Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Abstract

Purpose Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. The current study addressed this research gap, and explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Participants and Methods We conducted 12 in-depth interviews with the help of a translated interview guide, and they were audio recorded. Participants were purposively enrolled in the study, which employed a phenomenological qualitative design. The study was conducted at three public health facilities in Mbarara City. The data was analyzed using thematic content analysis. Approval for this research was obtained from the Mbarara University Research Ethics Committee (MUST-REC) and administrative clearance from the city clerk of Mbarara City. Results The mean age of the participants was 38 years old, ranging from 20 to 67 years. An equal number of males (six) and females participated in this study. Most of them had at least secondary level education, and only three had primary education. Half of the participants disclosed their serostatus to partners immediately after testing HIV positive. Key emerging themes as experienced benefits of HIV serostatus disclosure included: 1) social support and care; 2) decisions regarding health, fertility, and child bearing; 3) sharing information on HIV prevention and protection measures; 4) positive living; and 5) ease of HIV serostatus disclosure. The challenges associated with serostatus disclosure were summarized as one theme: misunderstandings in the families of the discordant couples. Conclusion Socially, psychologically and financially HIV positive individuals have benefited from their negative partners. Healthwise, they have been supported, and cared for after disclosing their positive status, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Factors Associated with HIV Positive Serostatus Disclosure to Sexual Partners Among Sexually Active Young People on Anti-Retroviral Therapy in Central Uganda

“…Similarly, qualitative findings revealed that all participants who were staying with sexual partners had disclosed their serostatus to their sexual partners. Our findings are generally in tandem with the Malawian study by Shifraew et al; 30 the Ethiopian study by Shifraew et al, 30 , 39 a Nigerian study by Yaya et al, 40 and Ugandan studies by Atwijukire et al, 34 and Naigino et al, 32 where a big number of study participants who were staying with their partners had disclosed their HIV serostatus to their partners. The findings from the in-depth interviews indicate that several factors influenced HIV serostatus disclosure to sexual partners among study participants.…”

“…Our findings are slightly consistent with the study done in Ethiopia where disclosure of HIV serostatus to a sexual partner was 92.6% (95%, CI = 90-95%), 30 and another one in Zimbabwe where 93% of the study participants disclosed their status, 31 and one in Uganda where 73.3% had disclosed 32 to sexual partners. However, most studies, unlike ours, disclosure was one-way 33 while other studies mainly focused on people living with HIV not necessarily on ART 30,34 except the study in Haiti where 75.2% of the study participants were on ART. 35 Some studies had smaller sample sizes like the Ugandan study by Ngonzi et al 36 which had 103 participants, the Malawian study by Hino et al 33 which had 40 participants and another Ugandan study by Atwijukiire et al, 34 with 12 participants compared to our study.…”

“…However, most studies, unlike ours, disclosure was one-way 33 while other studies mainly focused on people living with HIV not necessarily on ART 30,34 except the study in Haiti where 75.2% of the study participants were on ART. 35 Some studies had smaller sample sizes like the Ugandan study by Ngonzi et al 36 which had 103 participants, the Malawian study by Hino et al 33 which had 40 participants and another Ugandan study by Atwijukiire et al, 34 with 12 participants compared to our study. Worth noting, the average age of study participants in the Malawian study 33 was 28 years while in the study in Haiti, 35 the participants' average age was 35 years.…”

Qualitative Study on the Voices of Adolescents Living with Perinatally Acquired HIV in Selected Clinics in the Limpopo Province of South Africa

“…Studies have recorded success stories resulting from the accurate application of the disclosure process, and most APHIV benefited from the disclosure process through empowerment and sustenance, as well as guidance on adherence to antiretroviral therapy (ART) [1,6]. However, there are unique issues in the current disclosure process that are not addressed by the guidelines and therefore undermine the main objective of disclosure [9,10]. The success of the disclosure process is determined by the reported positive coping skills by APHIV.…”

“…Studies reported major health problems after disclosure, such as high rates of mental health vulnerabilities (e.g., maladaptive coping mechanisms) and high-risk behaviors such as alcohol and substance abuse and risky sexual behavior [13][14][15]. Few studies have explored the experiences of APHIV on current disclosure practices both before and after disclosure [9,[16][17][18]. They are at the receiving end of the disclosure process, making their experiences vital to the effectiveness of the process.…”