Nature and Extent of HIV Self Disclosure by Seropositive Adults in HIV Support Groups in Nairobi County, Kenya

New treatment regimens in HIV management have led to the rapid growth in the numbers of People living with HIV (PLWHIV). Disclosure rates among this group remains low which limits their ability to access necessary support resulting in early progression to death and increased risk of infection and low uptake of protection among sexual partners. Understanding the predictors of sero-positive disclosure to sexual partners can be a step toward devising targeted strategies aimed at promoting HIV testing and disclosure thus enhancing HIV prevention and risk reduction efforts.  This study was a descriptive survey involving 232 PLWHIV drawn from HIV support groups in the area selected through non-proportionate systematic random sampling. Multiple logistic regression and Chi-square tests were used to establish the predictors and relationships of self disclosure of seropositive status by PLWHIV to sexual partners. Data was collected using interviewer administered questionnaires, key informant interviews and Focus Group Discussions (FGDs). Quantitative data was analyzed generating descriptive and inferential statistics. Qualitative data was analyzed using content analysis with the use of verbatim quotes to highlight the respondents’ voices. Study results showed that the general HIV disclosure rates were high (92.2%), but only 50.5% had disclosed to a sexual partner. Consistent disclosure to all sexual partners was low (29%) and this was mainly involved regular partners. Generally, PLWHIV had a positive perception of HIV self disclosure. Results point to high levels of anticipated stigma and discrimination from all support structures by PLWHIV. However, only 48% of PLWHIV recorded high levels of enacted stigma and discrimination. It was concluded that PLWHIV anticipated high levels of enacted stigma and discrimination from their social networks after disclosure. This acted as a barrier to HIV self disclosure. However, these fears did not translate into high levels of actual enacted stigma and discrimination. The study recommended that initiating income generating activities for the PLWHIV, consistent training and counseling on the management of self stigma and promotion of strategies of living positively with the disease can promote    effective self disclosure of sero-positive status to sexual partners. KeyWords: HIV self-disclosure, Support Groups, Seropositive adult

Supervision Challenges Encountered During Kenyan University Students’ Practicum Attachment

There is little published research that examines the supervision experience of field attachment supervisors in Kenya. In this study, we identify the challenges encountered by field supervisors during student field attachments with community organizations. Fifteen organizations that had hosted third year students from the Department of Community Resource Management and Extension (CRM&E) at Kenyatta University during their practicum attachment were sampled using purposive and convenience sampling. Data was collected using face-to-face key informant interviews with field supervisors (n=15). Data was analyzed using NVivo10 software for qualitative analysis. Thematic analysis resulted in the identification of key themes related to clarity of learning objectives for students and the supervision challenges encountered by field supervisors during practicum. Key findings indicate that the supervisors largely lacked a clear understanding of practicum expectations and the academic preparation of students in the Community Resource Management and Extension program. The main supervision challenge is largely on orienting students to community based field work so as to enable them link theory to practice. These results can be helpful for any academic program to improve the field attachment experience of university students and the community organizations hosting the students. A better understanding of the challenges that field supervisors’ encounter is fundamental to the enhancement of the practicum experience of university students since the requisite and appropriate support can be provided to the host organizations. Subsequently, the students will be more likely to optimize the intended benefits of the practicum as a result of the host organizations enhancing the quality of field-based learning. Keywords: practicum, supervision, experiential learning, community-based learning, learning methods, post-secondary education, higher educatio