HIV status disclosure to sexual partners and reaction to disclosure among clients on antiretroviral treatment at charlotte Maxeke Johannesburg Academic Hospital

Abstract

Background and introduction Disclosure of HIV sero-status is critical in the control of the spread of HIV and research. To better understand the factors influencing disclosure will enhance the development of prevention interventions and ultimately lead to better control of the spread of the disease. However literature shows that the rates of disclosure are generally low and vary substantially in different populations. Study purpose To determine the prevalence, reasons for disclosure, partner reaction to disclosure, and intentions of disclosure to sexual partners among HIV positive adults receiving antiretroviral treatment. Study design Cross sectional survey was conducted with 400 adult patients aged 18 years and above, who receive ART, and have known their HIV status for six more than six months. Structured close ended self-administered questionnaire was used to collect data. The study participants were recruited from a wellness clinic of an academic hospital in the City of Johannesburg, Gauteng province between October and November 2012. Descriptive and inferential statistics were performed using STATA 10 for analysis. Pearson X2 tests were used to determine variables associated with disclosure. Results A total of 400 HIV positive adults participated in the survey. There were slightly more female (n=229, 57%) than male (n=171, 43%), the mean age of participants was 39.9 years, (range 18-80 years). Almost half (n=176, 46%) had known of their HIV diagnosis for more than 5 years. High proportion (n=293, 73%) were sexually active three months prior to the survey, (n=250, 63%) knew their partner’s HIV status, more than a third (n=145, 36.3%) had more than one sexual partner, (n=263, 73.5%) reported condom use, (n=261, 75%) disclosed to their partners. Gender, discussing HIV testing with sexual partner, knowing partner’s HIV status, and living with partner were significantly associated with disclosure. iv The most common cited reasons for disclosure were that they needed to protect their partner from being infected with HIV, and needed support from their partner. Partner reactions to disclosure included support, shock, and denial of the test results, blame, abandonment, violence, anger, and divorce. The most cited reasons for nondisclosure were concerns that the partner might leave, partner might be afraid of catching HIV, partner might think they were unfaithful, partner might get angry, partner might hurt them physically and that partner might stop financial support. Conclusion The study concludes that the prevalence of disclosure to sexual partners among sexually active adults was high and that most respondents disclosed immediately after they were diagnosed with HIV. However, disclosure to multiple sexual partners was lower as compared to disclosure to the steady partner. Respondents disclosed to protect the partner from HIV infection and to receive support. Nondisclosure was mainly used to protect self from negative reactions from the partner. Recommendations Researchers and health care providers needs to take cognisant of the risk sexual behaviour an low condom use among HIV positive adults receiving ART. Secondary prevention efforts targeting risky sexual behaviour among HIV-positive persons need to receive greater attention.