‘People say that we are already dead much as we can still walk’: a qualitative investigation of community and couples’ understanding of HIV serodiscordance in rural Uganda

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dc.contributor.authorKim, Jiho
dc.contributor.authorNanfuka, Mastula
dc.contributor.authorMoore, David
dc.contributor.authorShafic, Murisho
dc.contributor.authorNyonyitono, Maureen
dc.contributor.authorBirungi, Josephine
dc.contributor.authorGalenda, Florence
dc.contributor.authorKing, Rachel
dc.date.accessioned2018-07-24T10:41:40Z
dc.date.available2018-07-24T10:41:40Z
dc.date.issued2016
dc.descriptionDespite the wide availability of antiretroviral treatment and HIV educational programs, heterosexual transmission continues to drive the HIV epidemic in Africa. To investigate some of the factors involved in transmission or maintenance of serodiscordant status, we designed a study to examine participants’ understanding of HIV serodiscordance and the implications this posed for their HIV prevention practices.en_US
dc.description.abstractBackground: Stable, co-habiting HIV serodiscordant couples are a key population in terms of heterosexual transmission in sub-Saharan Africa. Despite the wide availability of antiretroviral treatment and HIV educational programs, heterosexual transmission continues to drive the HIV epidemic in Africa. To investigate some of the factors involved in transmission or maintenance of serodiscordant status, we designed a study to examine participants’ understanding of HIV serodiscordance and the implications this posed for their HIV prevention practices. Methods: In-depth interviews were conducted with 28 serodiscordant couples enrolled in a treatment-asprevention study in Jinja, Uganda. Participants were asked questions regarding sexual behaviour, beliefs in treatment and prevention, participants’ and communities’ understanding and context around HIV serodiscordance. Qualitative framework analysis capturing several main themes was carried out by a team of four members, andwas cross-checked for consistency. Results: It was found that most couples had difficulty explaining the phenomenon of serodiscordance and tended to be confused regarding prevention. Many individuals still held beliefs in pseudoscientific explanations for HIV susceptibility such as blood type and blood “strength”. The participants’ trust of treatment and medical services were well established. However, the communities’ views of both serodiscordance and treatment were more pessimistic and wrought with mistrust. Stigmatization of serodiscordance and HIV-positive status were reported frequently. Conclusions: The results indicate that despite years of treatment and prevention methods being available, stigmatization and mistrust persist in the communities of HIV-affected individuals and may directly contribute to new cases and seroconversion. We suggest that to optimize the effects of HIV treatment and prevention, clear education and support of such methods are sorely needed in sub-Saharan African communities.en_US
dc.identifier.citationKim, Jiho, Nanfuka, Mastula, Moore, David, Shafic, Murisho, Nyonyitono, Maureen, Birungi, Josephine, Galenda, Florence and King, Rachel, 2016. ‘People say that we are already dead much as we can still walk’: a qualitative investigation of community and couples’ understanding of HIV serodiscordance in rural Uganda.en_US
dc.identifier.issn14712334
dc.identifier.urihttps://hdl.handle.net/20.500.11951/267
dc.language.isoenen_US
dc.publisherBioMed Central Ltden_US
dc.subjectHIVen_US
dc.subjectSexual healthen_US
dc.subjectSerodiscordanceen_US
dc.subjectUgandaen_US
dc.subjectAfricaen_US
dc.title‘People say that we are already dead much as we can still walk’: a qualitative investigation of community and couples’ understanding of HIV serodiscordance in rural Ugandaen_US
dc.typeArticleen_US
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The final, definitive version of this paper has been published in the BMC Infectious Diseases, Vol.6. 2016. https://doi.org/10.1186/s12879-016-1998-9; published by BioMed Central all rights reserved.
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