Influences on decision-making about disclosure of HIV status by adolescents and young adults living with HIV in KwaZulu-Natal, South Africa.

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ajar-African Journal of Aids Research Pub Date : 2023-12-01 Epub Date: 2023-12-20 DOI:10.2989/16085906.2023.2277358
Thandeka Smith, Janet Seeley, Maryam Shahmanesh, Christina Psaros, Chiedza Munikwa, Nothando Ngwenya
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Abstract

Background: Adolescents and young adults living with HIV (AYA) are faced with the challenge of living with a life-long chronic condition. We investigated the influences on the decisions by AYA to disclose their HIV status to family, intimate partners and friends.Methods: Twenty AYA aged between 15 and 24 years were purposely selected through local community-based organisations in eThekwini municipality and uMkhanyakude district in KwaZulu-Natal Province, South Africa. Virtual in-depth interviews were conducted between September 2020 to October 2021 using a topic guide focusing on HIV-status disclosure and the impact of stigma on decision-making capacity. An iterative thematic process was used for analysis.Results: Findings revealed the challenges that AYA experience for disclosure because of stigma and how this impacts their decision-making capacity. Family and friends influenced AYA in processing their discovery of their HIV status offering support needed to manage living with HIV. However, for some AYA disclosing to relatives, friends and intimate partners was difficult because of fears of rejection and recrimination. The act of disclosure was influenced by both internalised and external stigma and the type of relationships and interactions that AYA had with relatives, friends and caregivers.Conclusions: The decision to disclose is challenging for AYA because of the fear of rejection, along with internal and external stigma. The provision of support, whether from family or peers, is important. Enhancing the decision-making capacity of AYA is essential for developing their self-esteem as well as supporting future healthcare choices.

影响南非夸祖鲁-纳塔尔省感染艾滋病毒的青少年和年轻成人披露艾滋病毒感染状况决策的因素。
背景:青少年艾滋病病毒感染者(AYA)面临着终身慢性病的挑战。我们调查了影响感染者决定向家人、亲密伴侣和朋友公开其艾滋病病毒感染状况的因素:我们通过南非夸祖鲁-纳塔尔省 eThekwini 市和 uMkhanyakude 区的当地社区组织,有目的地挑选了 20 名年龄在 15-24 岁之间的青壮年艾滋病患者。在 2020 年 9 月至 2021 年 10 月期间,使用主题指南进行了虚拟深度访谈,重点关注 HIV 感染状况的披露以及污名化对决策能力的影响。访谈采用了迭代式主题分析过程:研究结果表明,由于污名化,青少 年在披露信息时遇到了挑战,这对他们的决策能力产生了影响。家人和朋友在他们发现自己感染艾滋病毒的过程中对他们产生了影响,为他们提供了处理艾滋病毒感染问题所需的支持。然而,对一些艾 滋病青年来说,向亲戚、朋友和亲密伙伴披露自己的情况是困难的,因为他们害怕被拒 绝和受到指责。披露行为受到内部和外部污名的影响,也受到艾青与亲属、朋友和照顾者的关系和互动类型的影响:由于害怕被拒绝,再加上内部和外部的污名化,决定公开病情对老年青少 年来说具有挑战性。无论是来自家人还是同伴的支持都非常重要。增强青少年的决策能力对于培养他们的自尊心以及支持他们未来的医疗保健选择至关重要。
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来源期刊
Ajar-African Journal of Aids Research
Ajar-African Journal of Aids Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.80
自引率
8.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
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