'I Am a Nurse': Oral Histories of African Nurses.

BACKGROUND: Much of African history has been written by colonial "masters" and is skewed by cultural bias. The voices of indigenous peoples have largely been ignored. PURPOSE: The purpose of this study was to collect the oral histories of African nursing leaders who studied and practiced nursing from the late colonial era (1950s) through decolonization and independence (1960s-70s), in order to better understand their experiences and perspectives. METHODS: This study relied on historical methodology, grounded specifically within the context of decolonization and independence. The method used was oral history. RESULTS: Oral histories were collected from 13 retired nurses from Mauritius, Malawi, and Togo. Participants' educational and work histories bore the distinct imprint of European educational and medical norms. Nursing education provided a means of earning a living and offered professional advancement and affirmation. Participants were reluctant to discuss the influence of race, but several recalled difficulties in working with both expatriate and indigenous physicians and matrons. Differences in African nurses' experiences were evident at the local level, particularly with regard to language barriers, gender-related divisions, and educational and practice opportunities. CONCLUSION: The data show that although institutional models and ideas were transported from colonial nursing leaders to African nursing students, the African nurses in this study adapted those models and ideas to meet their own needs. The findings also support the use of storytelling as a culturally appropriate research method. Participants' stories provide a better understanding of how time, place, and social and cultural forces influenced and affected local nursing practices. Their stories also reveal that nursing has held various meanings for participants, including as a means to personal and professional opportunities and as a way to help their countries' citizens.

HIV status disclosure to sexual partners, among people living with HIV and AIDS on antiretroviral therapy at Sokodé regional hospital, Togo.

BACKGROUND: Many studies have reported factors associated with HIV status disclosure among People Living With HIV and AIDS (PLWHA) but very few were conducted among PLWHA receiving ART. In Togo, no study on HIV status disclosure to sexual partners has been conducted among PLWHA on ART yet. We sought to document factors associated with HIV status disclosure among PLWHA receiving ART at Sokodé regional hospital in Togo. METHOD: This was a cross-sectional study conducted from May to July 2013 at the regional hospital of Sokodé among 291 PLWHA who had been on ART for at least three months. RESULTS: A total of 291 PLWHA on ART were enrolled in this study. Their mean age (± SD) was 37.3 ± 9.3 years and the sex ratio (Male/Female) was 0.4. Among them, 215 (74.6%) completed the questionnaire on HIV sero-status disclosure. We found that 131 PLWHA (60.9%) had disclosed their HIV sero-status to their sexual partners; 130 (60.5%) were aware of the HIV status of their sexual partners. In the multivariate analysis, the factors associated with HIV status disclosure to sexual partners were: adherence to ART (aOR = 4.89; 95%CI = [1.52; 15.78]), sexual partner awareness of HIV sero-status (aOR = 52.73; 95%CI = [14.76; 188.36]) and marital status of PLWHA (aOR = 6.10; 95%CI = [1.74; 21.37]). CONCLUSION: This study allowed us to note that the disclosure of HIV status to sexual partners is relatively low and to document the associated factors such as adherence to ART, sexual partner awareness of HIV sero-status and marital status.

Sexual risk behavior among people living with HIV and AIDS on antiretroviral therapy at the regional hospital of Sokodé, Togo.

BACKGROUND: Several studies on the sexual risk behaviors in sub-Saharan Africa have reported that the initiation of antiretroviral therapy leads to safer sexual behaviors. There is however a persistence of risky sexual behavior which is evidenced by a high prevalence of sexually transmitted infections among people living with HIV and AIDS (PLWHA). We sought to determine the factors associated with risky sex among PLWHA on antiretroviral therapy in Togo. METHODS: An analytical cross-sectional survey was conducted from May to July 2013 at regional hospital of Sokodé, Togo, and targeted 291 PLWHA on antiretroviral therapy for at least three months. RESULTS: From May to July 2013, 291 PLWHA on antiretroviral treatment were surveyed. The mean age of PLWHA was 37.3 years and the sex ratio (male/female) was 0.4. Overall, 217 (74.6%) PLWHA were sexually active since initiation of antiretroviral treatment, of which, 74 (34.6%) had risky sexual relations. In multivariate analysis, the factors associated with risky sex were: the duration of antiretroviral treatment (1 to 3 years: aOR = 27.08; p = 0.003; more than 3 years: aOR = 10.87; p = 0.028), adherence of antiretroviral therapy (aOR = 2.56; p = 0.014), alcohol consumption before sex (aOR = 3.59; p = 0.013) and level of education (primary school: aOR = 0.34 p = 0.011; secondary school: aOR = 0.23 p = 0.003; high school: aOR = 0.10; p = 0.006). CONCLUSION: There was a high prevalence of unsafe sex among PLWHA receiving ART at the hospital of Sokodé. Factors associated with sexual risk behaviors were: low education level, non-adherence to ART, alcohol consumption before sex and the duration of ART. It is important to strengthen the implementation of secondary prevention strategies among this population group.