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HIV status disclosure to sexual partners and reaction to disclosure among clients on antiretroviral treatment at charlotte Maxeke Johannesburg Academic HospitalLetsoalo, B.M January 2013 (has links)
Thesis ( MPH ) -- University of Limpopo (Medunsa Campus), 2013. / 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.
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