Processes and Outcomes of HIV Serostatus Disclosure to Sexual Partners among People Living with HIV in Uganda

Abstract

Disclosure of HIV serostatus to sexual partners supports risk reduction and facilitates access to prevention and care services for people living with HIV/AIDS. To assess health and social predictors of disclosure as well as to explore and describe the process, experiences and outcomes related to disclosure of HIV-infected men and women in Eastern Uganda, we conducted a study among HIV-infected men and women who were clients of The AIDS Support Organization (TASO) in Jinja, Uganda. We enrolled TASO clients in a cross-sectional study on transmission risk behavior. Demographic and behavioral data and CD4 cell count measurements were collected. Among 1,092 participants, 42% were currently sexually active and 69% had disclosed their HIV serostatus to their most recent sexual partner. Multivariate logistic regression analysis showed that disclosure of HIV-status was associated with being married, having attended TASO for more than 2 years, increased condom use, and knowledge of partner's serostatus. From these clients, 45 men and women were purposefully selected and interviewed in-depth on disclosure issues. Positive outcomes included risk reduction behavior, partner testing, increased care-seeking behavior, anxiety relief, increased sexual communication, and motivation to plan for the future.

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

“…In addition, close to 44% of participants reported that a partner went for testing as a result of their status disclosure. Similar findings have been reported from Uganda where knowledge of a partner's serostatus (a proxy for having tested) was significantly associated with disclosure of the individual's status (King et al 2008). Couples testing is not routinely offered in the clinic from which these participants were recruited, although attempts are being made to expand this service.…”

“…This is an encouraging finding given the fear of stigma and discrimination surrounding HIV in South Africa and confirms findings from other African countries. King et al in Uganda found that 69% of HIV-infected individuals had disclosed their status to their most recent sex partner (King et al 2008) and Maman et al in Tanzania found that 64% of HIVinfected women and 79.5% of HIV negative women reported having shared their status with their sex partners (Maman et al 2003). However, disclosure rates are not this high in all populations.…”

“…Generally, the majority of participants reported that partners were more supportive as a result of disclosure of their status. Couples counseling may further defer blame by removing the assumption that the partner who discovers their HIV status first is the partner who brought HIV into the relationship (King et al 2008). Couples counseling in Zambia has also been associated with increased condom use among discordant couples, although consistent condom use was imperfectly maintained (Allen et al 2003).…”

Disclosure, Knowledge of Partner Status, and Condom Use Among HIV-Positive Patients Attending Clinical Care in Tanzania, Kenya, and Namibia

“…The majority of participants (80%) reported disclosing their HIV status to their sex partners, a similar finding to other studies conducted among PLHIV attending clinical care in Africa. 42 Disclosure was significantly associated with both knowledge of partner's HIV status and consistent condom use; confirming findings from other studies in sub-Saharan Africa. [5][6][7]17 Participants who had disclosed their HIV status were 24 times more likely to know their partner's HIV status highlighting the importance of encouraging partner communication around knowing the HIV status of both partners.…”

HIV Positive Status Disclosure and Highly Active Antiretroviral Therapy Adherence among People Living with HIV in Ambo Hospital, West Shewa Zone, Oromia Region, Ethiopia

“…A study conducted in Cameroon among HIV infected women and in Uganda among people living with HIV revealed that disclosure of HIV sero status was critical because of its significant links to safer sex practices [10,11]. A study done in Botswana and New York showed that nondisclosure of positive HIV status to their partner/relatives was predictor of poor adherence to ART [12,13].…”