All Title Author
Keywords Abstract


Sources of Information on HIV and Sexual and Reproductive Health for Couples Living with HIV in Rural Southern Malawi

DOI: 10.1155/2013/235902

Full-Text   Cite this paper   Add to My Lib

Abstract:

With wider access to antiretroviral therapy, people living with HIV are reconsidering their reproductive decisions: remarrying and having children. The purpose of the paper is to explore sources of information for reproductive decision used by couples living with HIV in patrilineal and matrilineal districts of Malawi. Data were collected from forty couples from July to December 2010. Our results illuminate five specific issues: some of the informants (1) remarry after divorce/death of a spouse, (2) establish new marriage relationship with spouses living with HIV, and (3) have children hence the need for information to base their decisions. There are (4) shared and interactive couple decisions, and (5) informal networks of people living with HIV are the main sources of information. In addition, in matrilineal community, cultural practices about remarriage set up structures that constrained information availability unlike in patrilineal community where information on sexual and reproductive health, HIV, and AIDS was disseminated during remarriage counselling. However, both sources are not able to provide comprehensive information due to complexity and lack of up to date information. Therefore, health workers should, offer people living with HIV comprehensive information that takes into consideration the cultural specificity of groups, and empower already existing and accepted local structures with sexual and reproductive health, HIV, and AIDS knowledge. 1. Introduction When confronted with potentially life-threatening illness such as cancer, HIV, and AIDS, information may provide needed knowledge about the disease, treatment, and self-care management. It may also facilitate coping by mediating uncertainty and anxiety by providing social support [1, 2]. This paper therefore explores sources of information on sexual and reproductive health, HIV, and AIDS that concordant couples living with HIV (CLWH) in Malawi use in making reproductive decisions. HIV and AIDS information is an important resource for people living with HIV (PLWH) [3, 4] and remains the most important tool in HIV and AIDS management [5]. In the early days of the epidemic, information about HIV and AIDS was critical resource to prevent transmission of HIV and manage the complications that accompany HIV and AIDS [6]. Huber and Cruz [7] allude that where HIV and AIDS are concerned, a large portion of the affected population has been and continued to be active in the pursuit of relevant information in order to be able to make informed decisions. However, HIV and AIDS information is complex,

References

[1]  D. Brashers, D. Goldsmith, and E. Hsieh, “Information seeking and avoiding in health context,” Human Communication Research, vol. 28, no. 2, pp. 258–271, 2002.
[2]  D. K. Mayer, N. C. Terrin, G. L. Kreps et al., “Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer,” Patient Education and Counseling, vol. 65, no. 3, pp. 342–350, 2007.
[3]  S. C. Kalichman, C. Cherry, D. Cain et al., “Health information on the internet and people living with HIV/AIDS: information evaluation and coping styles,” Health Psychology, vol. 25, no. 2, pp. 205–210, 2006.
[4]  T. C. Veinot, “We have a lot of information to share with each other. understanding the value of peer-based health information exchange,” Information Research, vol. 15, no. 4, article 452, 2010.
[5]  K. S. Albright, “HIV/AIDS information seeking and healthcare communications in sub-Saharan Africa,” in Proceedings of the 73rd IFLA General Conference and Council, Durban, South Africa, August 2007, http://archive.ifla.org/IV/ifla73/papers/107-Albright-en.pdf.
[6]  S. Gruskin, R. Firestone, S. MacCarthy, and L. Ferguson, “HIV and pregnancy intentions: do services adequately respond to women's needs?” American Journal of Public Health, vol. 98, no. 10, pp. 1746–1750, 2008.
[7]  J. T. Huber and J. M. Cruz, “Information needs and information-seeking behaviors of HIV positive men and women,” Medical Reference Services Quarterly, vol. 19, no. 3, pp. 39–48, 2000.
[8]  T. P. Hogan and C. L. Palmer, “Information preferences and practices among people living with HIV/AIDS: results from a nationwide survey,” Journal of the Medical Library Association, vol. 93, no. 4, pp. 431–439, 2005.
[9]  Joint United Nations Programme on HIV/AIDS (UNAIDS), Global Report: Report on the Global AIDS Epidemic, UNAIDS, Geneva, Switzerland, 2010.
[10]  Malawi Government, The National HIV Prevention Strategy (2009–2013), Malawi Government, Lilongwe, Malawi, 2009.
[11]  C. S. Chasela, M. G. Hudgens, D. J. Jamieson et al., “Maternal or infant antiretroviral drugs to reduce HIV-1 transmission,” New England Journal of Medicine, vol. 362, no. 24, pp. 2271–2281, 2010.
[12]  I. Heard, R. Sitta, F. Lert et al., “Reproductive choice in men and women living with HIV: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA study),” AIDS, vol. 21, supplement 1, pp. S77–S82, 2007.
[13]  T. Kredo, J. S. van der Walt, N. Siegfried, and K. Cohen, “Therapeutic drug monitoring of antiretrovirals for people with HIV,” Cochrane Database of Systematic Reviews, vol. 8, no. 3, Article ID CD007268, 2009.
[14]  D. Cooper, J. Harries, L. Myer, P. Omer, and H. Bracken, “Life is still going on: reproductive intentions among HIV-positive women and men in South Africa,” Social Science & Medicine, vol. 65, no. 2, pp. 274–283, 2007.
[15]  B. Gombachika, E. Chirwa, J. Sundby, A. Malata, A. Maluwa, and H. Fjeld, “Marriage partner selection by heterosexual couples living with HIV from rural southern Malawi,” Journal of AIDS Clinical Research, supplement 1, article 016, 2012.
[16]  L. T. Matthews and J. S. Mukherjee, “Strategies for harm reduction among HIV-affected couples who want to conceive,” AIDS and Behavior, vol. 13, no. 1, pp. S5–S11, 2009.
[17]  V. Paiva, N. Santos, I. Fran?a-Junior, E. Filipe, J. R. Ayres, and A. Segurado, “Desire to have children: gender and reproductive rights of men and women living with HIV: a challenge to health care in Brazil,” AIDS Patient Care and STDs, vol. 21, no. 4, pp. 268–277, 2007.
[18]  M. K. McClellan, R. Patel, G. Kadzirange, T. Chipatod, and D. Katzenstein, “Fertility desires and condom use among HIV-positive women at an antiretroviral roll-out program in Zimbabwe,” African Journal of Reproductive Health, vol. 14, no. 2, pp. 27–35, 2010.
[19]  S. Fiore, I. Heard, C. Thorne et al., “Reproductive experience of HIV-infected women living in Europe,” Human Reproduction, vol. 23, no. 9, pp. 2140–2144, 2008.
[20]  P. Orner, D. Cooper, L. Myer, V. Zweigenthal, L. G. Bekker, and J. Moodley, “Clients' perspectives on HIV/AIDS care and treatment and reproductive health services in South Africa,” AIDS Care, vol. 20, no. 10, pp. 1217–1223, 2008.
[21]  A. A. Nóbrega, F. A. S. Oliveira, M. T. G. Galv?o et al., “Desire for a child among women living with HIV/AIDS in northeast Brazil,” AIDS Patient Care and STDs, vol. 21, no. 4, pp. 261–267, 2007.
[22]  S. C. Kalichman, E. G. Benotsch, L. S. Weinhardt, J. Austin, and W. Luke, “Internet use among people living with HIV/AIDS: association of health information, health behaviors, and health status,” AIDS Education and Prevention, vol. 14, no. 1, pp. 51–61, 2002.
[23]  A. M. Chimbiri, “The condom is an 'intruder' in marriage: evidence from rural Malawi,” Social Science and Medicine, vol. 64, no. 5, pp. 1102–1115, 2007.
[24]  A. C. Munthali, “Adaptive strategies and coping mechanisms of families and communities affected by HIV/AIDS in Malawi,” UNRISD Project on HIV and Development, UNRISD, Geneva, Switzerland, 2002.
[25]  National Statistical Office, Malawi Demographic and Health Survey, National Statistical Office, Zomba, Malawi, 2010.
[26]  J. Morse and L. Richards, Readme First for a User’s Guide to Qualitative Methods, Sage, London, UK, 2nd edition, 2007.
[27]  R. P. Weber, Basic Content Analysis, Sage, Newbury Park, Calif, USA, 2nd edition, 1990.
[28]  K. Krippendoff, Content Analysis: An Introduction to Its Methodology, Sage, Thousand Oaks, Calif, USA, 2nd edition, 2004.
[29]  D. O. Case, Looking for Information: A Survey of Research on Information Seeking, Needs and Behaviour, Academic Press, London, UK, 2007.
[30]  H. C. Kelman, “Negotiation as interactive problem solving,” International Negotiation, vol. 1, no. 1, pp. 99–123, 1996.
[31]  E. Mbweza, K. F. Norr, and B. McElmurry, “Couple decision making and use of cultural scripts in Malawi,” Journal of Nursing Scholarship, vol. 40, no. 1, pp. 12–19, 2008.
[32]  D. Johnson and H. Meischke, “Cancer-related channel selection,” Women & Health, vol. 20, no. 2, pp. 31–44, 1993.
[33]  B. R. Shaw, L. L. DuBenske, J. Y. Han et al., “Antecedent characteristics of online cancer information seeking among rural breast cancer patients: an application of the Cognitive-Social Health Information Processing (C-SHIP) model,” Journal of Health Communication, vol. 13, no. 4, pp. 389–408, 2008.
[34]  N. C. Wathen and R. M. Harris, “"I try to take care of it myself." How rural women search for health information,” Qualitative Health Research, vol. 17, no. 5, pp. 639–651, 2007.
[35]  J. Suitor and K. Pillmer, “Gender, social support and experiential similarity during chronic stress: the case of family caregivers,” in Social Networks and Health (Advances in Medical Sociology, J. A. Levy and B. A. Pescosolido, Eds., vol. 8, pp. 247–266, Emerald, Bingley, UK, 2002.
[36]  E. Rogers, Diffusion of Innovations, Free Press, New York, NY, USA, 5th edition, 2003.
[37]  R. Harris and N. Wathen, “"If my mother was alive I'd probably have called her." Women's search for health information in rural canada,” Reference and User Services Quarterly, vol. 47, no. 1, pp. 67–79, 2007.
[38]  T. Veinot, R. Harris, L. Bella, I. Rootman, and J. Krajnak, “HIV/AIDS information exchange in rural communities: preliminary findings from a three-province study,” Canadian Journal of Information and Library Science, vol. 30, no. 3-4, pp. 271–290, 2006.
[39]  C. O. Airhihenbuwa, “Health promotion and the discourse on culture: implications for empowerment.,” Health Education Quarterly, vol. 21, no. 3, pp. 345–353, 1994.
[40]  R. A. White, “Ten major lines of research on grassroot, participatory communication in Africa,” African Communication Research, vol. 1, no. 1, pp. 11–45, 2008.
[41]  J. Negin, B. Nemser, R. Cumming, E. Lelerai, Y. ben Amor, and P. Pronyk, “HIV attitudes, awareness and testing among older adults in Africa,” AIDS and Behavior, vol. 15, no. 5, pp. 1–6, 2011.
[42]  H. Boon, R. A. C. Ruiter, S. James, B. van den Borne, E. Williams, and P. Reddy, “The impact of a community-based pilot health education intervention for older people as caregivers of orphaned and sick children as a result of HIV and AIDS in South Africa,” Journal of Cross-Cultural Gerontology, vol. 24, no. 4, pp. 373–389, 2009.
[43]  R. Bezner Kerr, L. Dakishoni, L. Shumba, R. Msachi, and M. Chirwa, “"We Grandmothers Know Plenty": breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi,” Social Science and Medicine, vol. 66, no. 5, pp. 1095–1105, 2008.
[44]  C. O. Airhihenbuwa and J. D. Webster, “Culture and African contexts of HIV/AIDS prevention, care and support,” Journal of Social Aspects of HIV/AIDS Research Alliance, vol. 1, no. 1, pp. 4–13, 2004.
[45]  ?. A. Botillen, Diffusions of innovations and HIV/AIDS—analysis of IEC—interventions in Malawi [M.Phil. dissertation], Multicultural and International Education, Oslo University College, Faculty of Education and International Studies, Oslo, Norway, 2008, http://www.saih.no/noop/file.php?id=6525.
[46]  S. A. Rains, “Perceptions of traditional information sources and use of the world wide web to seek health information: findings from the health information national trends survey,” Journal of Health Communication, vol. 12, no. 7, pp. 667–680, 2007.
[47]  P. V. Sharada, C. Venkataramana, and K. Rao Nirupama, “Media, audience, and policy perspectives in health broadcasting,” Health Communication, vol. 13, no. 4, pp. 387–408, 2001.
[48]  Malawi Government, National HIV Prevention Strategy, 2009–2013, National AIDS Commission of Malawi, Lilongwe, Malawi, 2009.
[49]  C. K. Mbekenga, K. Christensson, H. I. Lugina, and P. Olsson, “Joy, struggle and support: postpartum experiences of first-time mothers in a Tanzanian suburb,” Women and Birth, vol. 24, no. 1, pp. 24–31, 2011.
[50]  A. Kagee, R. H. Remien, A. Berkman, S. Hoffman, L. Campos, and L. Swartz, “Structural barriers to ART adherence in Southern Africa: challenges and potential ways forward,” Global Public Health, vol. 6, no. 1, pp. 83–97, 2011.
[51]  V. Ndlovu, “Considering childbearing in the age of highly active antiretroviral therapy (HAART): views of HIV-positive couples,” Journal of Social Aspects of HIV/AIDS Research Alliance, vol. 6, no. 2, pp. 58–68, 2009.
[52]  J. Harries, D. Cooper, L. Myer, H. Bracken, V. Zweigenthal, and P. Orner, “Policy maker and health care provider perspectives on reproductive decision-making amongst HIV-infected individuals in South Africa,” BMC Public Health, vol. 7, article 282, 2007.
[53]  J. D. Johnson, Cancer-Related Information Seeking, Hampton Press, Cresskill, NJ, USA, 1997.
[54]  R. L. Street, “Communication in medical encounters: an ecological perspective,” in Handbook of Health Communication, T. L. Thompson, A. M. Dorsey, K. I. Miler, and R. Parrott, Eds., pp. 63–90, Sage, Mahwah, NJ, USA, 2003.
[55]  P. Oosterhoff, N. T. Anh, N. T. Hanh, P. N. Yen, P. Wright, and A. Hardon, “Holding the line: family responses to pregnancy and the desire for a child in the context of HIV in Vietnam,” Culture, Health and Sexuality, vol. 10, no. 4, pp. 403–416, 2008.
[56]  M. Malta, C. S. Todd, M. A. Stibich, T. Garcia, D. Pacheco, and F. I. Bastos, “Patient-provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil,” Patient Education and Counseling, vol. 81, no. 3, pp. 476–482, 2010.
[57]  K. B. Newbold and J. Willinsky, “Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers,” Culture, Health and Sexuality, vol. 11, no. 4, pp. 369–382, 2009.
[58]  S. R. Schwartz, S. H. Mehta, T. E. Taha, H. V. Rees, F. Venter, and V. Black, “High pregnancy intentions and missed opportunities for patient-provider communication about fertility in a South African cohort of HIV-positive women on antiretroviral therapy,” AIDS and Behavior, vol. 16, no. 1, pp. 69–78, 2011.
[59]  S. Yeatman, “'HIV is an enemy of childbearers': the construction of local epidemiology in rural Malawi,” Culture, Health and Sexuality, vol. 13, no. 4, pp. 471–483, 2011.
[60]  K. Resnicow, T. Baranowski, J. S. Ahluwalia, and R. L. Braithwaite, “Cultural sensitivity in public health: defined and demystified,” Ethnicity and Disease, vol. 9, no. 1, pp. 10–21, 1999.
[61]  J. J. Myers, W. T. Steward, E. Charlebois, K. A. Koester, A. Maiorana, and S. F. Morin, “Written clinic procedures enhance delivery of HIV "prevention with positives" counseling in primary health care settings,” Journal of Acquired Immune Deficiency Syndromes, vol. 37, supplement 2, pp. S95–S100, 2004.
[62]  C. K. Mbekenga, H. I. Lugina, K. Christensson, and P. Olsson, “Postpartum experiences of first-time fathers in a Tanzanian suburb: a qualitative interview study,” Midwifery, vol. 27, no. 2, pp. 174–180, 2011.
[63]  F. Kasenga, P. Byass, M. Emmelin, and A. K. Hurtig, “The implications of policy changes on the uptake of a PMTCT programme in rural Malawi: first three years of experience,” Global Health Action, vol. 2, 2009.

Full-Text

comments powered by Disqus