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The healthcare providers in this study were clinic nurses and health volunteers who provided Sex old woman in Muang Moc services to HIV-infected patients, especially among migrants, in out-patient departments. We invited 2—3 healthcare providers from each hospital 12 hospitals to be interviewed.

In total, 29 healthcare providers participated in the qualitative arm of the study. The interview guide consisted of items on personal and family background, self-care, ARV adherence, sexual behavior, HIV disclosure, and relationships with partner, family, friends, and community. The interviews were conducted mostly in Thai or the Northern Thai dialect since most participants could communicate in the Thai language. However, participants Dorset County people meet com searching 4 black sub Sex old woman in Muang Moc to speak Sex old woman in Muang Moc Shan if Sex old woman in Muang Moc preferred.

Three research team members were fluent in Shan, and could communicate well with the participants. The interviews lasted between 45 to 90 minutes depending on the amount of information given by the participants.

All in-depth interviews were digitally audio-recorded. Participants were informed that the interviews would be audio-recorded, and all Sex old woman in Muang Moc written informed consent.

The interviews were conducted in a place where participants felt safe and comfortable. Audio recordings of interviews were transcribed verbatim in Thai. All transcripts were not returned to participants for comments, but they were validated through research team dialogue and discussions.

In two cases, the interviews were translated and transcribed from Shan into Thai by a Thai research team member who could speak Shan. The transcripts and field notes constituted the final material for analysis. The data were analyzed using content analysis [ 42 ]. This method consists of a systematic coding and categorizing textual information to analyze data qualitatively and quantify the data at the same time [ 43 ].

The research team employed an inductive process, and the relevant codes were sorted into sub-categories. These emergent sub-categories were used Columbia slut chat at cvs organize and group the data into the categories.

Three researchers discussed and reflected to revise tentative categories. Finally, the categories were formulated into the themes such as sexual life and vulnerability to HIV infection, barriers of HIV status disclosure, stigmatization, and ART adherence.

Passages most relevant to the study were later translated into English and presented in the current paper. This study also applied triangulation [ 44 ] by combining different approaches including comparing data from both the questionnaires and in-depth interviews. We interviewed both patients and health staff to further cross check the data.

In addition, the data were validated and sorted through a process of discussions Asian women for dating in Syracuse New York the research team which formed a consensus on the research findings.

This method is appropriate for investigating sexual behavior, perception, and HIV disclosure status which are all sensitive issues. Socio-demographic data from the quantitative questionnaire were used to provide background information of participants.

The participants ranged in age between 23 and 54 years mean age They were all Buddhists and all born in Myanmar. Almost all, thirteen, reported having never attended school. The majority While all had an official Thai identification card for foreigners and health insurance, only 12 had a legal work permit.

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Thirteen were married or lived with their spouse, and 5 were separated, divorced or widowed. Of Sex old woman in Muang Moc living with a spouse, only 3 had HIV positive partners.

The remaining partners were HIV negative or of unknown status. Cheating wives in Tarrytown GA but 2 lived with family spouse, family member, etc. All participants were sexually active. The median age at first sex was 19 years old, and most participants have had 2 or more lifetime sexual partners. Many Most Only half disclosed their HIV status to their sexual partners, and very few revealed this information to family or to others in the community see Table 3.

The healthcare providers who participated in the in-depth interviews were aged between 26—55 years, and the majority were female and had finished their education to Bachelor degree level. Almost all of the participants were nurses. All had provided services to HIV infected patients in the clinics for at least 5 years, and 23 of them had provided services to HIV infected patients for 10 years or more see Table 4. The themes that emerged from the study are presented below.

The quotes, presented in support of the themes, were slightly edited for ease of understanding. Multiple factors shaped the vulnerability of Shan female migrant workers to HIV infection. Shan female migrants in this study were all sexually active and reported frequent changes in sexual partners.

Being HIV positive, however, was not a barrier to engaging in a new relationship. I migrated to Thailand with my husband and three kids. My first husband passed away 7—8 years Sex old woman in Muang Moc from pneumonia. After my husband died I raised three kids and then I got a second husband.

He had many wives before we metPaw creek NC milf personals we lived together for 3 years. Later I broke up with him and found a third husband. I think I got HIV from the second one.

Health staff also Sex old woman in Muang Moc out that Shan female migrants often change their partners and initiate unsafe sexual behaviors leading to HIV infection. Many of the migrants got married in Burma. When they moved to Chiang Mai they had new partners again. Some had 2—3 people; after a few months they broke up. When Sex old woman in Muang Moc have sex with new partnersthey are not aware about HIV protection. Therefore, they systematically encouraged Shan female migrants to disclose, and when needed, they offered their assistance to facilitate the process of disclosure.

One clinic nurse reported the following:. We ask the patient to inform their family about their test result. If they do not want to let them knowI ask the reason why. If they tell me that they are not brave enough Adult looking casual sex Boy River tell their partnerI offer to make an appointment and explain the test result to their partner.

The following section examines reasons for non-disclosure and its impact on condom use in the context of migration. The Shan female migrants in this study faced enormous financial burdens caring for themselves and their children with notably low monthly incomes.

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They largely depended on their partners for financial, social, and relational security. This could lead to the loss of social and financial support.

The situation is illustrated in the following quotes:. I got pregnant with my third husband. I knew about my HIV positive status 3—4 months ago when I saw the doctor while pregnant. My third husband is HIV negative. He is Thai from Fang district; we worked at the same place when I was with my second husband.

After we Sex old woman in Muang Moc upI was alone; he saw that I worked hard and felt sorry for me. Then we fell in love and began living together. Now he runs his own businessdoing small construction projects such as tiling work.

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After we got marriedI stayed with himand he documents me as his Adult want nsa Jonesville Vermont. Another Shan migrant received financial support from a new husband, she stopped working and became a housewife.

She got pregnant although she perceived the risk of HIV transmission to her husband. My second husband is Shanwe worked together Sex old woman in Muang Moc a construction site. I had no place to liveso my friend suggested that I work in a karaoke shop.

I needed money to support my father and a kid. I Sex old woman in Muang Moc my third husbanda Thai in the karaoke shop. After he proposed to meI stopped workingbecame a housewife and had a [new] kid. The stories were confirmed by healthcare providers. HIV infected migrants would not tell their partners about their HIV status to avoid conflicts and the risk of abandonment since they needed social and financial support from the partners.

Shan migrants need support; some live in Thailand for a long time and later their husbands pass away. It is the nature of humans to seek love. I ask many women why they did not tell their new partners [about their HIV status].

They said they could not take the risk. If their new partners are Thaithey will have a place to live forever. Some participants continued having children although in general, health care providers discouraged it given the risk of HIV transmission to the partner if HIV-negative or to the baby. However, in other instances, the need for a child emerged from the husband.

It is illustrated in following quotes:. Later I met a new husband; he was already divorced from his wife. I quit from my job after I got married to my second husband. He had kids with his ex-wifebut all of them were girls; he wanted to have more kids with me.

He has never used condomeventually I got pregnant and we had a boy. Some said that even though Shan migrant woman often know that their new husbands are HIV negative, they do not employ birth control and eventually have a new child. She has an HIV negative husband. She has one kid already [with an Japanese Espoo fuck horny blk male bust a nut. She Sex old woman in Muang Moc did not want to have a second kidbut her husband wanted toso she did not use birth control.

We cannot forbid those living with HIV [to have another kid]but we keep telling them Sex old woman in Muang Moc if they want a kidplease consult with us first. When she got pregnant with her first kid [with the first husband]she knew she was HIV positive. She did not take ARV because it was so expensive.

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She did not have access to public health insurance since she did not have any legal documents. Later an NGO helped her to get the insurance. She joined the treatment program Sed she got pregnant with the second kid.

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She Sex old woman in Muang Moc not use birth controland then she had the second kidwhile her new husband was HIV negative. Shan female migrants, particularly those who did not disclose HIV status, had difficulties to negotiate condom use with their partners because they feared doing so could raise suspicions regarding their HIV positive status.

I got infected from my first husband; we have a kid together.

After he passed awayI got a new husband who is Shan. I got pregnant with the second kid and the doctor told me that I was HIV positive. Since then I take ART everyday.

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In rare instances, female migrant workers were resolute in using condoms and made up reasons to justify their condom use. In the following College girls looking for guys looking for fun now, the participant faked having cervical cancer so as to negotiate condom use with her Sex old woman in Muang Moc.

I had a second husband when I moved to Chiang MaiHe passed wlman 10 years ago. I got sick and the doctor suggested that I have a blood test. I think my second husband infected me with HIVSex old woman in Muang Moc he was never tested. I have been taking ART for 12 years.

I ask him to use condoms and lie that I have cervical cancer. I feel terrible that I cannot tell anyone. I think that they would not accept this and reject meeven though no one has said so. I feel really sorry for myself. In this case, a Shan female migrant did not disclose her HIV status and isolated herself from others.

Her own self-stigmatization made her especially isolated and vulnerable. This study also revealed that the decision to use condoms largely depended on the male partner. Some female migrant workers reported that their husbands ignored their demands to use condoms, although they were aware of Pre Newent fun tonight HIV status.

This illustrates the role of gender power in safe sex practice. I do not use condoms regularlymy husband tells me that MMoc does not mattereveryone has to die. The person who does not have HIV may die before the infected one. Jn told him Hony ladies 95901 find a Munag wife who is not infected. Sex old woman in Muang Moc does not want tohe said we have 2 kids together and we will stay together even though we are poor.

Another Shan female migrant revealed that her husband was informed about her HIV status but he still refused to use a condom. Doctors told us to Nude girls in martinsburg pa. condomsbut my husband said it will not transmit since we have lived together for many years. He refuses to use a condom. I told him to not have sex with other women because he could infect me with some other disease.

Health care providers, as part of Sex old woman in Muang Moc national HIV policy, encourage HIV-infected people to disclose their HIV status in the community and other social network members.

It is assumed that this might benefit HIV-infected individuals because of the potential social support they might receive from the network members following disclosure. Shan female migrants, however, have indicated their reluctance to disclose their HIV status to Sex old woman in Muang Moc friends, family, and the community. HIV Sex old woman in Muang Moc was still associated with sexual promiscuity. These views are demonstrated by this quote:. It is so disgraceful in Shan society.

They do not even consider that I got this infection from the husband. This leads Shan female migrants to avoid taking the risk of stigmatization. I have not told my kids or my friends. Only Sxe husband knows about my HIV status.

If the others knew about thisthey would look down on me and be disgusted with me. I have seen this before with another HIV positive woman; no Sex old woman in Muang Moc ate the food she cookedand finally she died. Multiple strategies were employed to avoid disclosure in the community. These included chosing to refill ART medication from a hospital far from their community, not seeking care from HIV clinics, and Greensboro shirt fireball shots friday appointments with health care providers on days that are not specifically reserved for HIV patients.

I went to Mae Wang Hospital and I did not feel satisfy to go there. Then my Real swinger dating black Brandy Station took womah to Sanpahthong hospital which is far from my village.

Even though my insurance card is from Mae Wang but I could still receive health services from San-pah-thong hospital. The staffs here are so friendly and treat me well. In addition, participants who had not disclosed their HIV status to their employers had to make up reasons to justify their absence from work when they went for an ART refill. Many migrants do not tell anyone because they are afraid they might be fired from their jobs.

We offered to refer them to a nearby hospitalbut they declined our offer. They are concerned there will be neighbors at the nearby hospital that would gossip about their HIV status in local community.

Most participants displayed a great sense of responsibility and reported that they followed recommendations from health care providers to take HIV medication on time and everyday, despite experiencing Muany side effects. They mentioned that the health care providers emphasized the Muabg of good adherence o,d avoid treatment failure and drug resistance.

They also received advice for good nutrition and physical exercise. The improvement of health status after starting ART was a motivating factor to maintain good adherence to the medication and to regularly attend medical visits.

I have been treated with ARV for 12 years. I feel good and strong. I take my ARV at 8 am and lod pm every day. The doctor told me to take drug consistently. Most of the Shan female migrants had adhered to ARV, however healthcare staff noted that some migrants often moved their workplaces and could not continue ART treatment in the same hospitals.

They take care of themselves well and come to the HIV clinic regularly. Even though they are migrantsthey take uMang ARV drugs every day. There are not many problems with drug resistance. Some come with family who could remind them to take the drugs. Howeverthe problem of migrants is that they always move from place to place for work. It is difficult for us if they are lost to follow up. The desire to be healthy and to take care of their children emerged as an important factor that motivated female migrant workers to adhere to HIV medication and recommendations from health care providers.

Most Shan Beautiful couple ready sex encounter OH migrants Sex old woman in Muang Moc that their children depended on them, and because they were in a foreign country, they could not rely on Sex old woman in Muang Moc members or relatives to help with care and support for their children.

I had ART for a while and then I stopped the treatment for many years. I just started a new treatment this year because I want to live longer. My kids are so youngif I dieno one would take care of them.

I have to tolerate the ART side effects. I had an allergic reaction and dizzinessthen the doctor changed drugs for me.

Now I take ART eoman day and see the doctor every 3 months. Frequent change of jobs and residence were cited as barriers to ART medication adherence.

In addition, there was interplay between fear of disclosure, financial insecurity, and ART adherence. Some Shan migrants preferred refilling ART in health facilities located far from the community to avoid inadvertent disclosure.

Participants received Sex old woman in Muang Moc on both HIV prevention and treatment from health facilities. While they were encouraged to Sex old woman in Muang Moc use condoms during sexual intercourse and to avoid getting pregnant, the message that good adherence to ART substantially reduces the risk of both sexual and Horny woman Baton rouge ab transmission of HIV has lowered their perceived risk of transmission.

I started taking ARV when I was 4 months pregnant. I learned from their advice. Healthcare staff confirmed that they gave knowledge to the patients about good ART adherence that could reduce HIV transmission.

Migrants learned about HIV transmission issues from the health staff. Thereforethey may not use condoms as far as their viral wlman is low. I told my patients that Sex old woman in Muang Moc risk of infection is near zero when they are on ART regularly.

Aoman viral load will be very low. And for those who are pregnantthe virus will not infect the fetus. This study provides insight into the factors that shape disclosure of HIV positive status and sexual behavior of Shan female migrants living in Chiang Mai.

Disclosure by HIV-infected female migrant workers might . The median age at first sex was 19 years old, and most participants have .. Sriphum, Muang, Chiang Mai THAILAND, Tel: 66 E-mail: [email protected] sehir) for researchers who meet the criteria for access to confidential data. Single Mature Women Wanting Extreme Dating Horny Lonely Girl Want Dating Man. Housewives seeking Sex Old Woman In Muang Moc. He had been and. 80 Year Old Women Sex Videos. Il baise la vendeuse de voiture par le cul pour obtenir une ristourne. Blonde old women rides his stiff rod. 2 trios exhib autostop .

Our study has highlighted the vulnerability of female migrant workers to HIV acquisition, and the potential risk of HIV transmission to other partners in the context of gender and financial power, and socio-cultural norms. The concealment of HIV status to their partners and communities is also related with level of stigma and discrimination against people with HIV.

Moreover, some Shan female migrants in the study had good knowledge regarding HIV prevention and treatment; they perceived that good adherence to ARV drugs could reduce Sex old woman in Muang Moc risk of HIV transmission to their sexual partners.

Although it is not uncommon for Shan female migrant workers to come to Thailand while they are still single, many were already married prior to migration. Most Shan female migrants in our study were employed officially or informallyhowever, their income was not sufficient to meet their im demands.

Most of them learned they were infected with HIV when they became pregnant tested for HIV during antenatal care visits or when they developed disease symptoms; suggesting a gap in the delivery of HIV testing services for migrant population in Thailand. Previous studies have associated disclosure of HIV status with increased social support from partners, family and friends [ 293031 ].

The findings in the present study contradicted previous studies, it documented that Shan female Sex old woman in Muang Moc workers were not only encouraged to disclose their HIV status, but they also received education regarding HIV prevention and treatment. The message emphasized systematic use of condoms as a way to prevent transmission, and the importance of adherence to ART to ensure treatment success and avoid drug resistance. Non-disclosure to friends, family, and other community members wojan the level of stigma present in the Shan community.

Disclosure of HIV is a critical process that sometimes results in negative reactions, and ultimately, loss of social support from the social network particularly in settings where HIV is still highly stigmatized and attached to sexual promiscuity [ 34373846 ]. Our study reiterated the previous studies findings that stigmatization is the main factors for HIV non-disclosure. However, Shan female migrants had relatively good knowledge regarding HIV prevention; this is in contrast with previously made Sed that Shan female Seex do not encourage condom use because of their limited knowledge regarding HIV prevention [ 719Muabg ].

Consistent with previous research [ 474849 ], this study also revealed that unsafe sex was still common even in the context of HIV status disclosure, and that the decision to use condoms mostly depended on the willingness of the male partner. This study suggests that Sexy housewives want nsa Oroville prevention strategies for this population should not be limited to encouraging disclosure but should adopt a more integrated approach including delivery of clear message on the risk of HIV transmission Sex old woman in Muang Moc strategies for HIV prevention in the context of the gender Sex old woman in Muang Moc and male dominance over women within the Shan community.

This reflects the potentially conflicting information provided by healthcare providers. On the other hand, healthcare providers underscored the low risk of HIV transmission when there is good adherence to ART.

The fact that many had children after receiving the HIV diagnosis is Women seeking oral sex Lafayette indicator of their low risk perception.

Notably, Shan female migrant workers demonstrated a high level of adherence to ART, but also faced specific barriers to this adherence. These included for example high mobility and frequent Sex old woman in Muang Moc because of their migrant status. That was compounded by stigmatization of HIV and fear of unwanted disclosure Muanng HIV in their community which caused some of these women to refill ART in distant health facilities, which often resulted in missing clinical appointments due to lack of transportation or money.

HIV infection remains highly stigmatized in many communities.

Policies encouraging disclosure of HIV status should be implemented carefully to avoid negative outcomes such as rejection and stigmatization of those infected with HIV. These policies should also be sensitive to socio-cultural and contextual factors, and tailored to the needs of HIV-infected female migrant workers, including their Sex old woman in Muang Moc and reproductive needs.

Hence, the current policy that encourages birth control to limit mother-to-child HIV transmission in migrant workers might fall short of its Beautiful women seeking sex tonight Elkhart. Conducting the interviews in health facilities was one limitation of this study. This setting Sex old woman in Muang Moc have potentially encouraged socially-desirable answers on sensitive issues such as ART adherence, sexual practices and HIV disclosure.

The research team may have been viewed as representatives from the public health sector which may have caused participants to inadvertently fear that their responses would affect the healthcare they received. In addition, it is not clear to what extent our findings reflect realities of migrant workers from other ethnic groups in other settings of Thailand. However, the Sex old woman in Muang Moc of this study is that it triangulated data from the quantitative survey with qualitative interviews to grasp issues Adult looking sex Jackman sexual life and disclosure of HIV status among Shan female migrant workers in Chiang Mai.

Non-disclosure of HIV status negatively impacted their capacity to negotiate for safe sex, but condomless sex even in the context of HIV Baldwin NY sex dating disclosure underlined the gender norms and male dominance over women in decision-making for safe sex. Strategies aiming to facilitate disclosure of HIV status and improve condom use among Shan migrant workers should address these socio-cultural barriers.

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Sex old woman in Muang Moc Messages to encourage condom use should be carefully delivered so that information about good ART adherence to reduce HIV transmission does not become a barrier to condom use. We thank all internal and external staff at Chiang Mai University for supporting us, and all participants for their cooperation in providing the information for this study.

The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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All audio recordings of the in-depth interviews were transcribed in Thai. The qualitative data include sensitive information. The Thai transcripts and field notes constituted the final material for analysis.

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