Experiencing HIV and AIDS information: a phenomenological study of serodiscordant couples in Malawi

There being no cure for HIV, information continues to play an important role in the management of the pandemic. However, the ability to design successful HIV and AIDS information campaigns is highly dependent on knowledge of people’s information behaviour. Accordingly, there is a need for a clear understanding of the information behaviour of specific groups of people affected and infected by HIV. This phenomenological study investigates how serodiscordant couples experience HIV and AIDS information. In-depth interviews were conducted in the homes of twenty-one serodiscordant couples and three individuals who had separated from their partners. Participants for the study were selected purposively. Data analysis was done using Max Van Manen’s phenomenological approach to generate descriptions and interpretations of the couples’ experiences of HIV and AIDS information. The findings of this study identify three major aspects of experiencing HIV and AIDS information. First, the life-world is the overarching context of experiencing HIV and AIDS information. The study identified five existentials of the life-world of serodiscordant couples. The four of the five existentials were similar to those described by Max Van Manen. These are: lived body, lived space, lived others, and lived time. In addition, my study identified spirituality as a fifth existential. The second aspect of experiencing HIV and AIDS information concerns the nature of HIV and AIDS information. Serodiscordant couples experienced information sources before experiencing the information itself. In these sources serodiscordant couples categorised HIV and AIDS information as being available or unavailable, and accessible or inaccessible. Thirdly, HIV and AIDS information was experienced with various emotional and cognitive states of mind. The emotions were categorised as positive, negative, and ambiguous. Furthermore, this study proposes a conceptual framework for experiencing HIV and AIDS information. The conceptual framework suggests that HIV and AIDS information was experienced while anticipating it, interacting with it, acting on it, and reflecting on it. These findings reveal the complexity of experiencing HIV and AIDS information among serodiscordant couples. Recommendations are made for policy makers and practitioners on the importance of using knowledge of how serodiscordant couples experience HIV and AIDS information to design information services that suit their needs. In addition, this thesis highlights the need to have standard information materials for specific groups such as serodiscordant couples in order to effectively address their unique information needs

Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018

No abstract available

Sexual and Reproductive Behaviour of HIV-positive Men and the Response of the Health Care Service: A Mixed Methods Study in Kano, Northern Nigeria

Background: HIV/AIDS remains a major public health challenge in sub-Saharan Africa. Despite their important role in the spread of HIV, the impact of a HIV-positive diagnosis and treatment on the sexual and reproductive behaviour of heterosexual Nigerian men is under-researched. Aim: To determine the sexual and reproductive behaviour of HIV-positive men in Kano, Nigeria in the era of antiretroviral therapy and the health care service response. Methods: A sequential, explanatory mixed methods design was used. First, a quantitative study collected and analyzed survey data on a clinic-based sample of HIV-positive men (n=270) and matched controls (n=270). This was followed by in-depth interviews with a sub-sample of survey participants (n=22) and health workers/health managers (n=5). Findings: Compared to controls, a greater proportion of HIV-positive men were sexually active (91.9% vs. 82.2%, P<0.05). However, they had reduced coital frequency, out of fear of transmission, psychological effect, energy expenditure and perceived nutrient loss. Post-diagnosis consistent condom use was higher compared to controls (18.9% vs. 13.0%, P<0.05). Lack of interest, reduced pleasure, partner’s refusal and desire to conceive were the reasons for low condom use. A smaller proportion of HIV-positive men desired more children than controls (79.3% vs. 91.1%, P<0.05) and intent to have a child within three years (57.0% vs. 67.0%, P<0.05). Being married and employed significantly predicted sexual activity among HIV-positive men. Also, marital status, religion and spousal HIV status predicted risky sexual behaviour while fertility intention was predicted by marital status and duration, religion, employment and existing children. Late diagnosis, inadequate health worker safe conception skills were evident. Conclusions: The majority of HIV-positive men were sexually active and desired to have children, but the health care service response was inadequate. The findings highlight the need for improved reproductive health education and services to reduce risky behaviour and promote safe conception

Perceptions and decision-making with regard to pregnancy among HIV positive women in rural Maputo Province, Mozambique : a qualitative study

Background: In preventing the transfer of HIV to their children, the Ministry of Health in Mozambique recommends all couples follow medical advice prior to a pregnancy. However, little is known about how such women experience pregnancy, nor the values they adhere to when making childbearing decisions. This qualitative study explores perceptions and decision-making processes regarding pregnancy among HIV positive women in rural Maputo Province. Methods: In-depth interviews and five focus group discussions with fifty-nine women who had recently become mothers were carried out. In addition, six semi-structured interviews were held with maternity and child health nurses. The ethnographic methods employed here were guided by Bourdieu's practice theory. Results: The study indicated that women often perceived pregnancy as a test of fertility and identity. It was not only viewed as a rite of passage from childhood to womanhood, but also as a duty for married women to have children. Most women did not follow recommended medical advice prior to gestation. This was primarily due to perceptions that decision-making about pregnancy was regarded as a private issue not requiring consultation with a healthcare provider. Additionally, stigmatisation of women living with HIV, lack of knowledge about the need to consult a healthcare provider prior to pregnancy, and unintended pregnancy due to inadequate use of contraceptive were crucial factors. Conclusion: Women's experiences and decisions regarding pregnancy are more influenced by social and cultural norms than medical advice. Therefore, education concerning sexual and reproductive health in relation to HIV/AIDS and childbearing is recommended. In particular, we recommend maternal and child healthcare nurses need to be sensitive to women's perceptions and the cultural context of maternity when providing information about sexual and reproductive health

Factors Associated with Primary and Secondary Sexual Transmission of HIV in Concurrent Relationships in Kenya

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between men and women. Semi-structured, open-ended questions were used to obtain data from 4 males and 5 females between the ages of 28 and 46 who had been sexually active for more than 12 months. Data was collected on participants\u27 cultural perspectives on condom use, HIV risk behaviors, and sexual morality. The interviews were transcribed and reviewed for consistent patterns of high risk sexual behaviors prior to coding. Through the use of NVivo, seven emergent themes were common among the participants. Findings from the small scale sexual risk behavioral data showed that among these participants, condom use and partner fidelity in unequal partnerships were low. The study also indicated the importance of developing an HIV intervention that focuses on gender and power in long-term sexual partnerships. The implications for positive social change included awareness that gender inequality exists among concurrent unions and formulating an effective cultural HIV prevention strategy for couples