Exploring the HIV Disclosure Patterns to Sexual Partners and Associated Factors Among HIV-Positive Adults in Sheger City, Ethiopia: A Multicenter Study

TL;DR

This study in Ethiopia found that about two-thirds of HIV-positive adults told their sexual partners about their status, with counseling and marriage increasing the likelihood of disclosure.

Contribution

The study identifies specific factors influencing HIV disclosure in Sheger City, Ethiopia, offering insights for targeted interventions.

Findings

67.9% of HIV-positive adults disclosed their status to sexual partners.

Pretest counseling and being married were strongly associated with higher disclosure rates.

Perceived HIV-related stigma was linked to lower disclosure rates.

Abstract

Background: Disclosing HIV serostatus to a partner is essential for HIV prevention and care. It encourages safer sexual practices, lowers the risk of transmission, and helps individual's access to treatment and support. However, the choice to share one's HIV status can be affected by a range of personal and societal influences. Ethiopia has a diverse population where traditional norms and health challenges intersect which might negatively influence HIV disclosure. Therefore, this study aims to explore HIV disclosure patterns to sexual partners and associated factors among HIV-positive adults in Sheger City, Ethiopia.

Methods: An institution-based cross-sectional study was conducted among 393 people living with HIV attending the ART clinic in Sheger City from August 1 to September 30, 2023. Study participants were selected using a systematic sampling technique. Data were collected through a pretested, interviewer-administered structured questionnaire. Multicollinearity was assessed using the variance inflation factor (VIF). To evaluate the goodness of fit of the logistic regression model, we calculated the pseudo-R2 values and the area under the receiver-operating characteristic (ROC) curve. Binary and multivariable logistic regression analyses were performed to identify factors independently associated with HIV disclosure status. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and statistical significance was determined at a p-value of < 0.05.

Results: The overall prevalence of HIV serostatus disclosure to sexual partners was 67.9% (95% CI: 63.5%, 72.5%). Factors significantly associated with HIV disclosure included pretest counseling (AOR = 7.86; 95% CI: 3.61, 17.08), marital status (AOR = 9.32; 95% CI: 2.62, 33.19), presence of initiating factors (AOR = 7.18; 95% CI: 3.41, 15.01), type of testing (AOR = 6.44; 95% CI: 2.43, 17.07), perception of HIV-related stigma (AOR = 0.21; 95% CI: 0.09, 0.47), and having clinical symptoms at the time of HIV testing (AOR = 22.12; 95% CI: 8.74, 56.20).

Conclusion: This study found that 67.9% of people living with HIV disclosed their serostatus to their sexual partners. Pretest counseling, being married, the presence of initiating factors, self-initiated testing, and experiencing clinical symptoms during testing were found to be positively associated with HIV status disclosure. In contrast to this, the perception of HIV-related stigma was associated with lower rate of disclosure. Thus, enhancing pretest counseling, launching community-based initiatives and offering extra support for symptomatic individuals are essential strategies to increase disclosure rates.

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