A Qualitative Study of the Barriers HIV Positive Youth in Atlanta Face in Disclosing Their Status 公开

Asare, Louisa (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/pn89d658s?locale=zh
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Abstract

Background- HIV remains a major global public health issue with approximately 36.7 million people worldwide infected, with 30% of all new HIV infections globally estimated to occur among youth. Since there is no cure for HIV, one way to avoid HIV infection is to prevent viral transmission. Advocating for HIV positive people to freely disclose their status has been shown to have a direct impact on preventing transmission as it facilitates risk-reduction strategies. This study aims to identify barriers HIV positive youth face to status disclosure and to recommend interventions to facilitate voluntary status disclosure.

Methods- This was a qualitative study based on secondary analysis of data collected by in-depth interviews of HIV positive youth. MaxQDA12, a qualitative data analysis software, was used to aid in developing codes and subsequent themes that led to the development of a conceptual framework to identify and describe barriers to HIV status disclosure

Results- The main barriers to status disclosure participants faced were Racism, Stigma and Homophobia from both family and society, and these were experienced in enacted, internalized and anticipated forms.

Conclusions- Though laws exist in certain places to mandate HIV status self-disclosure, these sometimes undermine public health efforts by having the opposite effect. Identifying barriers to voluntary status self -disclosure can help in the development of interventions that will ensure that HIV positive people have a safe space to express themselves, disclose their status and fully participate in society.

Table of Contents

1. Introduction .......................................................................................................1

1.1 Study purpose and significance .........................................................................6

1.2 Research Question.............................................................................................7

2. Literature review ...............................................................................................8

2.1 Introduction .......................................................................................................8

2.2 Epidemiology of HIV........................................................................................8

2.3 Mode of HIV transmission ..............................................................................13

2.4 Factors associated with the spread of HIV ......................................................13

2.5 HIV status disclosure ......................................................................................13

2.6 Advantages of HIV status disclosure ..............................................................14

2.7 Status disclosure and HIV Criminalization .....................................................14

2.8 Current rates of disclosure and associated problems ......................................15

3. Methodology ...................................................................................................17

4. Data Analysis ..................................................................................................19

5. Results .............................................................................................................21

5.1 Demographics .................................................................................................21

5.2 Barriers to disclosing HIV positive status.......................................................23

6. Discussion .......................................................................................................29

6.1 Discussion .......................................................................................................29

6.2 Significance of findings and implications in Public health.............................31

7. Challenges and Limitations of the study .........................................................35

7.1 Time ................................................................................................................35

7.2 Early saturation ...............................................................................................35

7.3 Reflexivity .......................................................................................................36

8. Conclusion ......................................................................................................37

9. Glossary ..........................................................................................................38

10. Bibliography....................................................................................................39

LIST OF FIGURES/TABLES

Figure 1: Male Transmission Categories in % .....................................................................3

Figure 2: Female Transmission Categories in % .................................................................3

Figure 3: Poverty in the United States .................................................................................5

Figure 4: Average global HIV prevalence (in %) ................................................................9

Figure 5: HIV prevalence and incidence in USA from 1980-2010 ...................................10

Figure 6: New HIV Infections & U.S Population by Race/Ethnicity,2010 .......................11

Figure 7: HIV incidence among key populations in the USA ...........................................12

Figure 8:Demographics Table...........................................................................................22

Figure 9:Barriers to HIV Disclosure .................................................................................28

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