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及时披露 HIV 血清阳性状况的障碍:坦桑尼亚达累斯萨拉姆关怀和治疗中心的定性研究。

Barriers to timely disclosure of HIV serostatus: A qualitative study at care and treatment centers in Dar es Salaam, Tanzania.

机构信息

Department of Family Medicine, Aga Khan University, Dar es Salaam, Tanzania.

School of Nursing and Midwifery, Aga Khan University, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2021 Aug 26;16(8):e0256537. doi: 10.1371/journal.pone.0256537. eCollection 2021.

Abstract

INTRODUCTION

Disclosure of Human Immunodeficiency Virus (HIV) status is important to prevent the spread of HIV and maintain the health of people living with HIV, their spouses, and the community. Despite the benefits of disclosure, many people living with HIV delay disclosing their status to those close to them thereby increasing the risk for disease transmission. This study aimed to determine the barriers to timely disclosure of HIV serostatus for people living with HIV in Dar es Salaam, Tanzania, and identify what motivated disclosure.

METHODS

A qualitative descriptive study using in-depth individual interviews was conducted with10 participants attending HIV care and treatment centers in Dar es Salaam. The participants were people living with HIV who had delayed disclosing their serostatus for more than one month after diagnosis. Data was analyzed using qualitative content analysis.

RESULTS

Three categories emerged from the analysis: Barriers hindering timely disclosure, motivation for disclosure of serostatus, and consequences of delayed disclosure. Barriers to timely disclosure included denial of one's status, the fear of stigmatization, fear of being separated or divorced, the need to protect loved ones, and lack of adequate knowledge about the disease. Reasons that motivated disclosure included gaining social support, preventing disease transmission and wanting to be at peace.

CONCLUSION

Timely disclosure is hindered by stigma because HIV is negatively perceived by the public. People living with HIV prefer not to disclose to avoid the negative consequences of disclosure, especially because of fear of being discriminated against and losing their social status, which plays a major role in social status in Tanzania. Trust and adequate counseling from health care workers helps prompt disclosure.

摘要

简介

披露人类免疫缺陷病毒(HIV)状况对于预防 HIV 的传播和维护 HIV 感染者、其配偶和社区的健康非常重要。尽管披露有很多好处,但许多 HIV 感染者会延迟向亲近的人透露自己的状况,从而增加疾病传播的风险。本研究旨在确定坦桑尼亚达累斯萨拉姆的 HIV 感染者及时披露 HIV 血清状况的障碍,并确定促使他们披露的动机。

方法

采用定性描述性研究方法,对 10 名在达累斯萨拉姆的 HIV 护理和治疗中心就诊的参与者进行了深入的个人访谈。这些参与者是 HIV 感染者,他们在诊断后超过一个月才延迟透露自己的血清状况。使用定性内容分析对数据进行分析。

结果

分析得出了三个类别:阻碍及时披露的障碍、披露血清状况的动机以及延迟披露的后果。及时披露的障碍包括否认自己的状况、对污名化的恐惧、害怕被分离或离婚、需要保护亲人以及对疾病缺乏足够的了解。促使披露的原因包括获得社会支持、预防疾病传播和想要内心平静。

结论

由于公众对 HIV 的负面看法,污名化阻碍了及时披露。HIV 感染者更愿意不披露,以避免披露的负面后果,尤其是因为害怕受到歧视和失去社会地位,这在坦桑尼亚的社会地位中起着重要作用。卫生保健工作者的信任和充分咨询有助于促使披露。

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