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"If the patients decide not to tell what can we do?"- TB/HIV counsellors' dilemma on partner notification for HIV.

Njozing BN, Edin KE, Sebastián MS, Hurtig AK - BMC Int Health Hum Rights (2011)

Bottom Line: However, to benefit from these services, knowledge of one's HIV status is critical.Partner notification for HIV is an important component of HIV counselling because it is an effective strategy to prevent secondary transmission, and promote early diagnosis and prompt treatment of HIV patients' sexual partners.Meanwhile, adopting a human rights perspective in HIV programmes will balance the interests of both patients and their partners, and ultimately enhance universal access to HIV services.

View Article: PubMed Central - HTML - PubMed

Affiliation: St, Mary Soledad Catholic Hospital, Mankon, Bamenda, P,O,Box 157, Cameroon. njozing.barnabas@epiph.umu.se.

ABSTRACT

Background: There is a global consensus towards universal access to human immunodeficiency virus (HIV) services consequent to the increasing availability of antiretroviral therapy. However, to benefit from these services, knowledge of one's HIV status is critical. Partner notification for HIV is an important component of HIV counselling because it is an effective strategy to prevent secondary transmission, and promote early diagnosis and prompt treatment of HIV patients' sexual partners. However, counsellors are often frustrated by the reluctance of HIV-positive patients to voluntarily notify their sexual partners. This study aimed to explore tuberculosis (TB)/HIV counsellors' perspectives regarding confidentiality and partner notification.

Methods: Qualitative research interviews were conducted in the Northwest Region of Cameroon with 30 TB/HIV counsellors in 4 treatment centres, and 2 legal professionals between September and December 2009. Situational Analysis (positional map) was used for data analysis.

Results: Confidentiality issues were perceived to be handled properly despite concerns about patients' reluctance to report cases of violation due to apprehension of reprisals from health care staffs. All the respondents encouraged voluntary partner notification, and held four varying positions when confronted with patients who refused to voluntarily notify their partners. Position one focused on absolute respect of patients' autonomy; position two balanced between the respect of patients' autonomy and their partners' safety; position three wished for protection of sexual partners at risk of HIV infection and legal protection for counsellors; and position four requested making HIV testing and partner notification routine processes.

Conclusion: Counsellors regularly encounter ethical, legal and moral dilemmas between respecting patients' confidentiality and autonomy, and protecting patients' sexual partners at risk of HIV infection.This reflects the complexity of partner notification and demonstrates that no single approach is optimal, but instead certain contextual factors and a combination of different approaches should be considered. Meanwhile, adopting a human rights perspective in HIV programmes will balance the interests of both patients and their partners, and ultimately enhance universal access to HIV services.

No MeSH data available.


Related in: MedlinePlus

Positional map depicting counsellors' reflections about partner notification for HIV.
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Figure 1: Positional map depicting counsellors' reflections about partner notification for HIV.

Mentions: Situational Analysis [22] was used to analyse the data. The transcripts were initially read through several times to obtain a thorough understanding of the participants' views regarding confidentiality and partner notification. Thereafter, traditional Grounded Theory coding of all the texts was performed manually. The codes from the different transcripts were then reviewed while maintaining the principle of constant comparison. Codes that contained similar ideas regarding confidentiality and partner notification were grouped together. From the grouped codes, four categories were developed which represented the different positions taken by participants regarding confidentiality and partner notification. Finally, a positional map was constructed as a visual representation of these four categories (Figure 1). Two axes were used to map the positions, one with emphasis on patients' autonomy (x-axis), and the other with emphasis on public health interest (y-axis). The axes reflect the fundamental questions or debates surrounding confidentiality and partner notification for HIV.


"If the patients decide not to tell what can we do?"- TB/HIV counsellors' dilemma on partner notification for HIV.

Njozing BN, Edin KE, Sebastián MS, Hurtig AK - BMC Int Health Hum Rights (2011)

Positional map depicting counsellors' reflections about partner notification for HIV.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3119031&req=5

Figure 1: Positional map depicting counsellors' reflections about partner notification for HIV.
Mentions: Situational Analysis [22] was used to analyse the data. The transcripts were initially read through several times to obtain a thorough understanding of the participants' views regarding confidentiality and partner notification. Thereafter, traditional Grounded Theory coding of all the texts was performed manually. The codes from the different transcripts were then reviewed while maintaining the principle of constant comparison. Codes that contained similar ideas regarding confidentiality and partner notification were grouped together. From the grouped codes, four categories were developed which represented the different positions taken by participants regarding confidentiality and partner notification. Finally, a positional map was constructed as a visual representation of these four categories (Figure 1). Two axes were used to map the positions, one with emphasis on patients' autonomy (x-axis), and the other with emphasis on public health interest (y-axis). The axes reflect the fundamental questions or debates surrounding confidentiality and partner notification for HIV.

Bottom Line: However, to benefit from these services, knowledge of one's HIV status is critical.Partner notification for HIV is an important component of HIV counselling because it is an effective strategy to prevent secondary transmission, and promote early diagnosis and prompt treatment of HIV patients' sexual partners.Meanwhile, adopting a human rights perspective in HIV programmes will balance the interests of both patients and their partners, and ultimately enhance universal access to HIV services.

View Article: PubMed Central - HTML - PubMed

Affiliation: St, Mary Soledad Catholic Hospital, Mankon, Bamenda, P,O,Box 157, Cameroon. njozing.barnabas@epiph.umu.se.

ABSTRACT

Background: There is a global consensus towards universal access to human immunodeficiency virus (HIV) services consequent to the increasing availability of antiretroviral therapy. However, to benefit from these services, knowledge of one's HIV status is critical. Partner notification for HIV is an important component of HIV counselling because it is an effective strategy to prevent secondary transmission, and promote early diagnosis and prompt treatment of HIV patients' sexual partners. However, counsellors are often frustrated by the reluctance of HIV-positive patients to voluntarily notify their sexual partners. This study aimed to explore tuberculosis (TB)/HIV counsellors' perspectives regarding confidentiality and partner notification.

Methods: Qualitative research interviews were conducted in the Northwest Region of Cameroon with 30 TB/HIV counsellors in 4 treatment centres, and 2 legal professionals between September and December 2009. Situational Analysis (positional map) was used for data analysis.

Results: Confidentiality issues were perceived to be handled properly despite concerns about patients' reluctance to report cases of violation due to apprehension of reprisals from health care staffs. All the respondents encouraged voluntary partner notification, and held four varying positions when confronted with patients who refused to voluntarily notify their partners. Position one focused on absolute respect of patients' autonomy; position two balanced between the respect of patients' autonomy and their partners' safety; position three wished for protection of sexual partners at risk of HIV infection and legal protection for counsellors; and position four requested making HIV testing and partner notification routine processes.

Conclusion: Counsellors regularly encounter ethical, legal and moral dilemmas between respecting patients' confidentiality and autonomy, and protecting patients' sexual partners at risk of HIV infection.This reflects the complexity of partner notification and demonstrates that no single approach is optimal, but instead certain contextual factors and a combination of different approaches should be considered. Meanwhile, adopting a human rights perspective in HIV programmes will balance the interests of both patients and their partners, and ultimately enhance universal access to HIV services.

No MeSH data available.


Related in: MedlinePlus