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Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review.
J Int AIDS Soc. 2015; 18(Suppl 5):20292.JI

Abstract

INTRODUCTION

Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma.

METHODS

We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool.

RESULTS

Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components.

CONCLUSIONS

The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe disclosure outcomes is needed to guide programme planners and policy makers.

Authors+Show Affiliations

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; caitlinkennedy@jhu.edu.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

26643462

Citation

Kennedy, Caitlin E., et al. "Safer Disclosure of HIV Serostatus for Women Living With HIV Who Experience or Fear Violence: a Systematic Review." Journal of the International AIDS Society, vol. 18, no. Suppl 5, 2015, p. 20292.
Kennedy CE, Haberlen S, Amin A, et al. Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review. J Int AIDS Soc. 2015;18(Suppl 5):20292.
Kennedy, C. E., Haberlen, S., Amin, A., Baggaley, R., & Narasimhan, M. (2015). Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review. Journal of the International AIDS Society, 18(Suppl 5), 20292. https://doi.org/10.7448/IAS.18.6.20292
Kennedy CE, et al. Safer Disclosure of HIV Serostatus for Women Living With HIV Who Experience or Fear Violence: a Systematic Review. J Int AIDS Soc. 2015;18(Suppl 5):20292. PubMed PMID: 26643462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review. AU - Kennedy,Caitlin E, AU - Haberlen,Sabina, AU - Amin,Avni, AU - Baggaley,Rachel, AU - Narasimhan,Manjulaa, Y1 - 2015/12/01/ PY - 2015/05/08/received PY - 2015/10/05/revised PY - 2015/10/14/accepted PY - 2015/12/9/entrez PY - 2015/12/9/pubmed PY - 2016/9/9/medline KW - disclosure KW - gender-based violence KW - review KW - systematic KW - violence SP - 20292 EP - 20292 JF - Journal of the International AIDS Society JO - J Int AIDS Soc VL - 18 IS - Suppl 5 N2 - INTRODUCTION: Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. METHODS: We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. RESULTS: Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. CONCLUSIONS: The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe disclosure outcomes is needed to guide programme planners and policy makers. SN - 1758-2652 UR - https://www.unboundmedicine.com/medline/citation/26643462/Safer_disclosure_of_HIV_serostatus_for_women_living_with_HIV_who_experience_or_fear_violence:_a_systematic_review_ L2 - https://doi.org/10.7448/IAS.18.6.20292 DB - PRIME DP - Unbound Medicine ER -