[People living with HIV: daily life and management of the risk of transmission in the infected person's entourage: study in Ouagadougou]. / Les personnes vivant avec le VIH, vécu quotidien et gestion du risque de transmission à l'entourage: étude à Ouagadougou.

HIV infection has modified social relationships not only within various population subgroups but also at the family level. Patient management has been seriously affected. In 2001 we undertook a descriptive study among a population of PLHIV treated in an ambulatory center in order to 1(o)) describe the socio-demographical characteristics of PLHIV admitted to the center and 2(o)) identify the strategies adopted by PLHIV and their families to control the risk of HIV transmission in the entourage. Patients were systematically included over a period of two weeks. Each patient was asked to indicate the name of a family member that could be interviewed by the research team. A total of 188 PLHIV (122 women) ranging in age from 19 to 55 years were questioned. Interviews were conducted in 66 families. Most PLHIV had received some formal education ranging from primary school to university. Over one third (36.4%) had known that they were seropositive for at least one year. Almost three-fourths (73.4%) were aware that HIV was transmissible to other people. The most frequently mentioned transmission hazards were handling contaminated articles (51.5%), unprotected sexual intercourse (46.4%), contact with blood (34.8%), and sharing personal toilet articles (11.6%). The most commonly mentioned preventive measures were abstinence from sex (27.1%), use condoms (28.7%), and protection from pointed or cutting objects (19.1%). According to responding family members, the most common protective measures against HIV transmission were observing hygiene measures (36.5%), discarding any fluids from the ill person in the toilet (26.5%), wearing gloves (25%), and protecting against handling contaminated objects (5.8%). These data suggest that programs aimed at educating PLHIV and their families on the risk of HIV transmission and preventive measure has had a positive impact on the quality of life.

[HIV infection and modification of social relationships: study of 188 HIV-infected persons in Ouagadougou (Burkina Faso)]. / Infection à VIH et modifications des relations sociales: étude auprès de 188 personnes infectées par le VIH à Ouagadougou (Burkina Faso).

HIV infection creates diverse representations among sick people, their families, the community and healthcare workers, representations that modify social relationships. To analyze the interpersonal relationships in families of people living with HIV, we began a cross-sectional descriptive study in 2001 of a population of HIV patients treated at an outpatient center in Ouagadougou. Our objectives were to: 1 degree) describe the changes in the social relationships between the subjects and members of their families; 2 degrees) itemize the difficulties they met within their families and identify the different types of discrimination they may suffer there. The systematic inclusion of HIV patients at the treatment center made it possible to question 188 subjects, including 122 women and 66 men aged 19 to 55 years. With the subjects' consent, 66 family members were also interviewed. According to these patients, the principal significant events experienced after disclosing their HIV status were absence of sexual intercourse with the partner (16.0%), rejection by their family (9.6%), taunting, criticism and contempt (6.4%). This conduct came from siblings (25%), other family members (20.8%), neighbours (20.8%), in-laws (16.7%), and the spouse (4.2%). Among our subjects, 74.5% informed their families that they were HIV-positive. Of the family members questioned, 82.1% considered the subject to be a victim and 17.9% considered him or her guilty. After receiving this information 21.5% of the families modified their relationships with the subjects. Despite information and awareness campaigns, HIV infection is laden with emotion and prejudice and subjects its victims to discriminatory behavior. Further public education is necessary to improve acceptance of people with this disease by their family and friends.

[Preliminary information to patients and presentation by Burkinabe physicians of the results of HIV detection test in Burkina Faso]. / Information préalable des patients et annonce par les médecins burkinabé des résultats des tests sérologiques de dépistage de l'infection à VIH au Burkina Faso.

BACKGROUND: The action of individuals and their family is determining in the result of AIDS control and the knowledge of people's serological situation facilitates their involvement in AIDS control. This study was carried out in order METHODS: A transversal investigation through a self-administered anonymous questionnaire was carried out among the 250 Burkinabe physicians working in a public, private or religious health care sector. The questionnaire was sent by mail, attached to a response coupon. A response of 74% was obtained. RESULTS: Seventy seven physicians, that is 48.7% of the sample, informed patients who were likely to be HIV infected about their intention to ask for an HIV test. Seventy five physicians, that is 47.5% of the sample informed patients on the results of their serological tests on HIV infection. The characteristics of physicians who informed customers on the results of their serological test were similar to those of physicians who informed their patients on the demand for test concerning them. There were often specialists, physicians with long experience in medical practice and physicians more involving in curative consultations than in preventive ones (respectively 54.7% versus 23.3%, p=0.002). CONCLUSIONS: These results show the necessity of providing young physicians with counselling training, especially general practitioners who should be working in prevention services. Moreover, they constitute a basis for an objective discussion between physicians working in hospital, officials in charge of the national program for AIDS control and medical training schools.

Parental HIV Disclosure in Burkina Faso: Experiences and Challenges in the Era of HAART

Increasingly parents living with HIV will have to confront the dilemmas of concealing their lifelong treatment or disclosing to their children exposed to their daily treatment practices. However; limited data are available regarding parental HIV disclosure to children in Burkina Faso. Do parents on antiretroviral therapy disclose their HIV status to their children? What drives them? How do they proceed and how do children respond? We conducted in-depth interviews with 63 parents of children aged seven and above where the parents had been in treatment for more than 3 years in two major cities of Burkina Faso. Interviews addressed parental disclosure and the children's role in their parents' treatment. The rate of parental HIV status disclosure is as high as that of non-disclosure. Factors associated with parental disclosure include female sex; parent's older age; parent's marital history and number of children. After adjustment; it appears that the only factor remaining associated with parental disclosure was the female gender of the parent. In most of the cases; children suspected; and among non-disclosers many believed their children already knew without formal disclosure. Age of the children and history of divorce or widowhood were associated with parental disclosure. Most parents believed children do not have the necessary emotional skills to understand or that they cannot keep a secret. However; parents who disclosed to their children did not experience blame nor was their secret revealed. Rather; children became treatment supporters. Challenges to parental HIV disclosure to children are neither essential nor specific since disclosure to adults is already difficult because of perceived risk of public disclosure and subsequent stigma. However; whether aware or not of their parents' HIV-positive status; children contribute positively to the care of parents living with HIV. Perceptions about children's vulnerability and will to protect them against stigma lead parents to delay disclosure and not to overwhelm them with their experience of living with HIV. Finally; without institutional counselling support; disclosure to children remains a challenge for both parents and children; which suggests a need for rethinking of current counselling practices