Factors Associated With Hiv Voluntary Disclosure to One's Steady Sexual Partner in Mali: Results From a Community-Based Study

Abstract

Despite the widespread dissemination of HIV information through public awareness campaigns in Mali, disclosing seropositivity to one's steady sexual partner (SSP) remains difficult for people living with HIV (PLHIV). Disclosure is a public health concern with serious implications and is also strongly linked to the quality of life of PLHIV. This study aimed to analyse factors associated with voluntary HIV disclosure to one's SSP, using a community-based cross-sectional study on 300 adult PLHIV in contact with a Malian community-based organization working in the field of AIDS response. A 125-item questionnaire was administered by trained personnel to study participants between May and October 2011. Analysis was restricted to the 219 participants who both reported having a SSP and answered to the question on disclosure to their SSP. A weighted multivariate logistic regression was used to determine variables independently associated with disclosure. In total, 161 participants (73%) reported HIV disclosure to their SSP. Having children (odds ratio [95% confidence interval]: 4.52 [1.84-11.12]), being accompanied to the survey site (3.66 [1.00-13.33]), knowing others who had publicly declared their seropositivity (3.12 [1.59-6.12]), having higher self-esteem (1.55 [1.09-2.19]) and using means other than anti-retroviral treatment to treat HIV (0.33 [0.11-1.00]) were independently associated with disclosure. This study identified several factors that should be considered for the design of interventions aimed at facilitating disclosure if/when desired in this cultural context.

Sexual partnerships of people living with HIV / Aids: sexual orientation, sociodemographic, clinical and behavioral aspects

“…En general, las nuevas infecciones por el VIH entre HSH ocurren debido a relaciones sexuales desprotegidas en presencia de carga viral detectable especialmente cuando no se tiene el conocimiento de la propia situación serológica. La transmisión de esta infección a menudo ocurre antes del establecimiento de una asociación fija, o como resultado de relaciones sexuales con otras personas durante la relación (15,16) .…”

Parceria sexual entre pessoas vivendo com HIV: gerenciando as diferenças sorológicas

“…Además, esta estrategia está siendo reconocida como una parte importante en la prevención de esta infección, sobre todo debido a la posibilidad de apoyo de la pareja para la adherencia a los cuidados clínicos, la medicación y el apoyo emocional a la persona infectada. Asimismo, la pareja aún puede discutir la mejor estrategia para ser utilizada (27,28) .…”

Social, Historical and Cultural Dimensions of Tuberculosis

“…To broaden current models, anthropological fieldwork may interpret critically the qualitative experience of gender and how socially constructed and socially vulnerable gender roles influence agency, health seeking and treatment compliance. In the absence of conclusive data about the biological predisposition to TB disease due to sex, TB policies and programmes should try to address the known obstacles created by gender norms, such as integrating flexible clinic hours to increase women's access to TB treatment services (Oshi et al, 2014). Capturing epidemiological data about sex and ethnographic data about how gender is constructed, performed and challenged in the social spaces where TB diagnoses are revealed and concealed will lead to transformative health care practices that promote the social inclusion of all TB patients.…”

“…The objective, one shared by others in the field (e.g. Oshi et al, 2014), is to encourage a systematic exploration of the social, historical and cultural factors that influence health seeking, treatment adherence and successful public health policies. The aim is to stimulate more social studies of TB and to open the space for more collaboration among quantitative and qualitative researchers.…”