Effects of a peer educator program for HIV status disclosure and health system strengthening: Findings from a clinic-based disclosure support program in Mozambique
| Autor: | Florindo Mudender, Sebastian Kevany, Carol Dawson-Rose, Sarah A. Gutin, Elsa Hunguana |
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| Přispěvatelé: | Torpey, Kwasi |
| Rok vydání: | 2020 |
| Předmět: |
RNA viruses
Counseling Male Coping (psychology) Social stigma Epidemiology Social Stigma Human immunodeficiency virus (HIV) HIV Infections 030312 virology Pathology and Laboratory Medicine medicine.disease_cause Geographical Locations 0302 clinical medicine Immunodeficiency Viruses Health care Medicine and Health Sciences Medicine 030212 general & internal medicine Mozambique Pediatric 0303 health sciences Multidisciplinary HIV diagnosis and management Viral Load Infectious Diseases Health Education and Awareness Medical Microbiology HIV epidemiology Viral Pathogens Viruses Self-disclosure Infectious diseases HIV/AIDS Female Pathogens Infection Research Article Adult medicine.medical_specialty Self Disclosure General Science & Technology Science HIV prevention MEDLINE Viral diseases Microbiology Peer Group 03 medical and health sciences Social support Clinical Research Virology Retroviruses Behavioral and Social Science Humans Microbial Pathogens Preventive medicine business.industry Lentivirus Organisms Biology and Life Sciences HIV Peer group Diagnostic medicine Health Care Public and occupational health Family medicine People and Places Africa business Delivery of Health Care Viral Transmission and Infection |
| Zdroj: | PloS one, vol 15, iss 5 PLoS ONE, Vol 15, Iss 5, p e0232347 (2020) PLoS ONE |
| Popis: | Background In Mozambique, HIV counseling and testing (HCT) rates are low and the cascade (or continuum) of care is poor. Perhaps more importantly, low disclosure rates and low uptake of joint testing are also related to both (1) limitations on access to services and (2) the availability of trained staff. We describe the implementation and impact of a disclosure support implemented by peer educators (PE). Methods Ten PEs, previously trained in basic HIV and post-test counseling, completed additional training on providing disclosure support for newly-diagnosed persons living with HIV (PLH). Results Of the 6,092 persons who received HCT, 677 (11.1%) tested positive. Any newly-diagnosed PLH who was tested when PEs were present (606 / 677) was approached about participating in the disclosure program; of these, 94.2% of PLH (n = 574) agreed to participate. Of these, at follow-up (between 1 day and 3 months later, depending on client inclination and availability) 91.9% (n = 528) said that they had disclosed their HIV infection, of whom 66.9% (n = 384) were female and 24.1% (n = 144) male. In turn, 92.7% of partners (n = 508) who had received HIV-related exposure information were tested; of these, 78.7% (n = 400) were found to be HIV-positive. Of the latter, 96.3% (n = 385) were then seen by health care providers and referred for further diagnosis and treatment. Conclusions Supporting newly-diagnosed PLH is important both for their own health and that of others. For the newly-diagnosed, there are extensive challenges related to understanding the implications of their illness; social support from clinical care teams can be vital in planning and coping. Our study has shown that such support of PLH is also crucial to disclosure, in part via improving awareness of positive health implications for (and from) family, friends and other support networks. |
| Databáze: | OpenAIRE |
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