Skip to main content
SpringerLink
Log in

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

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Addai, I. (1999). Does religion matter in contraceptive use among Ghanaian women? Review of Religious Research, 40, 259–277.

    Article  Google Scholar 

  • Agadjanian, V. (2005). Gender, religious involvement, and HIV/AIDS prevention in Mozambique. Social Science & Medicine, 61, 1529–1539.

    Article  Google Scholar 

  • 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].

  • 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.

    Article  Google Scholar 

  • 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 

  • Bungener, C., Marchand-Gonod, N., & Jouvent, R. (2000). African and European HIV-positive women psychological and psychosocial differences. AIDS Care, 12, 541–548.

    Article  PubMed  CAS  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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 

  • 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].

  • 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 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • Ferrett, G. (2005). Africans trust religious leaders. Retrieved on Septebmer 15, 2005 from http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/2/hi/africa/4246754.

  • Garner, R. C. (2000). Safe sects? Dynamic religion and AIDS in South Africa. The Journal of Modern African Studies, 38, 41–69.

    Article  Google Scholar 

  • 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].

  • 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 

  • 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 

  • 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 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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 

  • Kimani, D. (2005). Pandemic in ‘death phase’: Health plan to guide country’s response to the Aids scourge. Sunday Nation, p. 40.

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • Lindlof, T. R., & Taylor, B. C. (2002). Qualitative communication research methods (2nd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparisons perspective (2d ed.). Belmont, CA: Wadsworth.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • 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].

  • 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.

    Article  CAS  Google Scholar 

  • 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.

    Article  PubMed  CAS  Google Scholar 

  • 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.

  • 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].

  • 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].

  • 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 

  • 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.

    Article  Google Scholar 

  • Temmerman, M., & Ndinya-Achola, J. (1995). The right not to know HIV-test results. The Lancet, 345, 969–970.

    Article  CAS  Google Scholar 

  • UNAIDS. (1999). Acting early to prevent AIDS: The case of Senegal. Geneva: Author.

    Google Scholar 

  • UNAIDS. (2004). Report on the global AIDS epidemic: Fourth global report. Geneva: Author.

Download references

Acknowledgments

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

Author information

Authors and Affiliations

  1. Daystar University, P.O. Box 44400, Nairobi, 00100, Kenya

    Ann Neville Miller

  2. University of Georgia, Athens, GA, USA

    Donald L. Rubin

  3. c/o 2682 Altadena Road, Birmingham, AL, 35243, USA

    Ann Neville Miller

Authors
  1. Ann Neville Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Donald L. Rubin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ann Neville Miller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miller, A.N., Rubin, D.L. Motivations and Methods for Self-disclosure of HIV Seropositivity in Nairobi, Kenya. AIDS Behav 11, 687–697 (2007). https://doi.org/10.1007/s10461-006-9198-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-006-9198-z

Keywords

Search

Navigation