Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa
Identifieur interne : 001368 ( Pmc/Checkpoint ); précédent : 001367; suivant : 001369Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa
Auteurs : Elisa Longinetti [Suède] ; Michele Santacatterina [Suède] ; Ziad El-Khatib [Suède, Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Abstract
Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels.
To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa.
A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa.
We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other.
A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years.
Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.1–1.0; p = 0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90–11.7; p = 0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02–1.99; p = 0.17) than men with lower income. Men were more likely than women to disclose to their partner (p<0.01), and to partner and family (p<0.01), women were more likely than men to disclose to child and family (p<0.01), to child, family and others (p = 0.01).
Being employed imposed a risk factor for HIV status disclosure, additionally we found an interaction effect of gender and income on disclosure. Interventions designed to reduce workplace discrimination and gender-sensitive interventions promoting disclosure are strongly recommended.
Url:
DOI: 10.1371/journal.pone.0095440
PubMed: 24743189
PubMed Central: 3990640
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa</title><author><name sortKey="Longinetti, Elisa" sort="Longinetti, Elisa" uniqKey="Longinetti E" first="Elisa" last="Longinetti">Elisa Longinetti</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Public Health Sciences, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Santacatterina, Michele" sort="Santacatterina, Michele" uniqKey="Santacatterina M" first="Michele" last="Santacatterina">Michele Santacatterina</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Unit of Biostatistics – Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Unit of Biostatistics – Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="El Khatib, Ziad" sort="El Khatib, Ziad" uniqKey="El Khatib Z" first="Ziad" last="El-Khatib">Ziad El-Khatib</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Health Systems and Policy Research Group (Global Health), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Health Systems and Policy Research Group (Global Health), Department of Public Health Sciences, Karolinska Institutet, 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wicri:corpus="PMC">002A95</idno><idno type="wicri:Area/Pmc/Curation">002A94</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002A94</idno><idno type="wicri:Area/Pmc/Checkpoint">001368</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001368</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa</title><author><name sortKey="Longinetti, Elisa" sort="Longinetti, Elisa" uniqKey="Longinetti E" first="Elisa" last="Longinetti">Elisa Longinetti</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Public Health Sciences, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Santacatterina, Michele" sort="Santacatterina, Michele" uniqKey="Santacatterina M" first="Michele" last="Santacatterina">Michele Santacatterina</name><affiliation wicri:level="3"><nlm:aff id="aff2"><addr-line>Unit of Biostatistics – Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Unit of Biostatistics – Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="El Khatib, Ziad" sort="El Khatib, Ziad" uniqKey="El Khatib Z" first="Ziad" last="El-Khatib">Ziad El-Khatib</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Health Systems and Policy Research Group (Global Health), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Health Systems and Policy Research Group (Global Health), Department of Public Health Sciences, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Global Health, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Global Health, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels.</p></sec><sec><title>Aim</title><p>To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa.</p></sec><sec><title>Setting</title><p>A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa.</p></sec><sec><title>Methods</title><p>We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other.</p></sec><sec><title>Patients</title><p>A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years.</p></sec><sec><title>Results</title><p>Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.1–1.0; p = 0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90–11.7; p = 0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02–1.99; p = 0.17) than men with lower income. Men were more likely than women to disclose to their partner (p<0.01), and to partner and family (p<0.01), women were more likely than men to disclose to child and family (p<0.01), to child, family and others (p = 0.01).</p></sec><sec><title>Conclusion</title><p>Being employed imposed a risk factor for HIV status disclosure, additionally we found an interaction effect of gender and income on disclosure. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24743189</article-id><article-id pub-id-type="pmc">3990640</article-id><article-id pub-id-type="publisher-id">PONE-D-13-47764</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0095440</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biology and Life Sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Medical Microbiology</subject><subj-group><subject>Microbial Pathogens</subject><subj-group><subject>Viral Pathogens</subject><subj-group><subject>Immunodeficiency Viruses</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine and health sciences</subject><subj-group><subject>Diagnostic medicine</subject><subj-group><subject>HIV diagnosis and management</subject></subj-group></subj-group><subj-group><subject>Epidemiology</subject><subj-group><subject>HIV epidemiology</subject><subject>Infectious disease epidemiology</subject><subject>Social epidemiology</subject></subj-group></subj-group><subj-group><subject>Health Care</subject><subj-group><subject>Health Care Policy</subject><subject>Health Statistics</subject><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Viral Diseases</subject><subj-group><subject>AIDS</subject></subj-group></subj-group><subj-group><subject>Sexually Transmitted Diseases</subject></subj-group></subj-group><subj-group><subject>Public and occupational health</subject><subj-group><subject>Preventive medicine</subject><subj-group><subject>HIV prevention</subject></subj-group></subj-group><subj-group><subject>Behavioral and Social Aspects of Health</subject><subject>Global Health</subject></subj-group></subj-group><subj-group><subject>Urology</subject><subj-group><subject>Genitourinary Infections</subject></subj-group></subj-group><subj-group><subject>Women's Health</subject><subj-group><subject>Obstetrics and Gynecology</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Gender Perspective of Risk Factors Associated with Disclosure of HIV Status, a Cross-Sectional Study in Soweto, South Africa</article-title><alt-title alt-title-type="running-head">Risk Factors Associated with HIV Status Disclosure</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Longinetti</surname><given-names>Elisa</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Santacatterina</surname><given-names>Michele</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>El-Khatib</surname><given-names>Ziad</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Unit of Biostatistics – Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Health Systems and Policy Research Group (Global Health), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Global Health, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Cameron</surname><given-names>D. William</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>University of Ottawa, Canada</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>ziad.khatib@gmail.com</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p>Analyzed the data: EL MS ZEK. Wrote the paper: EL ZEK. Supervised the study: ZEK.</p></fn></author-notes><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>17</day><month>4</month><year>2014</year></pub-date><volume>9</volume><issue>4</issue><elocation-id>e95440</elocation-id><history><date date-type="received"><day>14</day><month>11</month><year>2013</year></date><date date-type="accepted"><day>26</day><month>3</month><year>2014</year></date></history><permissions><copyright-year>2014</copyright-year><copyright-holder>Longinetti et al</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><sec><title>Background</title><p>Human Immunodeficiency Virus (HIV) status disclosure has been shown to provide several benefits, both at the individual and societal levels.</p></sec><sec><title>Aim</title><p>To determine risk factors associated with disclosing HIV status among antiretroviral therapy (ART) recipients in South Africa.</p></sec><sec><title>Setting</title><p>A cross-sectional study on risk factors for viremia and drug resistance took place at two outpatient HIV clinics in 2008, at a large hospital located in Soweto, South Africa.</p></sec><sec><title>Methods</title><p>We conducted a secondary data analysis on socio-economic characteristics and HIV status disclosure to anyone, focusing on gender differences. Descriptive and multivariable logistic regression analyses were performed to model the associations between risk factors and HIV status disclosure. Additionally, descriptive analysis was conducted to describe gender differences of HIV status disclosure to partner, parents, parents in law, partner, child, family, employer, and other.</p></sec><sec><title>Patients</title><p>A total of 883 patients were interviewed. The majority were women (73%) with median age of 39 years.</p></sec><sec><title>Results</title><p>Employed patients were less likely to disclose than unemployed (odds ratio (OR) 0.36; 95% confidence interval (CI) 0.1–1.0; p = 0.05)). Women with higher income were more likely to disclose (OR 3.25; 95% CI 0.90–11.7; p = 0.07) than women with lower income, while men with higher income were less likely (OR 0.20; 95% CI 0.02–1.99; p = 0.17) than men with lower income. Men were more likely than women to disclose to their partner (p<0.01), and to partner and family (p<0.01), women were more likely than men to disclose to child and family (p<0.01), to child, family and others (p = 0.01).</p></sec><sec><title>Conclusion</title><p>Being employed imposed a risk factor for HIV status disclosure, additionally we found an interaction effect of gender and income on disclosure. Interventions designed to reduce workplace discrimination and gender-sensitive interventions promoting disclosure are strongly recommended.</p></sec></abstract><funding-group><funding-statement>The original study was funded by a Karolinska Institutet faculty fund (<ext-link ext-link-type="uri" xlink:href="http://ki.se/ki/jsp/polopoly.jsp?d=13467&l=en">http://ki.se/ki/jsp/polopoly.jsp?d=13467&l=en</ext-link>), the Swedish International Development Agency (<ext-link ext-link-type="uri" xlink:href="http://www.sida.se/english/">http://www.sida.se/english/</ext-link>), the Stanford Fogarty International Collaboration (<ext-link ext-link-type="uri" xlink:href="http://med.stanford.edu/rmg/funding/internalfunding.html">http://med.stanford.edu/rmg/funding/internalfunding.html</ext-link>), and the Sven Gard Foundation for Virology, Stockholm. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><page-count count="8"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Canada</li><li>Suède</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Suède"><region name="Svealand"><name sortKey="Longinetti, Elisa" sort="Longinetti, Elisa" uniqKey="Longinetti E" first="Elisa" last="Longinetti">Elisa Longinetti</name></region><name sortKey="El Khatib, Ziad" sort="El Khatib, Ziad" uniqKey="El Khatib Z" first="Ziad" last="El-Khatib">Ziad El-Khatib</name><name sortKey="Santacatterina, Michele" sort="Santacatterina, Michele" uniqKey="Santacatterina M" first="Michele" last="Santacatterina">Michele Santacatterina</name></country><country name="Canada"><noRegion><name sortKey="El Khatib, Ziad" sort="El Khatib, Ziad" uniqKey="El Khatib Z" first="Ziad" last="El-Khatib">Ziad El-Khatib</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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