Community impact of HIV status disclosure through an integrated community home-based care programme

Abstract

The integration of HIV-prevention activities into care has received little attention within or outside formal healthcare settings. The contribution of community home-based care services in facilitating disclosure of HIV status and reducing stigma have also not been described. This study examines the community impact of an integrated community home-based care (ICHC) programme on HIV-prevention efforts and disclosure of status. Quantitative data was collected from 363 people living with HIV (PLHIV) and 1 028 members of their micro-communities; of these, 211 and 586, respectively, were in the ICHC programme (thus representing the ICHC-served group) and 152 and 442, respectively, were not in the programme (representing the non-served or control group). The microcommunity group served by the ICHC programme reported significantly more positive attitudes towards HIV, better knowledge of HIV, fewer instances of sexually-transmitted infections, a tendency for fewer sexual partners, and less perceived risk of acquiring HIV than the non-served micro-community group. Also, the micro-community served by the programme did not show significantly better uptake of voluntary counselling and testing than did the nonserved micro-community. There was no difference in condom-use between the two groups.

Keywords: integrated care model, knowledge/attitudes/behaviour, sexual behaviour change, stigmatisation, voluntary
counselling and testing

African Journal of AIDS Research 2006, 5(3): 265–271