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

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Abstract

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.

Resumen

La revelación del estado serológico del VIH puede ayudar a los pacientes a obtener apoyo que podría influir en la adherencia al tratamiento y en las necesidades de cuidado para su salud. Examinamos la frecuencia y factores asociados con la no revelación del estado serológico del VIH en 1180 adultos iniciando tratamiento antirretroviral (TARV) por primera vez. Mientras 91 % de los que estaban en una relación compartió su estado serológico con su pareja, 14 % de la muestra total no reveló su estado a nadie. La no revelación del estado serológico estuvo asociada positivamente con mayor edad, control sobre los recursos familiares, y preocupaciones sobre revelaciones no intencionales, interrupciones en la vida cotidiana y las reacciones familiares. Conocer otras personas VIH-positivas y mayor tiempo desde el diagnóstico estuvieron asociados con menor posibilidades de no revelación. La mayoría de los encuestados que revelaron su estado recibieron respuestas de apoyo, incluyendo una aceptación considerable del test de VIH en confidentes que no conocían su estado serológico. Aunque la revelación del VIH antes de iniciar TARV fue alta, ciertos individuos mencionaron preocupaciones sobre revelaciones no intencionales, chismes y violencia por parte de su pareja, y podrían beneficiarse de apoyo adicional para revelar su estado serológico.

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Acknowledgments

This study was funded by a grant from the National Institutes of Health R01 (5R01MH89831) entitled “Multi-level determinants of late ART initiation in sub-Saharan Africa” (LSTART) and the President’s Emergency Plan for AIDS Relief (PEPFAR).

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Authors and Affiliations

  1. ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA

    Tsigereda Gadisa, Maria Lahuerta, Muluneh Yigzaw & Zenebe Melaku

  2. Department of Epidemiology and Biostatistics, School of Urban Public Health, Hunter College, City University of New York, New York, NY, USA

    Olga Tymejczyk, Sarah Gorrell Kulkarni & Denis Nash

  3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Susie Hoffman, Maria Lahuerta, Batya Elul & Denis Nash

  4. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA

    Susie Hoffman, Robert H. Remien & Denis Nash

  5. Oromia State Regional Bureau of Health, Addis Ababa, Ethiopia

    Shalo Daba

Authors
  1. Tsigereda Gadisa
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  2. Olga Tymejczyk
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  3. Sarah Gorrell Kulkarni
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  4. Susie Hoffman
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  5. Maria Lahuerta
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  6. Robert H. Remien
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  7. Muluneh Yigzaw
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  8. Shalo Daba
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  10. Denis Nash
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  11. Zenebe Melaku
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Correspondence to Olga Tymejczyk.

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Gadisa, T., Tymejczyk, O., Kulkarni, S.G. et al. Disclosure History Among Persons Initiating Antiretroviral Treatment at Six HIV Clinics in Oromia, Ethiopia, 2012–2013. AIDS Behav 21, 70–81 (2017). https://doi.org/10.1007/s10461-016-1290-4

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