| dc.description.abstract | Background: HIV is still an epidemic infection globally with 38 million infected with it. HIV positive status disclosure is an important factor in HIV/AIDS prevention interventions and plays a role in ART adherence. However, many people living with HIV don’t disclose their status due to fear of the negative outcomes.
Objectives: To determine the prevalence and associated factors of HIV positive status disclosure to family members and the lived experiences women attending Kalisizo general hospital ART clinic.
Methods: Explanatory concurrent mixed methods which entailed both quantitative (cross-sectional study) and qualitative designs were used among HIV positive women attending Kalisizo general hospital ART clinic. A total of 684 women were consecutively sampled to participate in the cross-sectional survey where a structured questionnaire was administered by interviewers to collect quantitative data. Quantitative data was entered into EPI-data version 4.4.1.0 exported to STATA 15 for analysis using modified poison with 95% statistical significance to assess factors associated with HIV positive status disclosure to family members A total of 15 different HIV positive women were purposively enrolled in the in-depth interviews to explore lived experiences of disclosure to family members. In-depth interviews were audio-recorded, transcribed and analyzed using thematic analysis to identify lived experiences of HIV positive status disclosure.
Results: For the quantitative data, there were 684 women with mean (SD) age of 39.2 (±11.2). Overall, 83% (95% CI: 80-86) had disclosed their HIV status to at least one family member. Perceived social support from family members (PR=1.07, 95% CI: 1.03-1.11); HIV stigma (disclosure concern) (PR=0.88, 95% CI: 0.85-0.92); being unaware of sexual partner’s HIV status (PR=0.47, 95% CI: 0.35-0.65); poor ART adherence (PR=0.45, 95% CI:0.25-0.79); and WHO HIV stage I at diagnosis (PR=0.92, 95% CI:0.86-0.98) were significantly associated with HIV positive status disclosure to at least one family member.
For qualitative data, there were 15 women with mean age of 32.8 (SD=±7.7). Women reported both positive (such as; being reminded to take their ARVs, helped to pick their ARVs, encouraged to adhere to ART and financial support) and negative outcomes (like; abandonment, accusation of infidelity, physical abuse, stigmatization, marriage dissolution and financial withdrawal) after disclosing their status to their family members. Some women reported no reaction from the people they disclosed to. Women who did not disclose their status had strategies of avoiding disclosure such as hiding their ARVs.
Conclusion: The prevalence of HIV positive status disclosure to family members was high but below the 100% recommended by WHO and this increases the likelihood of HIV transmission especially among sexually active individuals as they may not take up safe sexual practices such as condom use. Couple HIV testing and counselling should be encouraged by health workers so that sexual partners know each other’s HIV status. Continuous posttest counselling should be provided by health workers to women still struggling with disclosure. | en_US |
