Secondly, the Treatment Action Campaign (TAC) which gave me information on prison conditions as well as the sample. Fourth, I would like to thank the health promotion team from the University of KwaZulu - Natal who also provided me with academic support during the proposal writing stages.
DEFINITIONS Offender
ABSTRACT
CHAPTER ONE INTRODUCTION
- OVERVIEW
- BACKGROUND OF STUDY
- PROBLEM STATEMENT
- Research problems and objectives
- Significance of the study
In short, this study examined both the process and experience of HIV disclosure among HIV-positive ex-offenders. The process of HIV disclosure among HIV-positive ex-offenders provides information about past risky behavior and future preventive behavior.
CHAPTER TWO LITERATURE REVIEW
Theoretical Framework
The breadth, duration, and depth of information determine how the individual perceives the situation and the goal. Once the individual is aware of the potential benefits, they will decide how to disclose, to whom to disclose, and the content of the disclosure.
Prison conditions
- Drug – abuse
- Overcrowding
- Gangs
- Consensual and Coercive Sexual Intercourse
- Responses by International Organisations and Local Government
Both consensual and forced anal sex lead to tearing of the rectum, making the individual more susceptible to HIV/AIDS. Apparently, male-on-male rape is a result of the construction of power relations between female prisoners and prison culture.
Voluntary HIV testing and counselling (VCT)
- Barriers to VCT
- Reasons for VCT
- Factors that motivate and hinder the process of disclosure
Individuals will also choose not to disclose their HIV status due to the need for privacy (Wong et al., 2009). In a separate study, Wong et al. 2008), compared disclosure rates between family members and partners.
Strategies for Disclosure
Concluding paragraph
CHAPTER THREE
RESEARCH METHODOLOGY 3.1 Research Design
- Ethical Considerations
- Type of Sampling
- Sample Size
- Data Collection Technique
- Instrument
- Data Analysis
- Validity
TAC contacted the participants and they were comfortable with the idea that the researcher knew their HIV status. What was also important is that the researcher had to ensure that the interviews were evenly balanced between the research objectives of the study as well as the free expression of the participants. The authenticity of the study was enhanced by displaying the diverse viewpoints of the participants.
CHAPTER FOUR FINDINGS
Introduction
Prison conditions
Participants alerted to the various channels through which high rates of HIV/AIDS remain within prisons. These factors range from the structure of the prison environment to the way power permeates the system.
Disclosure within prison: Place and Timeline
- Reasons for disclosing in prison
In addition, participants also referred to the dangerous conditions inside the prison, which influenced their decision to disclose. Participants also witnessed other deaths within the prison that led to participants' decision to disclose their HIV status. By doing this, the participants were motivated to explore inside the prison because of the challenges they faced on a daily basis.
Methods of disclosure within prison
- Intentional disclosure within prison
- Unintended means of disclosure in prison
P3: First of all he told the social worker that I told him and then the social worker called me about 30 minutes later the social worker called me. P4: And then I saw what happened in prison and said to myself, 'Hey, I'm not staying like this. I spent a long time with them and I didn't want to reveal it and then I told them, but I saw the people who were sick.
Experience of prison life overrides the experience of HIV
Experience of VCT
- Reasons for VCT
- The process of VCT
- Reactions to the HIV diagnosis
- Psychological adjustment to HIV/AIDS
At that time I saw people dying inside, but then I was fit and had no problems and I didn't cough anything in there that could make you think I was HIV positive, others didn't know I was HIV positive but the things I seeing them in myself I realize that I have to take another test. P2: Then the blood results came back and I was HIV positive at that time and then she told me not to join other people who are HIV positive. I couldn't sleep for a whole week and thought about those things that I am HIV positive, how is this, where did I get this from.
The role of significant others in disclosure
- Significant others that were disclosed too
- Responses by significant others
- Negative responses by significant others
- Positive responses by significant others
- Current relationship with significant others that were disclosed too Participants argued that the disclosure of their HIV status has strengthened their
- Outcomes of disclosure for the participants
Participants also spoke of the sense of ease and relief they experienced after disclosing their HIV status to significant others. Participants argued that significant others had reacted both negatively and positively to the HIV disclosure. Significant others responded this way because they believed that the participants were physically healthy and therefore could not be HIV positive.
Factors that influenced disclosure
- Factors that motivated disclosure
- Barriers to HIV disclosure
- Perceived advantages of disclosure
- Perceived disadvantages of disclosure
Overall, all participants were ready to disclose their HIV status as they felt they had a responsibility to disclose to significant others. According to the participants, the age of significant others had hindered their ability to disclose their HIV status. The extent to which participants had access to significant others influenced the participant's decision to disclose.
Strategies of disclosure
- Direct Strategies of disclosure
- Indirect Strategies of disclosure
Participants used empowerment and knowledge about HIV/AIDS as a way to disclose their HIV status. Significant others became aware of the participant's HIV status through a TV program through which they openly disclosed their HIV status. Furthermore, when participants disclosed their HIV status to significant others, they also told significant others to disclose their status to other family members.
Summary of Findings
Participants had chosen three methods to disclose their HIV status, including: the media, writing in their personal journals, and using significant others to disclose their HIV status. For these participants, using indirect strategies seemed to be the safest and most reassuring way to disclose their HIV status. These findings clearly indicate that prison conditions, social support, and the availability of significant others influenced the disclosure process among HIV-positive ex-offenders.
CHAPTER FIVE DISCUSSION
- Theoretical Formulation
- Stage 2: The selection of a significant other and strategy
- Stage 3: Breath, duration, and depth of the disclosure
- Factors that contributed to VCT
- VCT and HIV disclosure
- Prison conditions
- Community mobilization
- Social support
- The role of intimate relationships
- Stigma and discrimination
- Concluding comments
- CONCLUSION
Similarly, this study also warned that ex-offenders did not disclose their HIV status because they felt their children were too young. This was also consistent in this study, but ex-offenders also faced stigma in prison. More importantly, ex-offenders faced stigma as an HIV-positive individual and an ex-offender.
LIMITATIONS 6.1 Conclusions
Recommendations
- Prison Conditions and VCT
- Re - integration into the community and HIV disclosure
- Access to ARV treatment and Care, employment opportunities
- Significant other’s perspective
- Policy
In addition, programs should be implemented on how ex-presidents can take advantage of employment opportunities. It is recommended that a policy addressing issues surrounding HIV disclosure be implemented within the prison. This implies that all necessary prison authorities as well as relevant stakeholders should be involved in maintenance.
Limitations
More importantly, guidelines need to be established on how prisons can protect the offender's HIV status. It could be suggested that all offenders should be given a nutritional diet, regardless of their status. In addition, the roll-out of ARVs within the prison needs to be done more systematically and this can be addressed by more efficient healthcare staff within the prison.
Experiences of stigma and discrimination among HIV-positive men who have sex with men in Cape Town, South Africa. Confidentiality and disclosure of HIV infection: HIV-positive persons' experiences of HIV testing and coping with HIV infection in Latvia. The impact of antiretroviral treatment and counseling on HIV-serostatus disclosure in Johannesburg, South Africa.
APPENDIX TWO
APPENDIX THREE A: Informed Consent
CONSENT TO PARTICIPATE IN RESEARCH
APPENDIX FOUR TRANSCRIPT
This is the problem you face because my own family doesn't accept my current status, I don't know maybe I have to get sick so they can see that it's really true I'm HIV positive. They are now saying that you are now like the newborn Christian, you know they are pushing it. I want people to know what HIV is like, what it's like to live with HIV/AIDS, so that's where we started.
APPENDIX FIVE TRANSCRIPT: CODING
All the kids just do what they want, they know they don't go fishing, they just think they know they're promoting, it's called nomoknato in Zulu, that means you can say you can drink, then you can throw yourself into whatever you want, you can throw yourself at girls and boys because they drink too much. The things I hear are very bad because I see there is no goodbye there but when I got out of prison they told me that they are rehabilitating me when I get out I have to talk to the kids and now I don't know where I have to go, I have to do, but I see that now I am like a comedian. I look at the guys, I say hey guys, I don't want to hear that you're doing something wrong. I don't know exactly because he didn't stay with me this morning either, he stayed in Umlazi, he came to get something, so when I always do something about HIV, I wear this shirt, I just look out and tell him I'm going to the clinic, he just looks that I'm wearing such a normal shirt, but I don't want that.
Indirect means of disclosure)
I don't know exactly because he didn't stay with me this morning either, he stayed in Umlazi, he came to get something, so when I always do something about HIV, I wear this shirt, I just look out and tell him I'm going to the clinic, he just looks that I'm wearing such a normal shirt, but I don't want that. killing people who is on the mind but me. I have to consult my wife first and then I can tell my son. There is nothing that I would expect from my own experience, nothing; nothing changes either. Same with my neighbors, when I tell them I'm HIV positive, they say no, no, no, I'm fine, I'll be fine.
Understanding the experience through significant others)
Before you tell your son that you are HIV positive, you need to sit down with your wife and then you will do it in support. As far as your family is concerned, you disclosed to the family if you can give an example of who you told. I was told that I got this tuberculosis and HIV, some people told me that the tests were negative.
Understanding the experience through significant others) & (Stigma against those that are HIV positive)
The people you see are in denial. You can't get anything that people can say, hey, from this year until now, I'm HIV positive. Outwardly, there is a stigma for any person who is because of denial, but there is a stigma because even now the people they are talking about are not officially HIV positive because they are not joking. If you're not HIV positive, hey, there's a stigma. I didn't get a single one they support when you have HIV everyone should support a single one. I didn't get it, neither I in my family were happy when I came out, but with time I see that things have changed, so now I stay alone.
HIV/AIDS)
They say this brother and this brother-in-law, some of them, I can guess they have HIV, just like my uncle. I don't want to mention names because they're just telling me indirectly, you see, hey, I want to tell that they're just not ready. I come out with a rash, all I get is tuberculosis. There was a rash, everything when I came out. I can see the sign language. I am an old man. I see. Hey, they didn't want to help me, my family.
Prison Conditions)
The government they should give the food packages that you can take if you are on the ARVs and for the TB. Even here in Chestville everything is so overcrowded and many people think it's the nurses who don't want to do the work but it's the government that's lacking. I saw it with my own eyes and the nurses can't help them because there are too many.
Structure of institutions/politics/the role of the government)
And then I saw what was happening in the prison and I said, hey, I'm not going to stay like this. I see some people they know, some come up to me and ask me how you survive. You see, I saw in prison that if you keep quiet, the chest comes out once you keep quiet. You can say that I saw this man on TV and now he can speak freely when you suspect that you need to reveal something because you cannot survive in prison.
Disclosure within prison)
Some people when I tell that I am HIV positive they say that I am wrong but with my own experience I always use condom I don't flirt with everyone anymore. But you see I always talk to other people that they should use a condom the same as people I say that I am HIV positive they deny because they can see that I am healthy all these things hey I don't know what to do .
It's good with my partner too because when I got out of prison she had a lot of STIs but she couldn't run away because of the advice I give people and she stays with me because of the advice I give her.
APPENDIX SIX TABLES & MATRICES
