7 Long Distance Relationship Aids Love
Conclusions The review observed that a relationship between travelling further and . Seventy-seven per cent of the included studies identified a distance decay Distance from care predicts in-hospital mortality in HIV-infected patients with . Meanings and vulnerability to HIV/AIDS among long-distance truck . the relationships between private situations and specific social contexts. . the low search for health services by the male population. . However, often, these actions are punctual and not widely articulated with the health-care network;. These long distance relationship aids have helped countless couples succeed in staying together despite being far apart. People used to think that a couple in.
Women in the study were of reproductive age and were physically able to become pregnant by self-report. All women in the study were HIV-seropositive based on HIV antibody testing that had been verified by the cooperating agencies. Data for the current analysis Interview 1 were collected over a month period in — Procedure Potential participants were made aware of the study through notices flyers placed in cooperating clinics or ASOs or by case managers and social workers working in these agencies.
Women who expressed an interest were put in contact with female research assistants who were assigned to each of the cooperating agencies.
The purpose and procedures of the study were explained to each potential participant. For those women who indicated a desire to take part in the study, a brief screening questionnaire was used to insure that the women met inclusion criteria. Participant selection criteria included: All women who met study criteria were asked to participate. Once it was established that women met the inclusion criteria and wanted to take part in the study, an appointment was made for conducting the interview.
Some women preferred to complete the interview immediately. Other women expressed a desire to set up an appointment for the interview usually within 1 week giving them time to make arrangements for things like child care or to work around appointments or job responsibilities.
Following informed consent, all questions were read to the participants and their answers were recorded verbatim. Measures Women participating in the study were asked to complete a demographic questionnaire designed specifically for the study. Participants were asked to provide their age, race, marital status, education, religion, employment status, income and type of community in which they lived i.
Additionally, participants were asked to report their total number of children, number of pregnancies and children since being diagnosed with HIV infection. To examine issues surrounding disclosure of HIV status, women were asked to respond to a number of short-answer questions and an open-ended question.
Women were asked to indicate who was the first person they had told they were HIV-infected. Also, women were asked to indicate how long after learning they were HIV-infected that they disclosed to this first individual. A third question asked women if they had told their current partner that they had HIV. Following this question, women responded to nine items asking them to how many people from specific groups they had disclosed their HIV status.
7 Long Distance Relationship Aids
Finally, women were asked to describe, in their own words, how they decide to whom they reveal their HIV-positive status. Analysis plan Responses provided on the demographic and short answer questions were analyzed using frequencies, means and SDs.
Of the women participating in the study, The research team reviewed the thematic categories and three main categories describing approaches to disclosure of HIV-seropositive status emerged. After reaching consensus on the definitions of these categories, the researchers independently coded each response into one of the categories. While clear categories emerged from the data, categories were not completely independent and overlap among categories did exist in 14 of the descriptions provided by the women.
The researchers scrutinized these 14 responses and categorized women into one category that best fitted their response. Twenty-three women gave no response to the question. The researchers again scrutinized these cases until consensus was reached regarding what single category to which the 32 cases would be assigned.
Results The demographic characteristics of the participants reflected those of women with HIV infection who receive services in the clinics and agencies from which they were recruited Table I. Most women initially disclosed their HIV status to at least one parent, followed by their husband, siblings, friends, other relations and children Table II. The vast majority of these initial disclosures However, in the later question about disclosure to specific groups, only Three main categories emerged from the qualitative data analysis: One woman reported she got pleasure from disclosing in that she was able to help others potentially avoid getting HIV.
Criteria for disclosure Many participants have specific criteria for deciding to whom to disclose.
These criteria were generally based on one of three factors: Women reported disclosing to family members and friends selectively. Fears about how disclosure of their HIV infection would affect their child was an important consideration for many women who had children.
Some participants told people with whom they were living. However, other participants delayed or did not tell sexual partners. For these women potential negative consequences of disclosure represented criteria on which they made the decision to not disclose or to delay disclosure. People who were perceived to be supportive and accepting were disclosed to selectively.
Clearly in these reports, women had personal criteria on which they based their decisions to disclose. Emotional disclosure Many participants based their decision to disclose their HIV infection on being close to someone, trusting someone or through prayer or feeling that it was the right person to tell.
I feel comfortable with people who have confided something about themselves to me. However, women acknowledged that trusting a person did not guarantee that the person to whom they disclosed would keep the secret.
Some women described a more intuitive basis on which they made disclosure decisions.
I just got tired of hiding it. I had to tell somebody. Some women reported that after successfully disclosing to family members or partners they sought input concerning future decisions from that person. This input provided them with a level of emotional support in making these decisions.
Such emotional support not only in making decisions about disclosure but in dealing with HIV infection was reported as important. Even so, disclosure remained difficult to most women.
One woman, in discussing her conflict in disclosing to her mother, said: The bivariate analysis revealed only one significant relationship. Overall differences were detected for bosses, close friends, casual friends, parents, brothers, other relations and sex partners. No overall differences were detected for children or health care providers.
HIV and AIDS in Tanzania | AVERT
No significant differences were detected for full disclosers to parents, brothers and sisters, children, sex partners and health care providers. Healthcare uptake at licensed health facilities in a rural area of Uganda among children under the age of five years with febrile illness was lower for those who resided more than 3 km from the nearest health facility [ 13 ].
In a rural area of Zambia, the uptake of adequate antenatal care among pregnant women was lower among those residing farther from available health facilities [ 14 ]. In many rural areas of Uganda, economic and geographic barriers limit the uptake of HIV testing and treatment [ 415 — 17 ].
For example, pregnant women enrolled in antenatal care who resided more than 3 km from the nearest health facility with onsite HIV testing were less likely to be tested for HIV compared with those who lived closer to the clinic, leading to missed opportunities for linkage to prevention of mother-to-child transmission PMTCT services [ 16 ].
High cost of transport and distance are often cited as major impediments to ART uptake, adherence and continued engagement in the HIV care cascade [ 1517 — 19 ]. Fear of stigmatization, should they be seen and recognized by members of their community, may be one explanation for why PLHIV travel farther [ 23 ].
Moreover, PLHIV may travel further either because they require specialized HIV services like ART, which may only be available at larger, centralized facilities providing tertiary or higher level care, which are often located in urban centres, or because they perceive those facilities to provide more comprehensive or higher-quality care. We tested whether PLHIV are less likely than those not living with HIV to access the nearest and often most easily accessible health facility to their residence.
We explored whether the limited availability of higher-quality services explains any differences in distance travelled to access healthcare. We secondarily tested whether PLHIV who reported having accessed a facility that provides ART tended to access the closest facility to their residence or whether they opted for a facility further away.
Results of this study provide important first steps in our understanding of how to improve access to specialized HIV services among PLHIV in rural areas with limited availability of healthcare services, considering the unique geographic, economic and social constraints PLHIV face when accessing healthcare.
Like many other countries in East Africa, the burden of HIV is geographically heterogeneous, with the highest prevalence in rural, coastal areas of Lake Victoria. The study was conducted on Bugala Island in the Kalangala district of southern Uganda, the largest and the most populated of the Ssese Islands in Lake Victoria. The main economic activities involve fish production, farming and logging.
Most people in Bugala Island live in clusters around fishing villages and trading centres. Public health indicators in the district are poor: The large burden of HIV is at least in part due to engaging in high-risk behaviour including commercial sex, and the extremely poor status of the local health system. These facilities are ranked from 1 to 4 according to care level, with 4 indicating comprehensive service provision.
The facilities are either public, faith based or private. Private facilities operate on a fee for service model. Faith-based facilities offer subsidies and often charge a co-pay.
Government facilities are free but are often short of health workers, medicines and supplies, and patients often have to seek care or buy medicines in private facilities. Only two health facilities on the northern part of Bugala Island provide ART services, both of which are ranked as the highest tiered facilities on the island.
Global information and education on HIV and AIDS
Four of the 11 health facilities were excluded from the study as they are located on the southern part of the island and were not accessed by any of the surveyed population in the study. Heads of household were selected using a two-stage cluster sampling scheme. In the first sampling stage, 35 to 45 villages local council units on the northern portion of Bugala Island were randomly selected using simple random sampling. The sampling frame was provided by district authorities and a random number generator was used.
In the second sampling stage, an approximate map of the distribution of households in the selected villages was generated and a non-probability random sample of households was selected for participation in the study as follows: Inclusion criteria included self-reported head of household, 18 years of age or older, and willing and able to provide informed consent. Healthcare access Access to, and uptake of, healthcare on Bugala Island was defined as reporting uptake of any form of healthcare on Bugala Island in the last five years at any health facility.
The specified facility was assumed to be the health facility where healthcare was most commonly sought or where the individual would most likely go at the time of the survey.