A Content Analysis Study: Concerns of Indonesian Women Infected With HIV by Husbands Who Used Intravenous Drugs.

Reference:

Ismail, R., Voss, J. G., Woods, N. F., John-Stewart, G., Lowe, C., Nurachmah, E., ... & Boutain, D. (2018). A Content Analysis Study: Concerns of Indonesian Women Infected With HIV by Husbands Who Used Intravenous Drugs. Journal of the Association of Nurses in AIDS Care



Abstract:

A Content Analysis Study: Concerns of Indonesian Women Infected With HIV by Husbands Who Used Intravenous Drugs

Author links open overlay panelRitaIsmailPhD, RN, MPH, MTD (HE)Joachim G.VossPhD, RN, ACRN, FAANNancy FugateWoodsPhD, RN, FAANGraceJohn-StewartPhD, MD, MPHCeliaLowePhDEllyNurachmahDNSc, RN, MAppScSriYonaPhD, RN, MNTohaMuhaiminDrPH, MD, MScDorisBoutainPhD, RN, PHNA-BC

https://doi.org/10.1016/j.jana.2018.04.012Get rights and content

Few international studies document the concerns of women living with HIV (WLWH) who were infected by their intravenous drug-using husbands. Our content analysis described the concerns of this population by analyzing 12 interviews with WLWH. Three main concerns were discussed by the women: dealing with anger and being a dedicated wife, going home to one's parents as the only place to go, and being strong and staying alive for the children. Dealing with their own emotional responses to the HIV diagnosis, lacking financial resources after the husband's death, and remaining focused on staying healthy were major issues in their stories. Indonesia needs large-scale public HIV education campaigns about the risks women encounter as wives to husbands who use intravenous drugs as well as campaigns to educate husbands about their risks. Nurses need to encourage women to get tested during prenatal care to prevent infecting their children.

Methodology:

Methods Data Collection Our content analysis study was conducted in Jakarta, Indonesia. The Institutional Review Board of the University of Washington and the Universitas Indonesia approved the study procedures. All participants provided consent before any study procedures were conducted. Twelve participants were recruited through a nongovernmental organization (NGO) focused on supporting people living with HIV. After the director of the NGO approved the study, the organization’s staff distributed fliers to WLWH during monthly events. The fliers described the purpose of the study, listed the eligibility criteria for participants, and provided a phone number for those wanting to learn more about the study. There were four main study inclusion criteria. Women who were included in this study (a) self-identified as a woman infected with HIV by her IDU husband, (b) spoke Indonesian, (c) signed a consent to participate, and (d) agreed to participate in digitally audio-recorded interviews. Women were excluded from the study if they (a) were an IDU, (b) had sex outside of marriage, or (c) were uncertain how they were infected with HIV. Each participant received $3.80 USD for her time and transportation. Interviews were conducted in a private office and included only the interviewee and interviewer. The first interview lasted between 60 and 90 minutes, while the second interviews lasted 30 minutes. An interview guide was developed based on previous HIV studies and discussions with an expert on HIV. Exemplar questions included, What sort of experiences have you had since you learned of your HIV status? and How does your family treat you as a WLWH? The second interviews were held with three of the participants to validate initial findings. All interviews were transcribed verbatim and translated from Indonesian into English. All data were treated as confidential. Data were stored in a passwordprotected computer and participants’ personal information was kept confidential.

Conclusion:

onclusion Women in our study had limited knowledge about HIV and did not expect to be infected with HIV by their IDU husbands. They blamed their husbands for infecting them with a stigmatized disease. The women continued to care for their sick husbands and children in the context of experiencing anger. The women reported experiencing financial struggles after the deaths of their husbands because the husbands had supplied income and financial resources for the family. A lack of life skills and work experiences outside of the home made it difficult for the women to find reliable employment. Thus, the women could only turn to their parents for help, despite the often negative receptions given by their parents. As the main caregivers for children, the women expressed their most pressing concerns as finances and the futures of their children. Indonesia needs large-scale HIV campaigns to educate the public about the risks of women who have husbands who use intravenous drugs and to also educate people who inject drugs about their risks. In addition, nurses need to encourage women to get tested for HIV during prenatal and primary care.