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The virus stops with me: HIV-infected Ugandans' motivations in preventing HIV transmission

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  • King, Rachel
  • Lifshay, Julie
  • Nakayiwa, Sylvia
  • Katuntu, David
  • Lindkvist, Pille
  • Bunnell, Rebecca

Abstract

Few Positive Prevention interventions have been implemented in Africa; however, greater attention is now being paid to interventions that include messages of personal responsibility or altruism that may motivate HIV-infected individuals towards HIV prevention behaviors in Africa. We conducted 47 in-depth interviews in 2004 with HIV-infected men and women purposefully sampled to represent a range of sexual activities among clients of an AIDS support organization in Uganda. Qualitative interviews were selected from a cross-sectional survey of 1092 HIV-infected men and women. Clients were interviewed about their concerns around sexual HIV transmission, feelings of responsibility and reasons for these feelings, as well as about the challenges and consequences of actions to prevent HIV transmission. The reasons they provided for their sense of prevention responsibility revolved around ethical and practical themes. Responsibility toward sexual partners was linked to the belief that conscious transmission of HIV equals murder, would cause physical and emotional harm, and would leave children orphaned. The primary reason specific to preventing HIV transmission to unborn children was the perception that they are 'innocent'. Most participants felt that HIV-infected individuals held a greater responsibility for preventing HIV transmission than did HIV-uninfected individuals. Respondents reported that their sense of responsibility lead them to reduce HIV transmission risk, encourage partner testing, disclose HIV test results, and assume an HIV/AIDS educator role. Challenges to HIV preventive behavior and altruistic intentions included: sexual desire; inconsistent condom use, especially in long term relationships; myths around condom use; fear of disclosure; gender-power dynamics; and social and financial pressure. Our finding that altruism played an important role in motivating preventive behaviors among HIV-infected persons in Uganda supports the inclusion of altruistic prevention and counseling messages within Positive Prevention interventions.

Suggested Citation

  • King, Rachel & Lifshay, Julie & Nakayiwa, Sylvia & Katuntu, David & Lindkvist, Pille & Bunnell, Rebecca, 2009. "The virus stops with me: HIV-infected Ugandans' motivations in preventing HIV transmission," Social Science & Medicine, Elsevier, vol. 68(4), pages 749-757, February.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:4:p:749-757
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    References listed on IDEAS

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    1. Janssen, R.S. & Holtgrave, D.R. & Valdiserri, R.O. & Shepherd, M. & Gayle, H.D. & De Cock, K.M., 2001. "The serostatus approach to fighting the HIV epidemic: Prevention strategies for infected individuals," American Journal of Public Health, American Public Health Association, vol. 91(7), pages 1019-1024.
    2. Schiltz, M. A. & Sandfort, Th. G. M., 2000. "HIV-positive people, risk and sexual behaviour," Social Science & Medicine, Elsevier, vol. 50(11), pages 1571-1588, June.
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    Cited by:

    1. Lall, Priya, 2014. "Social Factors Affecting Women's Susceptibility to HIV in India," ADBI Working Papers 485, Asian Development Bank Institute.

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