Factors associated with HIV status disclosure to partners and its outcomes among HIV-positive women attending Care and Treatment Clinics at Kilimanjaro region, Tanzania

Abstract

BackgroundSub Saharan Africa continues to be the epicenter of HIV with 70% of people living with HIV globally. Women form nearly 60% of those living with HIV. Studies have shown disclosure of one’s HIV status is important in HIV prevention, in increasing partners who are tested and getting into care early as well as in improving retention in PMTCT and ART programs. This study aimed to determine the prevalence, factors and outcomes of HIV status disclosure to partners among HIV-positive women attending HIV care-and-treatment clinics (CTCs) at Kilimanjaro region, northern Tanzania.MethodsA cross-sectional study was conducted from January to June 2014 in 3 out of the 7 districts of Kilimanjaro region. The study population was HIV-positive women aged 15–49, who were attending for routine HIV care at 19 selected clinics. Face-to-face interviews were conducted with consenting women to collect necessary information. Multivariate logistic regression analyses were used to determine the independent predictors of HIV status disclosure to partner.ResultsA total of 672 HIV-positive women in Moshi municipal, Hai and Mwanga districts were enrolled. Of them, 609 HIV-positive women reported to have a regular partner. Prevalence of serostatus disclosure to partners was 66%. Of the 400 who had disclosed; 56% did so within the first month of knowing their HIV status. In a multiple logistic regression model, HIV serostatus disclosure was higher among women who: were married/cohabiting (AOR = 4.16, 95% CI: 2.39–7.25; p<0.001), currently on ART (AOR = 2.06, 95% CI: 1.11–3.82; p = 0.020), and who reported had ever communicated with partners on number of children (AOR = 1.85, 95% CI: 1.15–2.98; p = 0.010) and contraceptives use (AOR = 2.01, 95% CI: 1.27–3.20; p = 0.208). Most of the women (81%) who disclosed their HIV status to did not reported negative outcomes.ConclusionIn this setting still a third of the HIV-positive women (34%) fail to disclose their HIV- serostatus to partners. Interventions to impart skills in communication and negotiation between partners may help in improving disclosure of HIV. Efforts to involve men in general sexual and reproductive health including couple counseling and testing will contribute in improving disclosure and communication on HIV among partners.

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

“…In contrast to our study population, the majority of the women in the South African study were not married or cohabitating with a partner, and they used a different definition of being in a current relationship. A study published 2019 including 680 non- pregnant women living with HIV in Tanzania did not find age to be significantly associated with disclosure of HIV status [38]. The study included older women (the majority were 35-49 years old), and the age intervals tested in the analysis were different (the youngest age interval was 17-34 years).…”

“…The associations between social concerns and HIV status disclosure to a partner or a relative were assessed by calculating odds ratios (OR) and 95% confidence intervals (CI) using multivariable-adjusted logistic regression. Based on previous literature of factors associated with HIV status disclosure, ORs were adjusted for age [33,34], educational level [35], marital-and cohabitation status [26,[36][37][38], working status [39], time since HIV diagnosis [33], living with relatives [40] and economic situation [19,26,33]. A variable was excluded from the logistic regression model if a response alternative was reported by < 10 subjects (excluding concerns about IPV, a child taken away and property taken away).…”

Determinants of undisclosed HIV status to a community-based HIV program: findings from caregivers of orphans and vulnerable children in Tanzania

“…HIV status disclosure is vital in HIV prevention and treatment programs as a tool for prevention and care strategies [1][2][3][4][5][6]. In 2014 at the 20th International AIDS Conference in Melbourne, Australia, the United Nations Programme on HIV and AIDS (UNAIDS) launched the 90-90-90 targets for HIV and AIDS programming.…”

“…Many factors positively and negatively associated with HIV status disclosure have been identified including stigma and discrimination [15][16][17], knowledge of partner's HIV status and membership in HIV and AIDS control associations [6], economic status [35,36], literacy [37], gender [24], age [38][39][40], marital status [5,[38][39][40], being on ART, contraceptive use [5], and many others [25,26,33,[41][42][43].…”

Disclosure of HIV seropositivity to sexual partner and psychosocial factors in Ethiopia: Systematic review and meta-analysis&nbsp;

“…However, regardless of many supportive interventions, only 58.7% of HIV seropositive pregnant women disclose to their sexual partners in South Africa (19). Similarly, 50.9% of Nigerian people who were living with HIV disclose HIV status to their sexual partner (20); 50.5% of seropositive adults in HIV support groups in Kenya (21), and 66% of HIV-positive women attending care and treatment clinics in Tanzania (22) were disclosed their HIV status to their sexual partners.…”