title: How HIV diagnosis and disclosure affect sexual behavior and relationships in Ugandan fishing communities.
abstract: In this article we examine how members of fishing communities on the shores of Lake Victoria in Uganda respond to HIV diagnosis in terms of disclosure to sexual partners. We then explore the subsequent changes in sexual behavior and relationships. To access this information, we collected life history data from 78 HIV-positive individuals in five fishing communities. We found that the strength of the sexual relationships shaped how and why individuals disclosed to partners, and that these relationships tended to be stronger when partners shared familial responsibility. Those who perceived their current sexual partnership to be weak sought to conceal their status by maintaining prediagnosis patterns of sexual behavior. The majority of the study's participants rarely changed their sexual behavior following HIV diagnosis, regardless of their relationship's strength. These findings elucidate barriers to disclosure and behavior change, and suggest that a life-course approach might enhance individual-level counseling so that counselors can provide tailored support to individuals regarding disclosure decisions and outcomes.
authors.affiliation: University of Tennessee, Knoxville, Tennessee, USA.
authors.forename: Moriah
authors.initials: M
authors.lastname: McArthur
authors.forename: Isolde
authors.initials: I
authors.lastname: Birdthistle
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.forename: Juliet
authors.initials: J
authors.lastname: Mpendo
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017280:Condoms / Q000706:statistics & numerical data; D030881:Disclosure; D005260:Female; D005298:Fertility; D005398:Fisheries; D006679:HIV Seropositivity / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology*; D012959:Socioeconomic Factors; D014171:Transients and Migrants / Q000523:psychology* / Q000706:statistics & numerical data; D014454:Uganda; D000078329:Workforce; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Africa, sub-Saharan; HIV/AIDS; case studies; decision making; disclosure; life history; relationships; risk, behaviors