-Saharan Africa. AIDS Care 21 (sup1):13-21.
Ivankova, Nataliya V., John W. Creswell, and Sheldon L. Stick. 2006. Using Mixed- Methods Sequential Explanatory Design: From Theory to Practice. Field Methods 18 (1):3-20.
Izugbara, Chimaraoke O., and Eliud Wekesa. 2011. Beliefs and practices about antiretroviral medication: a study of poor urban Kenyans living with HIV/AIDS. Sociology of Health & Illness 33 (6):869-883.
Kalipeni, Ezekiel, Joseph Oppong, and Assata Zerai. 2007. HIV/AIDS, gender, agency and empowerment issues in Africa. Social Science & Medicine 64 (5):1015- 1018.
Kennedy, C., K. O'Reilly, A. Medley, and M. Sweat. 2007. The impact of HIV treatment on risk behaviour in developing countries: A systematic review. AIDS Care 19 (6):707 - 720.
Kralik, Debbie. 2002. The quest for ordinariness: transition experienced by midlife women living Lekas, Helen-Maria, Karolynn Siegel, and Jason Leider. 2011. Felt and Enacted Stigma Among HIV/HCV-Coinfected Adults: The Impact of Stigma Layering. Qualitative Health Research with chronic illness. Journal of Advanced Nursing 39 (2):146- 154.
Maclachlan, Ellen W. 2007. Factors that Influence Risk Behaviour in HIV Infected Women Receiving Antiretroviral Therapy in Kampala and Masaka, Uganda. PhD Thesis, Public Health, Oregon State University, Oregon.
Mathews C, Coetzee N, Zwarenstein M, Lombard C, Guttmacher S, Oxman A, et al. (2002)A systematic review of strategies for partner notification for sexually transmitted diseases including HIV/AIDS. Int J STD AIDS 13:285-300.
Mbizvo, M. T., and M. T. Bassett. 1996. Reproductive health and AIDS prevention in sub-Saharan Africa: the case for increased male participation. Health Policy and Planning 11 (1):84-92.
Mill, Judy E., and John K. Anarfi. 2002. HIV risk environment for Ghanaian women: challenges to prevention. Social Science & Medicine 54 (3):325-337.
Njogu, W., and T.C. Martin. 2005. The persisting gap between HIV/AIDS knowledge and risk prevention among Kenyan youth. Genus 62 (2):135-168.
Paxton, S. 2002. The paradox of public HIV disclosure: Psychological and Socio-medical Aspects of AIDS/HIV. AIDS Care 14 (4):559-567.
Russell, Steven, and Janet Seeley. 2010. The transition to living with HIV as a chronic condition in rural Uganda: Working to create order and control when on antiretroviral therapy. Social Science & Medicine 70 (3):375-382.
Salami, K.A, Fadeyi, A, Ogunmodede, J.A. and Desalu O.O 2011 Status Disclosure among People Living With HIV/AIDS in Ilorin, Nigeria. West African Journal of Medicine Vol 30, No 5
Sarna, A., S. M. F. Luchters, S. Geibel, S. Kaai, P. Munyao, K. S. Shikely, K. Mandaliya, J. van Dam, and M. Temmerman. 2008. Sexual risk behaviour and HAART: a comparative study of HIV-infected persons on HAART and on preventive therapy in Kenya. International Journal of STD and AIDS 19 (2):85- 89.
Segurado A.C, Paiva V. 2007. Rights of HIV positive people to sexual and reproductive health: parenthood.Reprod Health Matters. May;15(29 Suppl):27-45.
Smith, Daniel Jordan, and Benjamin C. Mbakwem. 2010. Antiretroviral therapy and reproductive life projects: Mitigating the stigma of AIDS in Nigeria. Social Science & Medicine 71 (2):345-352.
Ssali, S. N., L. Atuyambe, C. Tumwine, E. Segujja, N. Nekesa, A. Nannungi, G. Ryan, and G. Wagner. 2010. Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care and STDs 24 (10):675-681.
Stillwaggon, E. 2002. HIV/AIDS in Africa: Fertile Terrain. Journal of Development Studies 38 (6):1 - 22.
Stillwaggon, E. 2006. AIDS and the Ecology of Poverty. New York: Oxford University Press.
UNAIDS (2010) 'UNAIDS report on the global AIDS epidemic'
Varga, Christine A. 2003. How Gender Roles Influence Sexual and Reproductive Health Among South African Adolescents. Studies in Family Planning 34 (3):160-172.
Authors
[1]
“Effect of Disclosure and Social Support on Change in Childbearing Intentions among People Diagnosed With Hiv”, Soc. sci. humanities j., vol. 3, no. 05, pp. 1118–1133, May 2019, Accessed: Nov. 23, 2024. [Online]. Available: https://sshjournal.com/index.php/sshj/article/view/372
Copyright and license info is not available