Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda
Abstract Background HIV status disclosure among sexual partners is vital in HIV management. Community health workers (CHW) support HIV disclosure among adults living with HIV (ALHIV) in sexual relationships with disclosure difficulties. However, experiences and challenges of using CHW-led disclosure...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | AIDS Research and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12981-023-00508-0 |
| _version_ | 1827982700415287296 |
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| author | Zubair Lukyamuzi Bashir Ssuna Ruth Nabisere Mirembe Denis Mawanda Paul Kinkumu Christine Nalugo Esther Adikin Faridah Namisango Rita Nakalega Patience Atuhaire Philippa Musoke Lisa M. Butler |
| author_facet | Zubair Lukyamuzi Bashir Ssuna Ruth Nabisere Mirembe Denis Mawanda Paul Kinkumu Christine Nalugo Esther Adikin Faridah Namisango Rita Nakalega Patience Atuhaire Philippa Musoke Lisa M. Butler |
| author_sort | Zubair Lukyamuzi |
| collection | DOAJ |
| description | Abstract Background HIV status disclosure among sexual partners is vital in HIV management. Community health workers (CHW) support HIV disclosure among adults living with HIV (ALHIV) in sexual relationships with disclosure difficulties. However, experiences and challenges of using CHW-led disclosure support mechanism were not documented. This study explored experiences and challenges involved in using CHW-led disclosure support mechanism among ALHIV in heterosexual relationships in the rural Uganda. Methods This was a phenomenological qualitative study involving in-depth interviews among CHWs and ALHIV with HIV disclosure difficulties to sexual partners in greater Luwero region, Uganda. We conducted 27 interviews among purposively selected CHWs and participants who had participated in the CHW-led disclosure support mechanism. Interviews were conducted until saturation was reached; and analysis was done using inductive and deductive content analysis in Atlas. Results All respondents viewed HIV disclosure as an important strategy in HIV management. Provision of adequate counseling and support to those intending to disclose was instrumental for successful disclosure. However, fear of the negative disclosure outcomes was viewed as a barrier to disclosure. The CHWs were viewed as having an added advantage in supporting disclosure as opposed to the routine disclosure counseling. However, HIV disclosure using CHW-led support mechanism would be limited by possible bleach of client’s confidentiality. Therefore, respondents thought that appropriate selection of CHWs would improve their trust in the community. Additionally, providing CHWs with adequate training and facilitation during the disclosure support mechanism was viewed to improve their work. Conclusion Community health workers were viewed as being more supportive in HIV disclosure among ALHIV with disclosure difficulties to sexual partners compared to routine facility based disclosure counseling. Therefore, near location CHW-led disclosure mechanism was acceptable and useful in supporting HIV disclosure among HIV-affected sexual partners in rural settings. |
| first_indexed | 2024-04-09T22:37:26Z |
| format | Article |
| id | doaj.art-b5f477ed99ec4c04b8e7a242c514302d |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-04-09T22:37:26Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-b5f477ed99ec4c04b8e7a242c514302d2023-03-22T12:26:23ZengBMCAIDS Research and Therapy1742-64052023-03-0120111210.1186/s12981-023-00508-0Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural UgandaZubair Lukyamuzi0Bashir Ssuna1Ruth Nabisere Mirembe2Denis Mawanda3Paul Kinkumu4Christine Nalugo5Esther Adikin6Faridah Namisango7Rita Nakalega8Patience Atuhaire9Philippa Musoke10Lisa M. Butler11Johns Hopkins University Collaboration (MU-JHU), Makerere UniversityUganda Tuberculosis Implementation Research Consortium (U-TIRC)Infectious Diseases Institute (IDI), College of Health Sciences, Makerere UniversityJohns Hopkins University Collaboration (MU-JHU), Makerere UniversityMildmay Hospital and Institute of Health Sciences, Mildmay UgandaMildmay Hospital and Institute of Health Sciences, Mildmay UgandaMildmay Hospital and Institute of Health Sciences, Mildmay UgandaIslamic University in UgandaJohns Hopkins University Collaboration (MU-JHU), Makerere UniversityJohns Hopkins University Collaboration (MU-JHU), Makerere UniversityJohns Hopkins University Collaboration (MU-JHU), Makerere UniversityInstitute for Collaboration On Health, Intervention, and Policy, University of ConnecticutAbstract Background HIV status disclosure among sexual partners is vital in HIV management. Community health workers (CHW) support HIV disclosure among adults living with HIV (ALHIV) in sexual relationships with disclosure difficulties. However, experiences and challenges of using CHW-led disclosure support mechanism were not documented. This study explored experiences and challenges involved in using CHW-led disclosure support mechanism among ALHIV in heterosexual relationships in the rural Uganda. Methods This was a phenomenological qualitative study involving in-depth interviews among CHWs and ALHIV with HIV disclosure difficulties to sexual partners in greater Luwero region, Uganda. We conducted 27 interviews among purposively selected CHWs and participants who had participated in the CHW-led disclosure support mechanism. Interviews were conducted until saturation was reached; and analysis was done using inductive and deductive content analysis in Atlas. Results All respondents viewed HIV disclosure as an important strategy in HIV management. Provision of adequate counseling and support to those intending to disclose was instrumental for successful disclosure. However, fear of the negative disclosure outcomes was viewed as a barrier to disclosure. The CHWs were viewed as having an added advantage in supporting disclosure as opposed to the routine disclosure counseling. However, HIV disclosure using CHW-led support mechanism would be limited by possible bleach of client’s confidentiality. Therefore, respondents thought that appropriate selection of CHWs would improve their trust in the community. Additionally, providing CHWs with adequate training and facilitation during the disclosure support mechanism was viewed to improve their work. Conclusion Community health workers were viewed as being more supportive in HIV disclosure among ALHIV with disclosure difficulties to sexual partners compared to routine facility based disclosure counseling. Therefore, near location CHW-led disclosure mechanism was acceptable and useful in supporting HIV disclosure among HIV-affected sexual partners in rural settings.https://doi.org/10.1186/s12981-023-00508-0HIV disclosureHeterosexual partnersCommunity health workersExperiencesChallenges |
| spellingShingle | Zubair Lukyamuzi Bashir Ssuna Ruth Nabisere Mirembe Denis Mawanda Paul Kinkumu Christine Nalugo Esther Adikin Faridah Namisango Rita Nakalega Patience Atuhaire Philippa Musoke Lisa M. Butler Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda AIDS Research and Therapy HIV disclosure Heterosexual partners Community health workers Experiences Challenges |
| title | Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda |
| title_full | Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda |
| title_fullStr | Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda |
| title_full_unstemmed | Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda |
| title_short | Experiences and challenges of using community health worker-led mechanism in supporting HIV disclosure among adults living with HIV in heterosexual relationships in the rural Uganda |
| title_sort | experiences and challenges of using community health worker led mechanism in supporting hiv disclosure among adults living with hiv in heterosexual relationships in the rural uganda |
| topic | HIV disclosure Heterosexual partners Community health workers Experiences Challenges |
| url | https://doi.org/10.1186/s12981-023-00508-0 |
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