Healthcare providers’ understanding of HIV serodiscordance in South Africa and Uganda: implications for HIV prevention in sub-Saharan Africa

Autor: David R. Bangsberg, Ross Greener, Angela Kaida, Lavanya Pillay, Lynn T. Matthews, Faith N Mosery, Rachel Rifkin, Claudia K Ng, Jasmine Kastner, Cecilia Milford, Francis Bajunirwe, Jennifer A. Smit
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Adult
Counseling
Male
Health Knowledge
Attitudes
Practice

Sub saharan
Human immunodeficiency virus (HIV)
HIV Infections
medicine.disease_cause
Article
03 medical and health sciences
South Africa
0302 clinical medicine
Virology
Environmental health
Physicians
parasitic diseases
Health care
medicine
Humans
Uganda
030212 general & internal medicine
Practice Patterns
Physicians'

Hiv transmission
Heterosexuality
Reproductive health
Community Health Workers
business.industry
Public sector
Public Health
Environmental and Occupational Health

virus diseases
HIV
General Medicine
Focus Groups
030112 virology
Infectious Diseases
Sexual Partners
Anti-Retroviral Agents
Circumcision
Male

Serodiscordant
Female
Pre-Exposure Prophylaxis
business
Healthcare providers
antiretroviral treatment
HIV counselling
HIV knowledge
HIV transmission
reproductive health
Zdroj: African Journal of AIDS Research; Vol 17, No 2 (2018)
ISSN: 1727-9445
1608-5906
Popis: HIV transmission within stable heterosexual HIV serodiscordant couples accounts for almost half the new incident infections in South Africa and Uganda. Advances in HIV prevention provide opportunities to reduce transmission risk within serodiscordant partnerships (e.g., antiretroviral treatment (ART), pre-exposure prophylaxis (PrEP), medical male circumcision, and couples-based HIV counselling and testing). These interventions require a clinical encounter with a provider who recognises prevention opportunities within these partnerships. We explored healthcare provider understanding of HIV serodiscordance in a reproductive counselling study with providers in eThekwini district, South Africa, and Mbarara district, Uganda. In eThekwini, in-depth interviews (29) and focus group discussions (2) were conducted with 42 providers (counsellors, nurses and doctors) from public sector clinics. In Mbarara, in-depth interviews were conducted with 38 providers (medical officers, clinical officers, nurses, peer counsellors and village health workers). Thematic analysis was conducted using NVivo software. In eThekwini, many providers assumed HIV seroconcordance among client partners and had difficulty articulating how serodiscordance occurs. Mbarara providers had a better understanding of HIV serodiscordance. In the two countries, providers who understood HIV serodiscordance were better able to describe useful HIV-prevention strategies. Healthcare providers require training and support to better understand the prevalence and mechanisms of HIV serodiscordance to implement HIV-prevention strategies for HIV serodiscordant couples.Keywords: antiretroviral treatment, HIV counselling, HIV knowledge, HIV transmission, reproductive health
Databáze: OpenAIRE