Human immunodeficiency virus positive status disclosure to a sexual partner and its determinant factors in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Disclosure of Human Immunodeficiency Virus positive status significantly reduced the transmission of HIV; yet, it remains a challenge for many HIV patients. Disclosure serves plays a crucial role to raise awareness and to reduce risky behaviors. Hence, this study aimed to determine the pooled prevalence and effect sizes of determinant factors of HIV positive status disclosure through a systematic review and meta-analysis of the results of the existing primary studies in Ethiopia. Method: This systematic review and meta-analysis was aimed to determine prevalence of HIV positive status disclosure and associated factors by considering and searching published primary articles from different sources. A sensitivity test was conducted to evaluate the presence of influential studies. Besides, the heterogeneity test has been conducted; and publication bias was examined through observing the funnel plot as well as objectively by interpreting the Egger's regression test. Following the Egger's regression test, P-value < 0.05 was considered as statistically significant at 95% Confidence Interval. Result: A total of 18 primary studies were searched from different data sources. The overall pooled prevalence of HIV positive status disclosure among adult PLWHA in Ethiopia was indicated to be 75.95% (95% CI:69.93-81.98); the highest and lowest pooled estimated HIV status disclosure was in Amhara (82.78%) and Tigray (54.31%) regions respectively. Furthermore, Knowing the HIV positive status of sexual partner, AOR = 19.66(95% CI: 10.19-37.91), having prior discussion about HIV testing with their partner, AOR = 9.18(95% CI: 5.53-15.24), got Human Immunodeficiency Virus pretest counseling service AOR = 4.29(95% CI: 2.56-7.21) and being a member of HIV/AIDS associations, AOR = 3.34(95% CI: 2.17-5.12), were significantly associated with HIV positive status disclosure among People living With HIV/AIDS in Ethiopia.

The proportion of HIV disclosure to sexual partners among people diagnosed with HIV in China: A systematic review and meta-analysis

“…One ( 31 ) reported 76.03% of pooled disclosure rate (18 studies, 8,009 participants), while the other ( 32 ) reported 73% of disclosure rate (12 studies, 4,528 participants). Two other reviews ( 33 , 34 ) reported 74.63% (22 studies, 8,873 participants) and 75.95% (18 studies, 7,084 participants) disclosure proportions, respectively. However, there is still a lack of knowledge about the special characteristics of HIV disclosure to sexual partners ( 31 – 34 ).…”

“…Two other reviews ( 33 , 34 ) reported 74.63% (22 studies, 8,873 participants) and 75.95% (18 studies, 7,084 participants) disclosure proportions, respectively. However, there is still a lack of knowledge about the special characteristics of HIV disclosure to sexual partners ( 31 – 34 ). The quality of the reviews was also low, resulting in high publication bias ( 32 , 34 ).…”

“…They focused on influencing factors of HIV disclosure ( 14 , 20 – 22 ), disclosure policies and their effectiveness ( 13 , 23 , 24 ), interventions for HIV disclosure ( 25 , 26 ), evaluation of self-report disclosure tools ( 27 ), and the HIV disclosure among specific populations such as adolescents or immigrants ( 28 – 30 ). Four reviews synthesized the proportions of HIV partner disclosure among Ethiopian adults with PDWH ( 31 – 34 ). One ( 31 ) reported 76.03% of pooled disclosure rate (18 studies, 8,009 participants), while the other ( 32 ) reported 73% of disclosure rate (12 studies, 4,528 participants).…”

“…However, there is still a lack of knowledge about the special characteristics of HIV disclosure to sexual partners ( 31 – 34 ). The quality of the reviews was also low, resulting in high publication bias ( 32 , 34 ). Considering that sexual contact has become the main transmission route of the increasing global HIV epidemic, disclosing HIV to sexual partners could be an effective strategy in preventing secondary HIV transmission from HIV high-risk populations to the general population ( 35 , 36 ).…”

Highly active antiretroviral therapy is necessary but not sufficient. A systematic review and meta-analysis of mortality incidence rates and predictors among HIV-infected adults receiving treatment in Ethiopia, a surrogate study for resource-poor settings

“…A systematic review by Yehualashet et al . [ 91 ] indicated that the pooled national estimate of HIV-positive status disclosure among adult PLHIVs was lower in Ethiopia than in developing countries. This study found that PLHIVs with non-disclosure status had threefold higher mortality hazards than those who disclosed their status.…”