Researcher, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Infectious Diseases and Global Health, Radboud University Medical Centre, Nijmegen, The Netherlands. Correspondence:
Head of HIV Research Group, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia.
Sex Reprod Health Matters. 2022 Dec;30(1):2028971. doi: 10.1080/26410397.2022.2028971.
This mixed-methods study investigated HIV status disclosure and partner testing of women living with HIV (WLWH) in a concentrated epidemic setting in Bandung, Indonesia. The qualitative exploratory strand used theoretical sampling to carry out semi-structured interviews with 47 HIV-infected women with varying anti-retroviral therapy status. The quantitative strand included 122 female patients receiving HIV care at a referral clinic. HIV diagnosis made women reassess their sexual partnerships. Some lost their partner due to death or divorce. Women with a longstanding HIV infection often formed new partnerships. They disclosed their status to new partners without assistance from health providers; the type and stability of the partnership influenced decision to disclose. Fear of rejection prevented initial disclosure prior to bringing the new partners to a health provider. Disclosure did not always result in partner testing because of low risk-awareness or denial of the partner. Despite a similar proportion of status disclosure to partner (92.8%), only 53.7% of new partners of WLWH were tested in contrast to 89.7% of partners tested among WLWH who stayed with the same partner. In antenatal care, where same-day testing was often done for pregnant couples, more partners were tested. Overall, consistent condom use was low and HIV status forced WLWH who continued sex work to work at settings where condom use was not enforced. WLWH face barriers to HIV status disclosure and partner testing and would benefit from partnership counselling. Guidelines for partner notification and testing should include specific strategies for women with longstanding HIV infection.
本混合方法研究调查了印度尼西亚万隆集中流行地区 HIV 阳性妇女(WLWH)的 HIV 状况披露和伴侣检测情况。定性探索部分采用理论抽样,对 47 名接受不同抗逆转录病毒治疗的 HIV 感染妇女进行了半结构式访谈。定量部分包括在一家转诊诊所接受 HIV 护理的 122 名女性患者。HIV 诊断使妇女重新评估她们的性伴侣关系。一些人因死亡或离婚而失去了伴侣。长期感染 HIV 的女性通常会形成新的伴侣关系。她们在没有卫生保健提供者帮助的情况下向新伴侣透露了自己的状况;伴侣关系的类型和稳定性影响了披露的决定。对拒绝的恐惧阻止了她们在带新伴侣去卫生保健提供者之前进行初步披露。由于风险意识低或否认伴侣的存在,披露并不总是导致伴侣接受检测。尽管向伴侣透露 HIV 状况的比例相似(92.8%),但与 WLWH 中与同一伴侣保持关系的伴侣中接受检测的比例(89.7%)相比,只有 53.7%的 WLWH 的新伴侣接受了检测。在产前保健中,经常为怀孕夫妇进行同日检测,因此更多的伴侣接受了检测。总体而言,坚持使用安全套的比例较低,HIV 状况迫使继续从事性工作的 WLWH 在不强制使用安全套的场所工作。WLWH 在 HIV 状况披露和伴侣检测方面面临障碍,将受益于伴侣咨询。伴侣通知和检测指南应包括针对长期感染 HIV 的妇女的具体策略。
Sex Reprod Health Matters. 2022-12
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