Browsing by Author "Loos, Jasna"
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Item Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa(Taylor & Francis., 2015) Nöstlinger, Christiana; Bakeera-Kitaka, Sabrina; Buyze, Jozefien; Loos, Jasna; Buvé, AnneAdolescents living with HIV (ALHIV) face many psychosocial challenges, including HIV disclosure to others. Given the importance of socialization during the adolescent transition process, this study investigated the psychological and social factors influencing self-disclosure of own HIV status to peers. We examined social HIV self-disclosure to peers, and its relationship to perceived HIV-related stigma, self-efficacy to disclose, self-esteem, and social support among a sample of n = 582 ALHIV aged 13–17 years in Kampala, Uganda, and Western Kenya. Data were collected between February and April 2011. Among them, 39% were double orphans. We conducted a secondary data analysis to assess the degree of social disclosure, reactions received, and influencing factors. Interviewer-administered questionnaires assessed medical, socio-demographic, and psychological variables (Rosenberg self-esteem scale; self-efficacy to disclose to peers), HIV-related stigma (10-item stigma scale), and social support (family–life and friends). Descriptive, bivariate, and logistic regression analyses were performed with social self-disclosure to peers with gender as covariates. Almost half of ALHIV had told nobody (except health-care providers) about their HIV status, and about 18% had disclosed to either one of their friends, schoolmates, or a boy- or girlfriend. Logistic regression models revealed that having disclosed to peers was significantly related to being older, being a paternal orphan, contributing to family income, regular visits to the HIV clinic, and greater social support through peers. Low self-efficacy to disclose was negatively associated to the outcome variable. While social self-disclosure was linked to individual factors such as self-efficacy, factors relating to the social context and adolescents’ access to psychosocial resources play an important role. ALHIV need safe environments to practice disclosure skills. Interventions should enable them to make optimal use of available psychosocial resources even under constraining conditions such as disruptive family structures.Item Having sex, becoming somebody: A qualitative study assessing (sexual) identity development of adolescents living with HIV/AIDS(Routledge, 2012) Loos, Jasna; Nöstlinger, Christiana; Murungi, Irene; Adipo, Daniel; Amimo, Brenda; Bakeera-Kitaka, Sabrina; Oluoch, Dorothy; Mboi, Phyllis; Wobudeya, Eric; Vandenhoudt, Hilde; Buvé, AnneA growing number of adolescents are living with HIV/AIDS. For their well-being and for prevention, age- and culturally appropriate interventions become increasingly important. This qualitative study was conducted as the first step to develop a sexual and reproductive health (SRH) intervention. The study’s objective was to assess the impact of HIV and related contextual conditions on identity formation of adolescents living with HIV/AIDS (ALH) in the domains of physical, cognitive, social, and sexual development. Data were collected using focus group discussions (FGDs). Through HIV care centers in western Kenya and Greater Kampala, Uganda, we recruited 119 ALH aged 10–19 years, 54 of their caregivers, and 55 service providers for 28 FGDs. Following analytic induction principles, data analysis showed that many ALH had grown up in HIV-affected families in poverty. They reported experiencing long histories of illness and HIV-related stigma and discrimination, affecting their self-esteem. The physical changes of puberty, fueled by effective HIV treatment, symbolized a new start in life. The cognitive changes typical for adolescence enhanced their self-esteem, resilience, and belief in the future, particularly among older adolescents. In discovering their new social identity, ALH experimented with behaviors and norms, especially related to sexuality. ALH carefully examined the contrasting sexual norms of their peers, caregivers, and service providers and balanced them when developing their own sexual identity. For many ALH, sex is the way to become a social “somebody.” For some, having sex served to cope with the emotional pains of growing up with HIV. Sexual relationships also enabled some ALH to gain financial and emotional independence. This study shows how ALH’s identity development is influenced by the individual and social consequences of HIV. Multiple factors contribute to the importance that ALH attribute to sexuality, which calls for comprehensive interventions addressing the broader context of positive living and SRH rights.