Disclosure of HIV seropositive status to sexual partners and its associated factors among patients attending antiretroviral treatment clinic follow up at Mekelle Hospital, Ethiopia: a cross sectional study

Intimate partner violence and factors influencing HIV status disclosure among women living with HIV in Indonesia: a cross-sectional study

The disclosure of HIV status poses challenges, and women living with HIV often face intimate partner violence as a result of revealing their HIV status. This study aims to investigate the prevalence of intimate partner violence and HIV status disclosure among women living with HIV in Indonesia, as well as the factors associated with disclosure. A total of 283 women with HIV participated in an online survey, and descriptive and logistic regression analyses were performed. The findings revealed that women reported experiencing physical (9.54%), sexual (6.01%), mental (23.67%), and economic (14.49%) abuse. HIV status disclosure varied among different individuals, with higher rates observed for partners (71.2%), other family members (65.02%), close friends (37.10%), and lower rates for health workers (1.77%). Factors such as employment status and partner's HIV status influenced disclosure to partners, while the duration of knowing one's HIV status, experiences of intimate partner violence, and perceived barriers influenced disclosure to both family and non-family members. To mitigate the negative consequences of HIV status disclosure, targeted health promotion efforts should prioritize partners, family members, and non-family members, focusing on enhancing knowledge and awareness about HIV, including the impact of violence.

Factors Associated with HIV Positive Serostatus Disclosure to Sexual Partners Among Sexually Active Young People on Anti-Retroviral Therapy in Central Uganda

Introduction

HIV serostatus disclosure is a fundamental HIV prevention and care strategy yet with a paucity of literature. This study comprehended the factors associated with HIV serostatus disclosure to sexual partners among young people aged 15-24 years on anti-retroviral therapy (ART).

Methods

This explanatory sequential study utilized quantitative data from 238 young people who had been on ART for over 12 months and were sexually active for at least 6 months in seven districts of Central Uganda. Pearson's Chi-square and multinomial logistic regression analysis at α=0.05 was used to determine the factors associated with serostatus disclosure among study participants. Qualitative data from 18 young people were collected using an in-depth interview guide and analyzed thematically.

Results

Non-disclosure was at 26.9%, one-way disclosure was at 24.4%, and two-way disclosure was at 48.7%. Participants who contracted HIV from their partners were three times more likely (RRR=2.752; 95% CI: 1.100-6.888) to have one-way disclosure than non-disclosure, compared to those who had a perinatal infection. Those who contracted HIV from their partners were twice more likely (RRR=2.357; 95% CI: 1.065-5.214) to have two-way disclosure than non-disclosure, compared to those who had a perinatal infection. Participants who stayed with their partners were four times more likely (RRR=3.869; 95% CI: 1.146-13.060) to have two-way disclosure than non-disclosure, compared to those who stayed with their parents. Young people disclosed because they were tired of secrecy and desired treatment adherence and did not disclose due to fear of stigma and losing their partners' support.

Conclusion

Many sexually active young people on ART did not disclose their HIV-positive status to sexual partners mainly due to poverty, having multiple-sexual partners, and stigma. Interventions fighting stigma, multiple-sexual relationships, and poverty among sexually active young people on ART should be strengthened.

Birth Preparedness Plans and Status Disclosure Among Pregnant Women Living with HIV Who are Receiving Antiretroviral Therapy in Ibadan, Southwest, Nigeria

Background

Promoting the maternal health of pregnant women who are living with human immunodeficiency virus (HIV; [PWLH]) is key to reducing maternal mortality and morbidity. Thus, inadequate birth preparedness plans, non-institutional delivery, and status concealment among PWLH contribute to the spread of HIV infection and threaten the prevention of mother-to-child transmission (PMTCT). Therefore, this study aimed to assess the birth preparedness plan and status disclosure among PWLH, as well as the prevalence of HIV infection among pregnant women.

Methods

The study adopted a descriptive cross-sectional research design; a quantitative approach was used for data collection. Three healthcare facilities that represented the three levels of healthcare institutions and referral centers for the care of PWLH in the Ibadan metropolis were selected for the recruitment process. A validated questionnaire was used to collect data from 77 participants within the targeted population. Ethical approval was obtained prior to the commencement of data collection.

Results

The prevalence rate of HIV infection among the participants was 3.7%. Only 37.1% of the participants had a birth preparedness plan. A total of 40% of the participants tested for HIV, because testing was compulsory for antenatal registration. Only 7.1% of the participants had their status disclosed to their partners. Although 90% of the participants proposed delivering their babies in a hospital, only 80% of these participants had their status known in their proposed place of birth.

Conclusion and Global Health Implications

The prevalence of HIV infection among pregnant women is very low, which is an indication of improved maternal health. However, the level of birth preparedness plan and status disclosure to partners are equally low, and these factors can hinder PMTCT. Institutional delivery should be encouraged among all PWLH, and their HIV status must be disclosed at their place of birth.

Magnitude of Prompt HIV-Seropositive Status Disclosure to Partner and Associated Factors among Adult Clients on ART at Holeta Health Center, Central Ethiopia, 2020

Background. Disclosure of HIV-seropositive status is important for HIV prevention and maintenance of health for people living with HIV and the community at large. Most of the disclosure in our country and elsewhere were after putting the partner at risk of contracting HIV/AIDS. This study aimed to assess prompt HIV-seropositive status disclosure to partner and its associated factors among people living with HIV and attending care and treatment at a health center, in central Ethiopia. Methods. A cross-sectional study was carried out from September 15, 2019, to March 15, 2020, among 438 people living with HIV who were more than 18 years old and had sexual partner attending ART clinic at Holeta Health Center, central Ethiopia. The data were collected through face-to-face interviews using a structured questionnaire. The data were entered into Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive analysis was conducted to determine the magnitude of prompt HIV seropositive status disclosure to partner and multivariable logistic regression analysis was computed to identify factors associated with prompt HIV seropositive status disclosure. Results. A total of 434 study participants took part in this study giving a response rate of 99%. Three hundred thirteen (72.1%) respondents disclosed their seropositive status to their partners promptly. Being married (AOR = 2.99, 95% CI = 1.09–8.21), less than 24-months duration on treatment (AOR = 0.185, 95% CI = 0.076–0.454), discouraging response of partner about the test (AOR = 0.34, 95% CI = 0.0149–0.780), knowing serostatus of one’s own partner (AOR = 10.42, 95% CI = 4.19–25.19), and using condom always with a partner (AOR = 11.44, 95% CI = 3.37–38.79) were factors significantly associated with prompt HIV seropositive status disclosure to partner. Conclusion. The proportion of prompt disclosure of HIV seropositive status to partner was low when compared to the overall partner disclosure rate. Being in marriage, less than 24 months duration on treatment, discouraging response of partner about the test, knowing serostatus of one’s partner, and using condom always with a partner were identified as predictors of prompt HIV seropositive status disclosure to partner.

Predictors of HIV Status Disclosure to Sexual Partners Among People Living with HIV in Brazil

The objective of this study was to identify the factors associated with the non-disclosure of HIV seropositivity among people living with HIV/AIDS undergoing antiretroviral treatment. A cross-sectional study was carried out in five HIV clinics in the interior of the state of São Paulo, Brazil. Logistic regression analysis was used to determine independent predictors of HIV status disclosure. It was found that 68.5% revealed their HIV seropositivity to their most recent sexual partner. The variables "casual partner" [OR 19.08, 95% CI (4.08, 20.23), p = 0.001], "sexual partners with negative HIV or unknown HIV" [OR 4.54, 95% CI (1.58, 1.01), p = 0.005], "multiple sexual partners" [OR = 3.17, 95% CI (1.34, 7.35), p = 0.009], and "lack of communication with the partner on HIV prevention"[OR = 8.3, 95% CI (3.88, 16.61), p = 0.001] were independently associated with non-disclosure of the diagnosis. Future HIV prevention interventions should encourage open communication between sexual partners.

Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat

Background

HIV continuum of care demands early ART initiation for all HIV-infected individuals. Early ART initiation reduces onward HIV transmission facilitating rapid viral suppression. Despite this, delayed ART use is a challenge among newly diagnosed HIV-positive individuals, and there is limited evidence on time to ART initiation among this group in Ethiopia. Thus, this study aimed to assess time to ART initiation and its predictors among newly diagnosed HIV-positive individuals in Nekemte town, Western Ethiopia.

Methods

An institution-based retrospective follow-up study was conducted on 518 newly diagnosed HIV-positive people from September 5, 2016 to December 20, 2020 at Nekemte town, Western Ethiopia. Data were collected from ART intake forms, registration log books and patient charts. The collected data were entered into Epi Data version 3.1 and STATA version 14.0 was used for analysis. Survival probability was checked graphically by Kaplan–Meier curve and statistically by Log rank test. Both bivariable and multivariable Cox Proportional hazards regression models were conducted to identify the predictors of ART initiation. Hazard ratio with 95% CI and p-value of <0.05 was used to declare a statistical significance.

Results

By the end of the follow-up, 371 (71.6%) individuals had initiated ART with an overall incidence rate of 51.9 per 1000 [95% CI: 54.07–66.32] person days; median time to ART initiation was 4 [IQR: 1–9] days. Being female (AHR = 1.33, 95% CI: 1.06–1.67), urban dwellers (AHR = 2.02, 95% CI: 1.37–2.97), having baseline OIs (AHR = 1.62, 95% CI: 1.60–4.30); being tested via VCT (AHR = 1.33, 95% CI: 1.02–1.74); linked from OPD (AHR = 0.64, 95% CI: 0.47–0.85); disclosing HIV sero-status (AHR = 2.07, 95% CI: 1.17–3.68); and college and above education level (AHR = 1.43, 95% CI: 1.00–2.0) were identified as significant predictors of early initiation of ART.

Conclusion

The proportion and incidence of ART initiation was high; a short median time to ART initiation was revealed in this study. Strictly screening OIs, encouraging HIV sero-status disclosure and voluntary HIV testing are recommended to increase early ART initiation.

Challenges to nutrition management among patients using antiretroviral therapy in primary health 'centres' in Addis Ababa, Ethiopia: A phenomenological study

INTRODUCTION

Nutritional management is a fundamental practice of concern to all patients infected with the human immunodeficiency virus (HIV). The nature of HIV/AIDS and malnutrition impacts are interlocked and intensify one another.

OBJECTIVE

This study aimed to explore nutrition management challenges among people living with HIV on antiretroviral therapy (ART) in primary health centres in Addis Ababa, Ethiopia.

METHODS AND MATERIALS

We used a hermeneutic (interpretive) phenomenological study design. The study used in-depth interviews to describe lived experiences among adult patients aged 18 and above. We selected the participants purposively until the saturation of the idea reached. We maintained the scientific rigor and trustworthiness by applying credibility, transferability, dependability, and conformability, followed by translation and re-reading of the data has been achieved. The data have been analyzed through inductive thematic analysis assisted by NVIVO version 12 pro software.

RESULT

Nutrition management challenges for HIV patients have been described using six significant themes. The major themes were: acceptance of the disease and the health status; facilitators and barriers to treatment adherence; behavioural changes in eating patterns; experience of food insecurity issues; nutrition knowledge; and support. The themes have explained how patients using ART have been challenged to manage their nutrition ever since their diagnosis. Of all challenges, food insecurity is found to be the core reason for poor nutrition management.

CONCLUSION AND RECOMMENDATION

We found that many factors in managing their nutrition challenged patients with HIV. There should be an increasing interest in managing food insecurity issues as food insecurity has been strongly related to other factors.

The effect of counseling, antiretroviral therapy and relationship on disclosing HIV positive status to sexual partner among adult HIV patients in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Human Immunodeficiency Virus (HIV) is continued as a major public health problem, especially in developing countries. Therefore, this study aimed to estimate the effect of counseling, antiretroviral therapy (ART) and relationship on disclosing HIV positive status to sexual partner among adult HIV patients in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was used during this review. The study included both published and unpublished studies which were conducted in Ethiopia until the end of 2019. Different electronic databases (PubMed, Cochrane library, CINAHL, Global Health, HINARI and Google scholar) were searched. Data were extracted in Microsoft Excel sheet and STATA/SE 14 was used to meta-analysis. I2 and Egger test statistics were used to test heterogeneity and publication bias respectively.

RESULTS

Twenty-two articles with 8,873 adult HIV infected peoples were included in this systematic review and meta-analysis. The pooled magnitude of disclosing HIV status to sexual partner was 74.63% [95% CI: (67.79, 81.47)]. Counseled [AOR = 4.96, 95% CI: (2.87, 8.55)], ART initiated [AOR = 4.78, 95% CI: (3.84, 5.94)] and who had a smooth relationship before HIV testing [AOR = 6.82, 95% CI: (3.49, 13.33)] were significantly associated with disclosing HIV status to sexual partner.

CONCLUSIONS

Disclosing HIV positive status to sexual partner in Ethiopia was low as the government invested in partner notification. Counseling, ART initiation and smooth relationship before HIV testing were significantly associated with disclosing HIV status to sexual partner. The government needs to strengthen pre and post HIV test counseling even after treatment started to increase disclosing status.

REGISTRATION

The protocol of this systematic review and meta-analysis was registered in the PROSPERO with a specific registration number: CRD42020161276; https://clinicaltrials.gov/.

Patterns and Predictors of HIV Status Disclosure in the 12 Months After Diagnosis in Mozambique

BACKGROUND

HIV disclosure benefits people living with HIV, their partners, and HIV programs. However, data on the prevalence of disclosure and associated correlates have come largely from patients already in HIV care, potentially overestimating disclosure rates and precluding examination of the impact of disclosure on HIV care outcomes.

SETTING

We used data from an implementation study conducted in Maputo City and Inhambane Province, Mozambique. Adults were enrolled at HIV testing clinics after diagnosis and traced in the community 1 and 12 months later when they reported on disclosure and other outcomes.

METHODS

We examined patterns of participants' disclosure to their social networks (N = 1573) and sexual partners (N = 1024) at both follow-up assessments and used relative risk regression to identify correlates of nondisclosure.

RESULTS

Disclosure to one's social network and sexual partners was reported by 77.8% and 57.7% of participants, respectively, at 1 month and 92.9% and 72.4% of participants, respectively, at 12 months. At both time points, living in Inhambane Province, being single or not living with a partner, having high levels of anticipated stigma, and not initiating HIV treatment were associated with increased risks of nondisclosure to social networks. Nondisclosure to sexual partners at both follow-up assessments was associated with being women, living in Inhambane Province and in a household without other people living with HIV, and reporting that posttest counseling addressed disclosure.

CONCLUSIONS

Although reported disclosure to social networks was high, disclosure to sexual partners was suboptimal. Effective and acceptable approaches to support partner disclosure, particularly for women, are needed.

Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

Introduction:

In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners.

Methods:

CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I² statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation.

Results:

The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure.

Conclusion:

In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

HIV-Positive Status Disclosure and Associated Factors among HIV-Positive Adult Patients Attending Art Clinics at Public Health Facilities of Butajira Town, Southern Ethiopia

Background

Human immunodeficiency virus-positive status disclosure is the process of informing one's HIV-positive status to others. It is the base for accessing care and treatment programs, attaining psychosocial support, reducing stigma, adhering to treatment, and promoting safer health. Even though different strategies were done in Ethiopia to increase the magnitude of HIV status disclosure among HIV-positive patients, the magnitude is still low. The magnitude of HIV-positive status disclosure was not assessed yet after initiation of the new strategy (test and treat strategy). The aim of this study is to assess the magnitude and factors associated with HIV-positive status disclosure among HIV-positive adults attending antiretroviral therapy clinic at the public health facilities of Butajira town.

Methods

Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 414 study participants were selected by systematic random sampling technique. Data were collected by using pretested interviewer-administered semistructured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis was used to identify factors associated with HIV-positive status disclosure. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistically significance was declared at p value <0.05 and 95% CI.

Results

The magnitude of HIV-positive status disclosure was 90%. Discussing about safer sex (AOR: 3.5; 95% CI: 1.3, 9.4), viral load suppression (AOR: 4; 95% CI: 1.5, 10.1), having good ART adherence (AOR: 6; 95% CI: 2.4, 14.0), receiving counseling (AOR: 2.5; 95% CI: 1.01, 6.3), and perceiving stigma (AOR: 0.25; 95% CI: 0.09, 0.60) were the independent factors associated with HIV-positive status disclosure.

Conclusion

Although the majority of the participants (90%) of them disclosed their HIV-positive status, lack of disclosure by few people can tackle HIV prevention and control programs. Health programs could improve disclosure of HIV-positive status by providing counseling service, strengthening adherence of antiretroviral therapy, suppressing viral load, and avoiding (reducing) stigma on HIV-positive patients by their community.

Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.

Human immunodeficiency virus positive status disclosure to a sexual partner and its determinant factors in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia.

METHOD

This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger's regression test. Following the Egger's regression test, P-value < 0.05 was considered as statistically significant at 95% Confidence Interval.

RESULT

A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR = 19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR = 9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR = 4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR = 3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia.

CONCLUSION

The pooled national estimate of HIV/AIDS positive status disclosure is low as compared to the WHO disclosure rate of developing countries and the findings of other national and international studies. Ministry of health and other stakeholders shall design new approaches and strategies to encourage disclosure of HIV status, educate the public about the negative impact of nondisclosure within family members. Health care providers working at Human HIV test centers shall emphasis extensive counseling on disclosure of status to a partner. Moreover, different stakeholders, health workers and community members shall establish, organize, and support HIV/AIDS Associations and motivate HIV positive people to be engaged and participated.

Sero-positive HIV result disclosure to sexual partner in Ethiopia: a systematic review and meta-analysis

Background

The infection of HIV continues to be an important public health problem in Ethiopia. Disclosing own HIV positive result is crucial, and considered as a good indicator of behavior change towards HIV/AIDs. A systematic review and meta-analysis was conducted to pool the prevalence of positive HIV status disclosure to sexual partners and determine the influence of selected factors.

Methods

This systematic review and meta-analysis was conducted in Ethiopia among HIV positive people receiving health care at health facilities. In this review, primary studies were searched in Medline via PubMed, Google scholar and Google up to November, 2018. Data on disclosure of HIV positive result, knowledge of partner’s HIV status and prior discussion on HIV were extracted, and effect sizes like proportion and odds ratios were pooled. Heterogeneity and publication bias were assessed by chi-square and I2, and Egger test, respectively.

Results

A total of 12 studies with 4528 participants were included in to this review to estimate the prevalence of disclosure of HIV positive result to sexual partner, and 10 and 7 studies were included to determine the associations of the outcome variable with knowledge of sexual partner’s HIV status and with prior discussion on HIV, respectively. The pooled prevalence of HIV status disclosure to sexual partner was 73% (95% CI: 64, 82%). Having the knowledge of sexual partner’s HIV status [OR: 95%CI; 17.63 (7.88, 39.45)], and previous discussion on HIV [OR: 95% CI; 9.24 (5.56, 15.37)] increased the disclosure of own HIV positive result to sexual partner. The sub-group analysis indicated a prevalence of 74% in Oromia, 86% in Southern Nations Nationalities and Peoples (SNNPR), 87% in Amhara, 73% in Addis Ababa, and 54% in Tigray.

Conclusions

Disclosure of HIV status to sexual partner is lower than expected. Knowledge of partner’s HIV status and previous discussion on HIV were strong predictors of HIV positive status disclosure. Strategies helpful for encouraging open HIV discussion need to be strengthened to increase HIV positive result disclosure. Furthermore, since the heterogeneity of studies is high, large nationally representative study is suggested.

Frequency of HIV status disclosure, associated factors and outcomes among HIV positive pregnant women at Mbarara Regional Referral Hospital, southwestern Uganda

Introduction

Positive HIV results disclosure plays a significant role in the successful prevention and care of HIV infected patients. It provides significant social and health benefits to the individual and the community. Non-disclosure is one of the contextual factors driving the HIV epidemic in Uganda. Study objectives: to determine the frequency of HIV disclosure, associated factors and disclosure outcomes among HIV positive pregnant women at Mbarara Hospital, southwestern Uganda.

Methods

A cross-sectional study using quantitative and qualitative methods among a group of HIV positive pregnant women attending antenatal clinic was done and consecutive sampling conducted.

Results

The total participant recruitment was 103, of which 88 (85.4%) had disclosed their serostatus with 57% disclosure to their partners. About 80% had disclosed within less than 2 months of testing HIV positive. Reasons for disclosure included their partners having disclosed to them (27.3%), caring partners (27.3%) and encouragement by health workers (25.0%). Following disclosure, 74%) were comforted and 6.8% were verbally abused. Reasons for non-disclosure were fear of abandonment (33.3%), being beaten (33.3%) and loss of financial and emotional support (13.3%). The factors associated with disclosure were age 26-35 years (OR 3.9, 95% CI 1.03-15.16), primary education (OR 3.53, 95%CI 1.10-11.307) and urban dwelling (OR 4.22, 95% CI 1.27-14.01).

Conclusion

Participants disclosed mainly to their partners and were comforted and many of them were encouraged by the health workers. There is need to optimize disclosure merits to enable increased participation in treatment and support programs.

Factors associated with HIV status disclosure to partners and its outcomes among HIV-positive women attending Care and Treatment Clinics at Kilimanjaro region, Tanzania

BACKGROUND

Sub Saharan Africa continues to be the epicenter of HIV with 70% of people living with HIV globally. Women form nearly 60% of those living with HIV. Studies have shown disclosure of one's HIV status is important in HIV prevention, in increasing partners who are tested and getting into care early as well as in improving retention in PMTCT and ART programs. This study aimed to determine the prevalence, factors and outcomes of HIV status disclosure to partners among HIV-positive women attending HIV care-and-treatment clinics (CTCs) at Kilimanjaro region, northern Tanzania.

METHODS

A cross-sectional study was conducted from January to June 2014 in 3 out of the 7 districts of Kilimanjaro region. The study population was HIV-positive women aged 15-49, who were attending for routine HIV care at 19 selected clinics. Face-to-face interviews were conducted with consenting women to collect necessary information. Multivariate logistic regression analyses were used to determine the independent predictors of HIV status disclosure to partner.

RESULTS

A total of 672 HIV-positive women in Moshi municipal, Hai and Mwanga districts were enrolled. Of them, 609 HIV-positive women reported to have a regular partner. Prevalence of serostatus disclosure to partners was 66%. Of the 400 who had disclosed; 56% did so within the first month of knowing their HIV status. In a multiple logistic regression model, HIV serostatus disclosure was higher among women who: were married/cohabiting (AOR = 4.16, 95% CI: 2.39-7.25; p<0.001), currently on ART (AOR = 2.06, 95% CI: 1.11-3.82; p = 0.020), and who reported had ever communicated with partners on number of children (AOR = 1.85, 95% CI: 1.15-2.98; p = 0.010) and contraceptives use (AOR = 2.01, 95% CI: 1.27-3.20; p = 0.208). Most of the women (81%) who disclosed their HIV status to did not reported negative outcomes.

CONCLUSION

In this setting still a third of the HIV-positive women (34%) fail to disclose their HIV- serostatus to partners. Interventions to impart skills in communication and negotiation between partners may help in improving disclosure of HIV. Efforts to involve men in general sexual and reproductive health including couple counseling and testing will contribute in improving disclosure and communication on HIV among partners.

The Effect of Partner Serostatus and Relationship Duration on HIV Medication Adherence

High adherence rates to antiretroviral medications are necessary for people living with HIV/AIDS. The current study focuses on relationship-level predictors of HIV medication adherence by testing whether adherence rates differ by dyadic serostatus (seroconcordant vs. serodiscordant couples) among individuals with HIV in romantic relationships. Results showed a significant interaction between dyadic serostatus and relationship duration on adherence, such that individuals in long-term serodiscordant relationships reported better adherence than short-term serodiscordant relationships or seroconcordant partners in long-term relationships. Future research is needed to understand what relationship dynamics explain differences in adherence rates based on dyadic serostatus.

Patterns and Predictors of HIV-Status Disclosure Among Pregnant Women in South Africa: Dimensions of Disclosure and Influence of Social and Economic Circumstances

HIV-status disclosure may improve psychosocial health and adherence to antiretroviral therapy (ART), but existing insights suffer from methodological limitations. We explored disclosure over time during pregnancy and postpartum among 1347 HIV-positive women in Cape Town. Among 995 women diagnosed HIV-positive before the pregnancy and entering antenatal care (median age 30 years), 95% had disclosed to ≥ 1 individual. In Mokken scale analysis, we observed two separate dimensions of disclosure: disclosure to a male partner, and disclosure to family/community members. Among 352 women diagnosed during the pregnancy and initiating ART (median age 27 years), 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis. Relationship status modified the impact of pregnancy intentions and poverty on disclosure to a male partner. These unique data provide important insights into dimensions of disclosure during pregnancy and postpartum, and suggest that women's social and economic circumstances are central determinants of disclosure.

HIV positive sero-status disclosure and its determinants among people living with HIV /AIDS following ART clinic in Jimma University Specialized Hospital, Southwest Ethiopia: a facility- based cross-sectional study

Background

Even though, the disclosure of HIV sero- status to sexual partners, friends or relatives is the main tool for prevention and care strategies, most of the HIV/AIDS patients do not inform their close friends. The most common reasons for not disclosure of their status to the community were majorly fear of social rejection and discriminations. Therefore, this study assessed the HIV positive sero-status disclosure and its determinants among People Living with HIV /AIDS (PLWH/A) followed by the Antiretroviral therapy (ART) Clinic in Jimma University Specialized Hospital, Southwest Ethiopia.

Methods

A facility based cross-sectional study design was used among 351 ART patients that selected by systematic random sampling from ART clinic of Jimma University Specialized Hospital in March-2014. Data were collected through interviewer-administered questionnaires and analyzed using SPSS version 20.0 software. In a descriptive analysis frequency, mean and percentage were calculated. Bivariate and multivariate analyses were used to identify associated factors and the association between the explanatory and dependent variables was estimated.

Results

Only 37.6% (n = 132) were revealed their HIV positive status to anyone. Disclosure was done towards the sexual partners (88.6%), close family (72.7%) and a larger population (18.2%). Age ≤ 39 years (AOR = 0.014 [95%, CI = 0.005, 0.037]),Male sex (AOR = 3.039, [95% CI = 1.164, 7.935]), WHO stage III – IV at ART start(AOR = 2.766, [95%, CI = 1.321, 5.791]), presence of comorbidity (AOR = 2.500, [95%, CI = 1.483, 4.214]), having any clinical symptoms for HIV(AOR = 2.98, [95%, CI = 1.724, 5.152]),Low physical domain related quality of life (AOR = 3.83, [95%, CI = 2.008, 7.315]) and high social domain related quality of life (AOR = 0.053, [95%, CI = 0.022, 0.125]) were statistically significant association with their HIV sero-status disclosure.

Conclusions

Findings of this study indicated, the disclosure of HIV status is very low. Discloser is more likely when the patient is older, male, and has a higher level of education. Clinical determinants for disclosure was the WHO stage III-IV, treatment duration of ≥2 years, comorbidity, presence of clinical symptoms for HIV, low physical domain related quality of life, low social domain related quality of life and low overall quality of life.

Use of alcohol and drugs in the view of people living with HIV/AIDS: a qualitative study

OBJECTIVE

To investigate the meaning of the experiences of patients infected by HIV using antiretroviral therapy, regarding the use of alcohol and drugs.

STUDY DESIGN

A qualitative phenomenological study.

METHOD

A total of 25 patients receiving antiretroviral treatment participated in the investigation, of which 14 were male and 11 were females, who expressed their feelings and perceptions through participation in focus groups and the interpretation of costumes. The empirical material was transcribed in full and later organized and analyzed using the phenomenological method.

RESULTS

Based on this amusing experience we realized that participants were unaware of the effects of the use of alcohol and drugs in the AIDS progression. Since they have kept with their smoking and alcoholism habits to be accepted in a social group and consequently prevent prejudice. We believe that our health education strategy was adequate to improve antiretroviral therapy, since it helped in subject comprehension and patients self-care body expression.

CONCLUSION

This phenomenological study made it possible to understand the experience of patients living with HIV regarding the use of alcohol and drugs, and contributes to the planning and implementation of intervention programs based on a participative model of care, with a view to prioritizing the holistic aspects involved in the treatment of people living with HIV/AIDS.

Mutual HIV status disclosure is associated with consistent condom use in public sector ART clients in Free State province, South Africa: a short report

Risky sexual behaviour in PLWHA on antiretroviral therapy threatens both prevention and treatment efforts, but disclosure promises to support safer sexual practices. This paper investigates the association between HIV self-disclosure and consistent condom use in a cohort of public sector patients on antiretroviral (ARV) treatment. Using data from the FEATS cohort study, logistic regression analysis shows that knowledge of your partner's HIV status is positively associated with consistent condom use (OR 2.73, 95% CI 1.37-5.43, p = 0.004) and so too mutual HIV disclosure (OR 3.38, 95% CI 1.60-7.18, p = 0.001). Prevention and treatment programmes, through couple HIV counselling and testing (CHCT) and other assistance programmes, should focus on supporting the mutual disclosure of HIV status among PLWHA on ARV treatment.

Disclosure History Among Persons Initiating Antiretroviral Treatment at Six HIV Clinics in Oromia, Ethiopia, 2012-2013

HIV status disclosure can help patients obtain support which may influence treatment adherence and subsequent healthcare needs. We examined the extent of disclosure and correlates of non-disclosure among 1180 adults newly initiating antiretroviral treatment (ART). While 91 % of those in a relationship shared their status with their partners, 14 % of the overall sample had not disclosed to anyone. Non-disclosure was positively associated with older age; control over household resources; and concerns about unintended disclosure, life disruptions, and family reactions. Knowing other HIV-positive people and longer time since diagnosis were associated with lower odds of non-disclosure. Most respondents reporting disclosure experienced supportive responses, frequently including decision to get an HIV test by confidants who had not known their own status. Although HIV status disclosure prior to ART initiation was high, some individuals cited concerns about unintended disclosure, gossip, and partner violence, and may benefit from additional disclosure support.

The legacy of gender-based violence and HIV/AIDS in the postgenocide era: Stories from women in Rwanda

Drawing on qualitative interviews with 22 Rwandan women, we describe the lived experiences of women survivors of gender-based violence (GBV) more than a decade and a half after the 1994 Genocide. We argue that the intersection between GBV and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) has long-term implications: the majority of women interviewed continue to endure trauma, stigma, social isolation, and economic hardship in the postgenocide era and are in need of expanded economic and mental health support. Our findings have implications for the importance of providing integrated psychosocial support to survivors of GBV postconflict contexts.