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Title: | Disclosure of HIV status: experiences of patients enrolled in an integrated TB and HAART pilot programme in South Africa |
Author: | Gebrekristos, Hirut T. |
Year: | 2009 |
Periodical: | African Journal of AIDS Research |
Volume: | 8 |
Issue: | 1 |
Pages: | 1-6 |
Language: | English |
Geographic term: | South Africa |
Subjects: | AIDS stereotypes discrimination tuberculosis |
External link: | https://www.tandfonline.com/doi/abs/10.2989/AJAR.2009.8.1.1.714 |
Abstract: | The convergence between the tuberculosis (TB) and HIV epidemics has led to studies investigating strategies for integrated HIV and TB care. The authors present the experiences of a cohort of 17 patients enrolled in the first integrated TB and HIV treatment pilot programme, conducted in Durban, South Africa, as a precursor to a pivotal trial to answer the question of when to start antiretroviral treatment (ART) in patients co-infected with HIV and TB. Patients' experiences with integrated TB and HIV care can provide insight into the problems or benefits of introducing HIV treatment in existing TB care in resource-constrained settings, where stigma and discrimination are often pervasive and determining factors influencing treatment uptake and coverage. Individual interviews, focus group discussions, and observations were used to understand patients' experiences with integrated TB and HIV treatment. The patients described incorporating highly active antiretroviral therapy (HAART) into their daily routine as 'easy'; however, the patients experienced difficulties with disclosing their HIV status. Nondisclosure to sexual partners may jeopardize safer-sex practices and enhance HIV transmission. Being on TB treatment created a safe space for all patients to conceal their HIV status from those to whom they did not wish to disclose. The data suggest that the context of directly observed therapy (DOT) for TB may have the added benefit of creating a safe space for introducing ART to patients who would benefit most from treatment initiation but who are not ready or prepared to disclose their HIV status to others. Bibliogr., sum. [Journal abstract] |