Factors affecting HIV disclosure among partners in Morongo, Tanzania

Hallberg, David; Kimario, T; Mtuya, Christina C.; Msuya, Marycelina; Björling, Gunilla

doi:10.1016/j.ijans.2019.01.006

Cited by 31 publications

(25 citation statements)

References 32 publications

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“…Disclosure had been delayed despite significant proportion (58%) of YPLHIV remaining in the relationship with the sexual partner after testing positive. Similar rates of delayed disclosure to sexual partners were found in other studies [ 21 , 22 , 23 , 24 ]. Lower disclosure rates imply that HIV transmission will continue to persist among sexual partners in these and similar settings [ 25 ].…”

Section: Discussionsupporting

confidence: 87%

Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

2020

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The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.

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Section: Discussionsupporting

confidence: 87%

Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

2020

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“…One study reported a disclosure rate of only 17% in developing countries, compared to a rate of 86% in developed countries [6]. Another study reported that rates of disclosure among partners in sub-Saharan Africa also vary greatly [25]. For example, one study in Ethiopia found that HIV status disclosure to sexual partners was 57.4% [26] and another estimated it at 82.5% [27].…”

Section: Introductionmentioning

confidence: 99%

“…Many factors positively and negatively associated with HIV status disclosure have been identified including stigma and discrimination [15][16][17], knowledge of partner's HIV status and membership in HIV and AIDS control associations [6], economic status [35,36], literacy [37], gender [24], age [38][39][40], marital status [5,[38][39][40], being on ART, contraceptive use [5], and many others [25,26,33,[41][42][43].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, disclosure estimates among partners in the general population in Tanzania are also variable, e.g. 93.3% in Mwanza [ 33 ], 66% in Kilimanjaro [ 5 ], 56.3% in Kisarawe [ 34 ], and 28% in Morogoro [ 25 ]. These variations in disclosure rates suggest variations in contexts and a need for further research and context-specific interventions.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of undisclosed HIV status to a community-based HIV program: findings from caregivers of orphans and vulnerable children in Tanzania

Charles¹,

Exavery²,

Barankena³

et al. 2020

AIDS Res Ther

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Background: HIV status disclosure facilitates receipt of HIV prevention and treatment services. Although disclosure to sexual partners, family members or friends has been extensively studied, disclosure to community-based HIV programs is missing. This study assesses the magnitude of, and factors associated with undisclosed HIV status to a community-based HIV prevention program among caregivers of orphans and vulnerable children (OVC) in Tanzania. Methods: Data are from the USAID-funded Kizazi Kipya project that seeks to increase uptake of HIV, health, and social services by OVC and their caregivers in Tanzania. Data on OVC caregivers who were enrolled in the project during January-March 2017 in 18 regions of Tanzania were analyzed. Caregivers included were those who had complete information on their HIV status disclosure, household socioeconomic status, and sociodemographic characteristics. HIV status was self-reported, with undisclosed status representing all those who knew their HIV status but did not disclose it. Multilevel mixed-effects logistic regression, with caregivers' HIV status disclosure being the outcome variable was conducted. Results: The analysis was based on 59,683 OVC caregivers (mean age = 50.4 years), 71.2% of whom were female. Of these, 37.2% did not disclose their HIV status to the USAID Kizazi Kipya program at the time of enrollment. Multivariate analysis showed that the likelihood of HIV status non-disclosure was significantly higher among: male caregivers (odds ratio (OR) = 1.22, 95% confidence interval (CI) 1.16-1.28); unmarried (OR = 1.12, 95% CI 1.03-1.23); widowed (OR = 1.12, 95% CI 1.07-1.18); those without health insurance (OR = 1.36, 95% CI 1.28-1.45); age 61 + years (OR = 1.72, 95% CI 1.59-1.88); those with physical or mental disability (OR = 1.14, 95% CI 1.04-1.25); and rural residents (OR = 1.58, 95% CI 1.34-1.86). HIV status non-disclosure was less likely with higher education (p < 0.001); and with better economic status (p < 0.001). Conclusion: While improved education, economic strengthening support and expanding health insurance coverage appear to improve HIV status disclosure, greater attention may be required for men, unmarried, widowed, rural residents, and the elderly populations for their higher likelihood to conceal HIV status. This is a clear missed opportunity for timely care and treatment services for those that may be HIV positive. Further support is needed to support disclosure in this population.

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“…A infecção pelo vírus atinge grandes proporções nas diferentes regiões do Brasil. Apesar de ser uma infecção incurável, recentemente passou a apresentar características singulares, como o aumento da expectativa de vida e a melhoria da qualidade de vida, o que possibilitou, a formação de parcerias sexuais entre pessoas com HIV, sejam elas sorodiscordantes, com apenas um parceiro infectado pelo HIV, ou soroconcordantes, caso em que ambos são infectados pelo vírus (4) .…”

Section: Introductionunclassified

The care provided to the sexual partners of people living with the human immunodeficiency virus

et al. 2020

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Objective: to analyze the care provided to sexual partners of people living with the human immunodeficiency virus. Methods: cross-sectional study with 173 participants, carried out in a service specialized in the treatment of people with the human immunodeficiency virus, submitted to a statistical analysis (chi-square test and Fisher’s exact test). Results: having the partner invited to attend the health service (p<0.001), receiving guidance on prevention in the health service (p<0.001), and being seen at the specialized service as a couple for counseling on sexual practices and preventive strategies (p<0.001) showed statistical differences. Conclusion: there are gaps in the care provided to sexual partners on strategies for preventing infection by the human immunodeficiency virus.

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Factors affecting HIV disclosure among partners in Morongo, Tanzania

Cited by 31 publications

References 32 publications

Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Low Disclosure Rates to Sexual Partners and Unsafe Sexual Practices of Youth Recently Diagnosed with HIV; Implications for HIV Prevention Interventions in South Africa

Determinants of undisclosed HIV status to a community-based HIV program: findings from caregivers of orphans and vulnerable children in Tanzania

The care provided to the sexual partners of people living with the human immunodeficiency virus

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