AIDS and Behavior

, Volume 11, Issue 5, pp 687–697 | Cite as

Motivations and Methods for Self-disclosure of HIV Seropositivity in Nairobi, Kenya

Original Paper


This study employed structured interviews with 307 people living with HIV (PLHIVs) in Nairobi, Kenya to investigate their serostatus disclosure with respect to four types of relationships in their lives: partners, friends, family members, and religious leaders/clergy. Regarding motivations for disclosure, it was found that a sense of duty and seeking material support motivated disclosure to family and partners, fear of loss of confidentiality inhibited disclosure to friends, and the need for advice encouraged disclosure to religious leaders. The method of disclosure most frequently mentioned was direct, with males less likely than females to use direct methods when disclosing to spouses or partners. Intermediated disclosure was common in partner/spouse relationships with around one-third of partners preferring to disclose through a third party. Methods used to disclose as well as reasons for doing so varied by relationship type.


Self-disclosure HIV AIDS Africa Kenya 



Partial funding for this research was provided by the University of Georgia Biomedical and Health Sciences Institute.


  1. Addai, I. (1999). Does religion matter in contraceptive use among Ghanaian women? Review of Religious Research, 40, 259–277.CrossRefGoogle Scholar
  2. Agadjanian, V. (2005). Gender, religious involvement, and HIV/AIDS prevention in Mozambique. Social Science & Medicine, 61, 1529–1539.CrossRefGoogle Scholar
  3. Alwano, M. G., Roels, T. H., Mwasalla, V., Ramosweu, M., Molosiwa, R., Mokomane, M. et al. (2004). High rates of discordance among couples at the Tebelopele voluntary counseling and testing centers (VCTC) – Botswana 2003. XV International AIDS Conference. Bangkok, 11 July [abstract no. MoPeC3467].Google Scholar
  4. Antelman, G., Fawzi, M. C. S., Kaaya, S., Mbwambo, J., Msamanga, G. I., Hunter, D. J., & Fawzi, W. W. (2001). Predictors of HIV-1 serostatus disclosure: A prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania. AIDS, 15, 1864–1875.CrossRefGoogle Scholar
  5. Banteyerga, H., Kidanu, A., Nyblade, L., MacQuarrie, K., & Pande, R. (2004). Yichalaliko!! Exploring HIV and AIDS stigma and related discrimination in Ethiopia: Causes, manifestations, consequences and coping mechanisms. Addis Ababa, Ethiopia: Miz-Hasab Research Center.Google Scholar
  6. Bungener, C., Marchand-Gonod, N., & Jouvent, R. (2000). African and European HIV-positive women psychological and psychosocial differences. AIDS Care, 12, 541–548.PubMedCrossRefGoogle Scholar
  7. Chatterjee, K., & Murray-Johnson, L. (2005). I’ve got a secret: Self-disclosure practices of individuals who have been tested for HIV/AIDS in Namibia, Africa. Indianapolis: Paper presented at the International Association for Relationship Research.Google Scholar
  8. Chesney, M. A., & Smith, A. W. (1999). Critical delays in HIV testing and care: The potential role of stigma. American Behavioral Scientist, 42, 1158–1170.CrossRefGoogle Scholar
  9. Cohen, J. (1965). Some statistical issues in psychological research. In B. B. Wolman (Ed.), Handbook of clinical psychology (pp. 95–121). New York: McGraw-Hill.Google Scholar
  10. Daniel, O. J., Falola, R. L., Ogundahunsi, O. A., Ogun, S. A., Odusoga, O. L., Salako, A. A., Oladapo, O. T., Ogunfowora, O. B., Osho, O. B., Adenekan, A. A., Oluwole, F. A., Kolapo, K. O., & Boyle, B. A. (2004). Self-disclosure of HIV status among PLHIV on HAART in Sagamu, Nigeria. XV International AIDS Conference, Bangkok, 11 July [abstract ThPD7777].Google Scholar
  11. Derlega, V. J., Lovejoy, D., & Winstead, B. A. (1998). Personal account of disclosing and concealing HIV-positive test results: Weighting the benefits and risks. In V. J. Derlega & A. P. Barbee (Eds.), HIV & social interaction (pp. 147–164). Thousand Oaks, CA: Sage.Google Scholar
  12. Derlega, V. J., Winstead, B. A., & Folk-Barron, L. (2000). Reasons for and against disclosing HIV-seropositive test results to an intimate partner: A functional perspective. In S. Petronio (Ed.), Balancing the secrets of private disclosures (pp. 53–69). Mahwah, New Jersey: Lawrence Erlbaum.Google Scholar
  13. Derlega, V. J., Winstead, B. A., Oldfield, E. C., & Barbee, A. P. (2003). Close relationships and social support in coping with HIV: A test of sensitive interaction systems theory. AIDS and Behavior, 7, 119–129.PubMedCrossRefGoogle Scholar
  14. Ferrett, G. (2005). Africans trust religious leaders. Retrieved on Septebmer 15, 2005 from Scholar
  15. Garner, R. C. (2000). Safe sects? Dynamic religion and AIDS in South Africa. The Journal of Modern African Studies, 38, 41–69.CrossRefGoogle Scholar
  16. Ghosh, S., Kumbirai, C., Taruberekera, N., & Osewe, P. (2003). Strategies to increase the couples seeking VCT services in Zimbabwe. 13th International conference on AIDS and sexually transmitted infections in Africa (ICASA). 22–25 September, Nairobi [abstract no. 202757].Google Scholar
  17. Greene, K., Derlega, V. J., Yep, G. A., & Petronio, S. (2003). Privacy and disclosure of HIV in interpersonal relationships: A sourcebook for researchers and practitioners. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  18. Grinstead, L. A., Van der Straten, A., & the Voluntary HIV-1 Counseling and Testing Efficacy Study Group (2000). Counsellors’ perspectives on the experience of providing HIV counseling in Kenya and Tanzania: The voluntary HIV-1 counselling and testing efficacy study. AIDS Care, 12, 625–642.Google Scholar
  19. Huberty, C. J., & Lowman, L. L. (1998). Discriminant analysis in higher education research. In J. C. Smart (Ed.), Higher education: Handbook of theory and research (Vol. XIII, pp. 181–233). New York: Agathon.Google Scholar
  20. Issiaka, S., Cartoux, M., Ky-Zerbo, O., Tiendrebeogo, S., Meda, N., Dabis, F., & Van de Perre, P. (2001). Living with HIV: Women’s experience in Burkina Faso, West Africa. AIDS Care, 13, 123–128.PubMedCrossRefGoogle Scholar
  21. Kesby, M. (2004). Participatory diagramming and the ethical and practical challenges of helping Africans themselves to move HIV work “Beyond epidemiology”. In E. Kalipeni, S. Craddock, J. R. Oppong, & J. Ghosh (Eds.), HIV and AIDS in Africa: Beyond epidemiology (pp. 217–228). Malden, MA: Blackwell.Google Scholar
  22. Kimani, D. (2005). Pandemic in ‘death phase’: Health plan to guide country’s response to the Aids scourge. Sunday Nation, p. 40.Google Scholar
  23. Lie, G. T., & Biswalo, P. M. (1996). HIV-positive patient’s [sic] choice of a significant other to be informed about the HIV-test result: Findings from an HIV/AIDS counseling programme in the regional hospitals of Arusha and Kilmanjaro, Tanzania. AIDS Care, 8, 285–296.PubMedCrossRefGoogle Scholar
  24. Lindlof, T. R., & Taylor, B. C. (2002). Qualitative communication research methods (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  25. MacNeil, J. M., Mberesero, F., & Kilonzo, G. (1999). Is care and support associated with preventive behaviour among people with HIV? AIDS Care, 11, 537–546.PubMedCrossRefGoogle Scholar
  26. Maman, S., Mbwambo, J., Hogan, N. M., Kilonzo, G. P., & Sweat, M. (2001). Women’s barriers to HIV-1 testing and disclosure: Challenges for HIV-1 voluntary counseling and testing. AIDS Care, 13, 595–603.PubMedCrossRefGoogle Scholar
  27. Maman, W., Mbwambo, J., Hogan, N. M., Weiss, E., Kilonzo, G. P., & Sweat, M. D. (2003). High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: Reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS and Behavior, 7, 373–381.PubMedCrossRefGoogle Scholar
  28. Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparisons perspective (2d ed.). Belmont, CA: Wadsworth.Google Scholar
  29. McFarland, W., Lindan, C. P., Mandel, J., & Rutherford, G. (2002). HIV prevention in the developing world: Training researchers for the long haul. AIDS and Behavior, 6, 207–209.CrossRefGoogle Scholar
  30. Miller, A. N., & Rubin, D. L. (2005). Disclosing a positive HIV diagnosis in Kenya: Targets, methods, and motivations. Indianapolis, IN: IARR conference on Exploring Health Relationships and Relationship Health.Google Scholar
  31. Ndase, P., Thior, I., Wester, C., Stevens, L., Peter, T., Lockman, S., et al. (2004). The evolving challenge of couples voluntary counseling and testing (VCT) and HIV sero-discordance in prevention of mother to child transmission (PMTCT) of HIV program design. XV International AIDS Conference. Bankok, 11 July [abstract no. ThPeE7944].Google Scholar
  32. Painter, T. M. (2001). Voluntary counseling and testing for couples: A high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Social Science & Medicine, 53, 1397–1411.CrossRefGoogle Scholar
  33. Pool, R., Nyanzi, S., & Whitworth, J. A. G. (2001). Attitudes to voluntary counseling and testing for HIV among pregnant women in rural south-west Uganda. AIDS Care, 13, 605–615.PubMedCrossRefGoogle Scholar
  34. Porter, L., Hao, L. X., Bishai, D., Serwadda, D., Wawer, M. J., Lutalo, T., Gray, R., & The Rakai Project Team (2004). HIV status and union dissolution in sub-Saharan Africa: The case of Rakai, Uganda. Demography, 41, 465–482.Google Scholar
  35. Siwale, M., Kankasa, C., Geibel, N. R., & Kalibala, S. (2003). Impact of VCT for PMTCT on effect on relationships with partners in Lusaka, Zambia. 13th International conference on AIDS and sexually transmitted infections in Africa (ICASA). 22–25 September, Nairobi [abstract no. 156131].Google Scholar
  36. Songkok, E., & Andayi, F. (2003). Effect of socio-cultural factors on HIV transmission flowing post HIV-test counseling of a cohort of pre- and post-natal clients in western Kenya. 13th International conference on AIDS and sexually transmitted infections in Africa (ICASA). 22–25 September, Nairobi [abstract no. 184583].Google Scholar
  37. Susser, I., & Stein, Z. (2004). Culture, sexuality, and women’s agency in he prevention of HIV/AIDS in southern Africa. In E. Kalipeni, S. Craddock, J. R. Oppong, & J. Ghosh (Eds.), HIV and AIDS in Africa: Beyond epidemiology (pp. 133–143). Malden, MA: Blackwell.Google Scholar
  38. Takyi, B. K. (2003). Religion and women’s health in Ghana: Insights into HIV/AIDS preventive and protective behavior. Social Science & Medicine, 56, 1221–1234.CrossRefGoogle Scholar
  39. Temmerman, M., & Ndinya-Achola, J. (1995). The right not to know HIV-test results. The Lancet, 345, 969–970.CrossRefGoogle Scholar
  40. UNAIDS. (1999). Acting early to prevent AIDS: The case of Senegal. Geneva: Author.Google Scholar
  41. UNAIDS. (2004). Report on the global AIDS epidemic: Fourth global report. Geneva: Author.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Daystar UniversityNairobiKenya
  2. 2.University of GeorgiaAthensUSA
  3. 3.BirminghamUSA

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