@article{0403c347d929435b9ca3f2f152a09ecb,
title = "From “Secret” to “Sensitive Issue”: Shifting Ideas About HIV Disclosure Among Middle-Aged and Older Rural South Africans in the Era of Antiretroviral Treatment",
abstract = "Objective: As HIV shifts from “death sentence” to “chronic condition,” disclosure of HIV status to intimate partners and family is a significant component of both prevention and treatment adherence. While disclosure is closely considered in many studies, few examine middle-aged and older persons{\textquoteright} (age 40+) perspectives or practices. We trace older rural South Africans{\textquoteright} views on HIV disclosure to their partners and family members in a high prevalence community over a period of extensive antiretroviral treatment (ART) rollout. Methods: Community focus group discussions (FGD) conducted in 2013 and 2018 show shifts in older persons{\textquoteright} thinking about HIV disclosure. Findings: Our FGD participants saw fewer negative consequences of disclosure in 2018 than in 2013, and highlighted positive outcomes including building trust (partners) as well as greater support for medication collection and adherence (family). Discussion: Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons{\textquoteright} views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence.",
keywords = "HIV disclosure, South Africa, aging, antiretroviral treatment",
author = "Enid Schatz and Ifeolu David and Nicole Angotti and G{\'o}mez-Oliv{\'e}, {F. Xavier} and Mojola, {Sanyu A.}",
note = "Funding Information: We are grateful to additional members of the HIV40 team including Brian Houle, Jane Menken, and Chodziwadziwa Kabudula for their numerous contributions to the project. We thank all the respondents who participated in this study. We also thank the Izindaba za Badala field team as well as the people of Agincourt for their long involvement with the AHDSS study. We thank Nicole Angotti, Sanyu A. Mojola, and Jill Williams for significant contributions to the design, data collection and intellectual underpinnings of the project. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We are grateful for funding support from: the National Institute on Aging?R01 AG049634 HIV after 40 in rural South Africa: Aging in the Context of an HIV epidemic (PI Sanyu Mojola); the National Institutes of Health - R24 AG032112-05 Partnership for Social Science AIDS Research in South Africa?s Era of ART Rollout (PI Jane Menken); the University of Colorado Innovative Seed Grant; the William and Flora Hewlett Foundation (grant 2008?1840), and the Andrew W. Mellon Foundation. This work has also benefited from research, administrative, and computing support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development?funded University of Colorado Population Center (P2C HD066613). We are indebted to Agincourt: The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any of the funders. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We are grateful for funding support from: the National Institute on Aging–R01 AG049634 HIV after 40 in rural South Africa: Aging in the Context of an HIV epidemic (PI Sanyu Mojola); the National Institutes of Health - R24 AG032112-05 Partnership for Social Science AIDS Research in South Africa{\textquoteright}s Era of ART Rollout (PI Jane Menken); the University of Colorado Innovative Seed Grant; the William and Flora Hewlett Foundation (grant 2008–1840), and the Andrew W. Mellon Foundation. This work has also benefited from research, administrative, and computing support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development–funded University of Colorado Population Center (P2C HD066613). We are indebted to Agincourt: The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any of the funders. Publisher Copyright: {\textcopyright} The Author(s) 2021.",
year = "2022",
month = jan,
doi = "10.1177/08982643211020202",
language = "English (US)",
volume = "34",
pages = "14--24",
journal = "Journal of Aging and Health",
issn = "0898-2643",
publisher = "SAGE Publications Inc.",
number = "1",
}