HIV-related Shame among Women Giving Birth in Tanzania: A Mixed Methods Study.

Autor: Hanson OR; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Williams Building, Room 1N410, 295 Chipeta Way, Salt Lake City, UT, 84108, USA. Olivia.hanson@utah.edu., Weglarz AJ; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Williams Building, Room 1N410, 295 Chipeta Way, Salt Lake City, UT, 84108, USA., Barabara ML; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Cohen SR; Department of Obstetrics and Gynecology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA., Minja LM; Kilimanjaro Clinical Research Institute, Moshi, Tanzania., Mlay PS; Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Center, Moshi, Tanzania., Stephens MJ; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Williams Building, Room 1N410, 295 Chipeta Way, Salt Lake City, UT, 84108, USA., Olomi GA; Health Management Department, Kilimanjaro Regional Secretary's Office, Moshi, Tanzania., Mlay J; Kilimanjaro Clinical Research Institute, Moshi, Tanzania., Mmbaga BT; Kilimanjaro Clinical Research Institute, Moshi, Tanzania., Watt MH; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Williams Building, Room 1N410, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Jul; Vol. 28 (7), pp. 2276-2285. Date of Electronic Publication: 2024 Mar 25.
DOI: 10.1007/s10461-024-04322-1
Abstrakt: Women living with HIV (WLHIV) commonly experience HIV-related shame which can interfere with HIV care-seeking behavior and lead to poor clinical outcomes. HIV-related shame may be particularly heightened during the pregnancy and postpartum periods. This study aimed to describe HIV-related shame among WLHIV giving birth, identify associated factors, and qualitatively examine the impacts of HIV-related shame on the childbirth experience. Postpartum WLHIV (n = 103) were enrolled in the study between March and July 2022 at six clinics in the Kilimanjaro Region, Tanzania. Participants completed a survey within 48 h after birth, prior to being discharged. The survey included a 13-item measure of HIV-related shame, which assessed levels of HIV-related shame (Range: 0-52). Univariable and multivariable regression models examined factors associated with HIV-related shame. Qualitative in-depth interviews were conducted with pregnant WLHIV (n = 12) and postpartum WLHIV (n = 12). Thematic analysis, including memo writing, coding, and synthesis, was employed to analyze the qualitative data. The survey sample had a mean age of 29.1 (SD = 5.7), and 52% were diagnosed with HIV during the current pregnancy. Nearly all participants (98%) endorsed at least one item reflecting HIV-related shame, with an average endorsement of 9 items (IQR = 6). In the final multivariable model, HIV-related shame was significantly associated with being Muslim vs. Christian (ß = 6.80; 95%CI: 1.51, 12.09), attending less than four antenatal care appointments (ß = 5.30; 95%CI: 0.04, 10.55), and reporting experiences of HIV stigma in the health system (ß = 0.69; 95%CI: 0.27, 1.12). Qualitative discussions revealed three key themes regarding the impact of HIV-related shame on the childbirth experience: reluctance to disclose HIV status, suboptimal adherence to care, and the influence on social support networks. WLHIV giving birth experience high rates of HIV-related shame, and social determinants may contribute to feelings of shame. HIV-related shame impacts the childbirth experience for WLHIV, making the labor and delivery setting an important site for intervention and support.The study is funded by the National Institutes of Health (R21 TW012001) and is registered on clinicaltrials.gov (NCT05271903).
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: