Tavakoli Fatemeh, Dehghan Mahlagha, Haghdoost Ali Akbar, Mirzazadeh Ali, Gouya Mohammad Mehdi, Sharifi Hamid
HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Reproductive Health, Family and Population Research Center, Kerman University of Medical Sciences, Kerman, Iran.
BMC Health Serv Res. 2024 May 2;24(1):570. doi: 10.1186/s12913-024-11049-1.
HIV partner notification services can help people living with HIV (PLHIV) to identify, locate, and inform their sexual and injecting partners who are exposed to HIV and refer them for proper and timely counseling and testing. To what extent these services were used by PLHIV and what are the related barriers and facilitators in southeast Iran are not known. So, this study aimed to explore HIV notification and its barriers and facilitators among PLHIV in Iran.
In this qualitative study, the number of 23 participants were recruited from November 2022 to February 2023 including PLHIV (N = 12), sexual partners of PLHIV (N = 5), and staff members (N = 6) of a Voluntary Counseling and Testing (VCT) center in Kerman located in the southeast of Iran. Our data collection included purposive sampling to increase variation. The content analysis was conducted using the Graneheim and Lundman approach. The analysis yielded 221 (out of 322) related codes related to HIV notification, its barriers, and its facilitators. These codes were further categorized into one main category with three categories and nine sub-categories.
The main category was HIV notification approaches, HIV notification barriers, and facilitators. HIV notification approaches were notification through clear, and direct conversation, notification through gradual preparation and reassurance, notification due to being with PLHIV, notification through suspicious talking of the physician, and notification due to the behavior of others. Also, the barriers were classified into individual, social, and environmental, and healthcare system barriers and the facilitators were at PLHIV, healthcare staff, and community levels. Stigma was a barrier mentioned by most participants. Also, the main facilitator of HIV notification was social support, especially from the family side.
The findings highlighted the multidimensionality of HIV notification emphasizing the importance of tailored support and education to enhance the notification process for PLHIV and their networks. Also, our results show that despite all the efforts to reduce stigma and discrimination in recent years, stigma still exists as a main obstacle to disclosing HIV status and other barriers are the product of stigma. It seems that all programs should be directed towards destigmatization.
艾滋病毒性伴通知服务可帮助艾滋病毒感染者（PLHIV）识别、查找并告知其面临艾滋病毒暴露风险的性伴和注射吸毒伙伴，并将他们转介至进行适当且及时的咨询和检测。伊朗东南部的艾滋病毒感染者在多大程度上利用了这些服务，以及相关的障碍和促进因素尚不清楚。因此，本研究旨在探讨伊朗艾滋病毒感染者中的艾滋病毒通报情况及其障碍和促进因素。
在这项定性研究中，2022年11月至2023年2月招募了23名参与者，包括艾滋病毒感染者（N = 12）、艾滋病毒感染者的性伴（N = 5）以及位于伊朗东南部克尔曼的一家自愿咨询和检测（VCT）中心的工作人员（N = 6）。我们的数据收集包括目的抽样以增加多样性。采用格兰海姆和伦德曼方法进行内容分析。分析得出了221条（共322条）与艾滋病毒通报、其障碍和促进因素相关的代码。这些代码进一步分为一个主要类别，包含三个类别和九个子类别。
主要类别为艾滋病毒通报方法、艾滋病毒通报障碍和促进因素。艾滋病毒通报方法包括通过清晰直接的交谈进行通报、通过逐步准备和安抚进行通报、因与艾滋病毒感染者在一起而通报、通过医生可疑的交谈进行通报以及因他人的行为而通报。此外，障碍分为个人、社会、环境和医疗保健系统障碍，促进因素则处于艾滋病毒感染者、医护人员和社区层面。耻辱感是大多数参与者提到的一个障碍。此外，艾滋病毒通报的主要促进因素是社会支持，尤其是来自家庭方面的支持。
研究结果突出了艾滋病毒通报的多维度性，强调了提供量身定制的支持和教育对于加强艾滋病毒感染者及其社交网络通报过程的重要性。此外，我们的结果表明，尽管近年来为减少耻辱感和歧视做出了所有努力，但耻辱感仍然是披露艾滋病毒感染状况的主要障碍，其他障碍是耻辱感的产物。似乎所有项目都应致力于消除耻辱感。
