Limited research has explored the unique impact of HIV-positive disclosure in healthcare and within interpersonal relationships. This study compared the impact of disclosing an HIV status to family, friends, sexual partners and health care providers on perceived stigma, health and wellbeing among people living with HIV (PLHIV) in Australia.
Methods: PLHIV in Australia were targeted via print and online media to take part in a brief online questionnaire. Participants completed measures of perceived HIV-related stigma and treatment-related stigma, social support, resilience, stress, anxiety, depression, health satisfaction and quality of life. Demographic data, including age and education, were also collected.
Results: A total of 697 valid responses were received. As expected, multivariate regression analysis indicated that disclosing to health care providers independently predicted higher health satisfaction. Disclosing to family and friends was associated with lower perceived treatment-related stigma. Additionally disclosing to friends was related to lower perceived general HIV-related stigma. While disclosure to family and to sexual partners predicted higher perceived social support, disclosing to family was also an independent predictor of diminished health satisfaction and quality of life. Outcome measures of resilience, stress and depression were not related to disclosure to any of the groups. Age was additionally unrelated to disclosure to any of the groups, while higher education independently predicted disclosure to family.
Conclusions: The findings from this study indicate that HIV disclosure to different groups of people has differing, albeit not always positive, impacts on the health and wellbeing PLHIV. These results shed light on the choice to selectively disclose an HIV-positive status among PLHIV, along with the health and social consequences of this selective disclosure.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Early first sexual intercourse has been proposed as an important marker of later sexual and reproductive health. Discussions of what constitutes early sexual debut in this context, however, have been limited.