Dataset Information

HIV Disclosure: HIV-positive status disclosure to sexual partners among individuals receiving HIV care in Addis Ababa, Ethiopia.

ABSTRACT:

Introduction

Disclosure of HIV status to sexual partners can help HIV prevention efforts and enable HIV positive people to receive social support, as well as increasing access and adherence to treatment. This study was conducted to determine the rate, processes, outcomes, and correlates of HIV status disclosure to sexual partners among HIV positive individuals.

Method

A cross-sectional study was conducted between September and November 2015 at two HIV outpatient clinics in Addis Ababa, Ethiopia. Data were collected using an interviewer- administered semi-structured questionnaire. Logistic analysis was used to determine the independent correlates of serostatus disclosure.

Results

Of 742 participants, (371 men and 371 women), 727 (98%) were on antiretroviral therapy and 676 (91.1%) had at least one sexual partner since their HIV diagnosis, of whom 558 (82.5%) had disclosed their HIV status to their most recent sexual partner. Of those who reported having disclosed their status to their most recent sexual partner, 82 (14.7%) had at least one unprotected sexual encounter with the partner, after HIV diagnosis but prior to disclosure. The most commonly reported initial outcome of disclosure was gaining emotional and/or financial support. Some (11.3%) also reported that their disclosure immediately initiated their partner for HIV testing. Negative outcomes to disclosure, such as stigma and discrimination, were more common among females (26.2%) compared to males (12.7%). In the multiple regression analysis, disclosure was associated with greater condom use, greater social support, knowing the partner's HIV status, having a good relationship with the partner, and cohabiting with the partner.

Conclusion

HIV disclosure was common amongst participants, although sometimes delayed, with possible consequences for onward transmission. Fear of negative outcomes, such as verbal abuse and physical violence, were major barriers to disclosure. Efforts to support disclosure have the potential to contribute to HIV control and prevention by encouraging safer sexual practice, initiating partners for HIV testing, and enhancing support for people living with HIV.

SUBMITTER: Dessalegn NG

PROVIDER: S-EPMC6415764 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

HIV Disclosure: HIV-positive status disclosure to sexual partners among individuals receiving HIV care in Addis Ababa, Ethiopia.

Dessalegn Noah G NG Hailemichael Rahel G RG Shewa-Amare Aster A Sawleshwarkar Shailendra S Lodebo Bereket B Amberbir Alemayehu A Hillman Richard J RJ

PloS one 20190215 2

<h4>Introduction</h4>Disclosure of HIV status to sexual partners can help HIV prevention efforts and enable HIV positive people to receive social support, as well as increasing access and adherence to treatment. This study was conducted to determine the rate, processes, outcomes, and correlates of HIV status disclosure to sexual partners among HIV positive individuals.<h4>Method</h4>A cross-sectional study was conducted between September and November 2015 at two HIV outpatient clinics in Addis A ...[more]

PMID: 30768642

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Project description:BackgroundSexual behavior of HIV positive individuals visiting anti- retroviral clinics is a neglected issue. With access to anti-retroviral treatment, HIV positive individuals experience improved health and are able to reintegrate into their social life and many of them engage in sexual activities. In the context of Ethiopia, safer sex practices among people living with HIV is critical in terms of preventing the acquisition of another strain of HIV and helping address the epidemic.MethodAn institution-based cross sectional study was conducted at Addis Ababa public hospitals from January to February 2017. A pretested structured questionnaire was used to collect the data. Using the systematic random sampling technique, a total of 562 respondents participated in the study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive statistics, bi-variate, and multi variable analyses were done. A p-value < 0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between dependent and independent variables.ResultsA total of 562 respondents participated in the study which revealed that the prevalence of risky sexual practice was 39.1% (95% CI: 35.2, 43.8) three months prior to the data collection. Educational status of participants who were below grade eight (AOR = 2.27, 95% CI:1.01,5.10) and went to grades eight to twelve (AOR = 2.12, 95% CI:1.02,4.41), were married (AOR = 2.07, 95% CI:1.06,4.02), had no concern for safer sexual practice (AOR = 3.74, 95% CI:2.28, 6.13), had CD4 count of ≥500cells/mm3(AOR = 1.66, 95% CI:1.04, 2.64), and used substance (AOR = 3.41, 95% CI:1.83, 6.35) were significantly associated with risky sexual practice.ConclusionThe prevalence of risky sexual practice was markedly high in this study due to such contributory factors as low educational status, marriage, lack of concern for safer sexual practices, and substance use.

Project description:BackgroundThe life and health of street children is becoming a global concern. Street children are vulnerable to a variety of problems including physical, psychological and sexual exploitations as well as social isolation. Therefore, it was the purpose of this study to point out the experience of sexual and physical exploitation and its determinant factors among street children in Addis Ababa, the capital city of Ethiopia.MethodologyA phenomenological qualitative method was conducted from March to June 2016 in Addis Ababa, Ethiopia. Data were collected from street children by focus group discussion (FGD) and in-depth interview. Open code was used to analyze data. The transcribed note was translated. Following this coding was done. Based on a coding book, major themes and main categories were developed and analyzed.ResultThe study has explored the life experience of street children in the city. Deaths of parents/unhealthy relationship of extended families forced them be on a street. Thus, flee to street to search for work was the main reason for joining to a street. Street children are vulnerable to sexual and physical exploitations on a daily basis. For street children, street is the world characterized by misery deprivation, physical, verbal and sexual abuse and become daily victims of violence. There is no safe place for the children of on-street. Most street children are involved in all types of sex; heterosexual, bisexual, homosexual and group sex are common among themselves and out siders. They are involved highly in transactional sex for survival. Drug use, stress and depression are common experiences. Thus, they were socially isolated. The main challenges of living on a street are lack of basic needs, social isolation, lack of safety and security and being out of school are the common problems these vulnerable groups are facing.ConclusionsStreet children are at high risk of sexual and physical exploitation. Interventions targeting integration and reunion with families, reduction of physical and sexual exploitation, access to education, mental health promotion and reduction of drug use behavior should be taken in to considerations.

Project description:BackgroundVertical transmission of HIV remains one of the most common transmission modes. Antiretroviral therapy (ART) decreases the risk of transmission to less than 2%, but maintaining adherence to treatment remains a challenge. Some of the commonly reported barriers to adherence to ART include stress (physical and emotional), depression, and alcohol and drug abuse. Integrating screening and treatment for psychological problem such as depression was reported to improve adherence. In this study, we sought to determine the prevalence of depression and its association with adherence to ART among HIV-positive pregnant women attending antenatal care (ANC) clinics in Addis Ababa, Ethiopia.MethodsWe conducted a cross-sectional survey from March through November 2018. Participants were conveniently sampled from 12 health institutions offering ANC services. We used the Patient Health Questionnaire-9 (PHQ-9) to screen for depression and the Center for Adherence Support Evaluation (CASE) Adherence index to evaluate adherence to ART. Descriptive statistics was used to estimate the prevalence of depression during third-trimester pregnancy and nonadherence to ART. A bivariate logistic regression analysis was used to get significant predictors for each of the two outcome measures. The final multivariable logistic regression analysis included variables with a P<0.25 in the bivariate logistic regression model; statistical significance was evaluated at P<0.05.ResultsWe approached 397 eligible individuals, of whom 368 (92.7%) participated and were included in the analysis. Of the total participants, 175(47.6%) had depression. The participants' overall level of adherence to ART was 82%. Pregnant women with low income were twice more likely to have depression (AOR = 2.10, 95%CI = 1.31-3.36). Women with WHO clinical Stage 1 disease were less likely to have depression than women with more advanced disease (AOR = 0.16, 95%CI = 0.05-0.48). There was a statistically significant association between depression and nonadherence to ART (P = 0.020); nonadherence was nearly two times higher among participants with depression (AOR = 1.88, 95%CI = 1.08-3.27).ConclusionWe found a high prevalence of depression among HIV-positive pregnant women in the selected health facilities in Addis Ababa, and what was more concerning was its association with higher rates of nonadherence to ART adversely affecting the outcome of their HIV care. We recommend integrating screening for depression in routine ANC services.

Project description:BACKGROUND:Many patients with chronic illness have sexual dysfunction that may be related to the condition itself, drug side effects, emotional sequel, or a combination of those factors. Patients with epilepsy are no exception. Men and women with epilepsy are frequently complaining sexual dysfunction and they appear to have a higher incidence of sexual dysfunction than peoples with other chronic neurologic illness. These problems can have a substantial impact on their sexuality thus; it needs careful study and evaluation. METHODS:Hospital based cross sectional study was conducted from January to July, 2016 among Patient with Epilepsy at Amanuel Mental Specialty Hospital. Interviewer administered Changes in Sexual Functioning Questionnaire (CSFQ-14) was used in order to assess the sexual problems. Finally, the data was analyzed by using Statistical Package for Social Science (SPSS) V-20. Descriptive statistics and logistic regression were used to describe the variables. Levels of significance of association determined at <?0.05. RESULTS:A total of 694 respondents participated, with response rate 99.14%. Among them 576 completed all items. The result showed that 363 subjects (63.9, 95%CI?=?59.5-67.7) had global sexual dysfunction. Furthermore, the rate of sexual dysfunction was reported as 55.6% (95%CI?=?49.1-62.6) and 67.4% (95%CI?=?62.8-72.1) in female and male participants, respectively. Among domains of sexual dysfunction; sexual arousal problem (97.8% (95%CI?=?95.8-98.3)) and sexual pain problem (11.3% (95%CI?=?8.8-13.9)) were the most and the least prevalent sexual dysfunctions respectively. Concerning associated factors; age grouped >?51, depression, being out of relationship or not satisfied with non-sexual aspect of relationship, being jobless and khat use has positive association with sexual dysfunction. By the other side alcohol use, level of education & age groups 18-21?years associated negatively. CONCLUSIONS:The prevalence of sexual dysfunction among patients with epilepsy is very high; its prevalence is more among males than females. Sexual arousal problem and sexual pain problem were the most and the least prevalent sexual dysfunctions respectively.

Project description:Child sexual abuse is a significant public health concern and a breach of basic human rights affecting millions of children each year globally. It is typically not reported by victims, hence it remains usually concealed. Except for single studies with varying reports, there is no national studies conducted on child sexual abuse in Ethiopia. Therefore, this review determined the pooled magnitude and determinants of sexual abuse among children in Ethiopia. Potential articles were searched from PubMed, Science Direct, Scopus, and Web of science using relevant searching key terms. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A random-effects model was applied during meta-analysis. The pooled prevalence of sexual abuse among 5,979 children in Ethiopia was 41.15% (95% CI: 24.44, 57.86). Sex of children (OR: 2.14, 95%CI: 1.12, 4.06), smoking (OR: 4.48, 95%CI: 1.26, 76.79), khat chewing (OR: 3.68, 95%CI: 1.62, 21.93), and alcohol use (OR: 4.77, 95%CI: 2.22, 10.25) were the determinants of child sexual abuse. The main perpetrators of sexual abuse against children were neighbors, boy/girlfriends, family members, school teachers, and stranger person. Child sexual abuse commonly took place in the victim's or perpetrator's home, school, and neighbor's home. This review revealed that the magnitude of child sexual abuse in Ethiopia was relatively high and multiple factors determined the likelihood of sexual violence against children. Thus, policy-makers and concerned stakeholders should strengthen comprehensive sexual and reproductive health education to reduce the magnitude and consequences of child sexual abuse. Moreover, support with special attention should be given to children with mental illness and physical disabilities.

Project description:Although homeless segment of the society could be the hotspots for tuberculosis (TB) transmission, there is little data on TB in homeless individuals in Ethiopia. The objective of this study was to investigate the molecular epidemiology and drug sensitivity of Mycobacterium tuberculosis (M. tuberculosis) isolated from homeless individuals in Addis Ababa, Ethiopia. The study was conducted on 59 M. tuberculosis isolates, which were recovered by the clinical screening of 5600 homeless individuals and bacteriological examination of 641 individuals with symptoms of pulmonary tuberculosis (PTB). Region of difference-9 (RD9) based polymerase-chain reaction (PCR), Spoligotyping and 24-loci Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat (MIRU-VNTR) typing were used for genotyping of the isolates. In addition, drug sensitivity test was performed on the isolates using BD Bactec Mycobacterial Growth Inhibition Tube (MGIT) 960. Fifty-eight of the 59 isolates were positive by spoligotyping and spoligotyping International type (SIT) 53, SIT 37, and SIT 149 were the dominant spoligotypes; each consisting of 19%, 15.5%, and10.3% of the isolates, respectively. The majority of the isolates (89.7%) were members of the Euro-American (EA) major lineage. MIRU-VNTR identified Ethiopia_3, Delhi/CAS, Ethiopia_2, TUR, X-type, Ethiopia_H37Rv-like strain, Haarlem and Latin-American Mediterranean (LAM) sub lineages. The proportion of clustering was 77.6% (45/58) in spoligotyping while it was 39.7% (23/58) in 24-loci MIRU-VNTR typing. Furthermore, the proportion of clustering was significantly lowered to 10.3% (6/58) when a combination of spoligotyping and 24-loci MIRU-VNTRplus was used. The recent transmission index (RTI) recorded by spoligotyping, 24-loci MIRU-VNTR typing, and a combination of the two genotyping methods were 58.6%, 27.6% and 5.2%, respectively. Young age and living in groups were significantly associated with strain clustering (P < 0.05). The drug sensitivity test (DST) result showed 8.9% (4/58) of the isolates were resistant to one or more first line ant-TB drugs; but multidrug resistant isolate was not detected. Clustering and RTI could suggest the transmission of TB in the homeless individuals, which could suggest a similar pattern of transmission between homeless individuals and the general population. Hence, the TB control program should consider homeless individuals during the implementation of TB control program.

Project description:BackgroundPublic health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening.MethodsIn two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations.ResultsThe two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations.ConclusionsBecause of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the overall referral densities suggests that improved connections throughout might benefit conditions in addition to HIV and family planning that need service integration.

Dataset Information

HIV Disclosure: HIV-positive status disclosure to sexual partners among individuals receiving HIV care in Addis Ababa, Ethiopia.

Introduction

Method

Results

Conclusion

Publications

HIV Disclosure: HIV-positive status disclosure to sexual partners among individuals receiving HIV care in Addis Ababa, Ethiopia.

Similar Datasets

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