High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners: Reasons for Cautious Optimism from a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

Maman, Suzanne; Mbwambo, Jessie; Hogan, Nora M.; Weiss, Ellen; Kilonzo, Gad P.; Sweat, Michael D.

doi:10.1023/b:aibe.0000004729.89102.d4

Cited by 131 publications

(129 citation statements)

References 20 publications

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“…Specifically, those women who feared break-up of the relationship relied on their partners financially for assistance with livelihood and child care, and thus were fearful of disclosing their HIV status to their partners, due to concerns that disclosure might result in a loss of the resources provided by the partner. This was consistent with other studies (Armistead, Morse, Forehand, Morse & Clark, 1999;Maman et al, 2003). This highlights the importance of gender specific approaches in HIV counselling, in order to address the different concerns of men and women.…”

Section: Discussionsupporting

confidence: 92%

Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

Deribe¹,

Woldemichael

Njau

et al. 2010

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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There are inconsistent findings about the relation between gender and HIV status disclosure. We conducted a facility-based crosssectional study, using qualitative and quantitative data collection methods, to explore gender differences in HIV-positive status disclosure among service users in south-west Ethiopia. Among 705 participants, an equal number of men and women (94.6% men v. 94.3%, women) indicated that they had disclosed their result to someone, and the majority (90.9% men v. 90.7% women) to their current main partner. 'It is customary to tell my partner everything' was the most frequently cited reason for disclosing (62.5% men v. 68.5% women). Reasons for non-disclosure varied by gender: men were concerned about their partner's worry and exposure of their own unfaithfulness. Women feared physical violence, and social and economic pressure in raising their children. Factors that influenced disclosure also indicated gender variation. For men, disclosure of HIV results to a sexual partner was positively associated with knowing the partner's HIV status and discussion about HIV testing prior to seeking services, while for women it was associated with knowing the partner's HIV status, advanced disease stage, having no more than primary education, being married, and perceiving the current relationship as long-lasting.There was no significant difference in the proportion of HIV status disclosure among men and women. However, the contextual barriers and motivators of disclosure varied by gender. Therefore it is important that clinicians, counsellors, and health educators underscore the importance of gender-specific interventions in efforts to dispel barriers to HIV status disclosure. Keywords: HIV, AIDS, disclosure, HIV result, serostatus disclosure, gender.Kebede Deribe (MPH) is a public health specialist working in Ethiopia. He holds a master's degree in public health and his research interests include health in humanitarian settings, migration and health, infectious disease and HIV/AIDS. He has published several journal articles.Kifle Woldemichael (MD, MPH) is an Associate Professor of epidemiology in the Department of Epidemiology, Jimma University, Addis Ababa, where he has been serving as head of the Public Health Faculty. He has authored many articles in national and international journals.Bernard Joseph Njau (MPH) is a public health specialist, and has been working for six years as assistant lecturer and research scientist, currently with KCMC-Duke University AIDS Program, Kilimanjaro Christian Medical College, Department of Community Health, Moshi, Tanzania. His research interests include HIV/AIDS voluntary counselling and testing (VCT), disclosure, and adolescent sexuality.Bereket Yakob is a public health specialist and is currently working as regional co-ordinator for NASTAD Global Programme in Ethiopia on HIV/AIDS prevention. He graduated with a BSc. in Public Health from Alemaya University in 2002, and then with an MPH from Addis Ababa University, Ethiopia, in 2007. He has been working in lea...

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Section: Discussionsupporting

confidence: 92%

Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

Deribe¹,

Woldemichael

Njau

et al. 2010

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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“…Other comparable studies conducted in Burkina Faso, Tanzania, Kenya, Ethiopia and United States of America also reported predominant supportive partner reactions of 62-92%. [2][3][4][5][6]15 It is also noteworthy that our results reveal an increase in supportive partner reactions overtime, with majority of partners who initially reported negative initial partner reaction subsequently reporting positive partner reactions. This subsequent change from negative to positive partner reactions may be used as a counselling strategy to allay fears and concerns of patients who initially experience negative partner reactions following disclosure.…”

Section: Discussionmentioning

confidence: 56%

“…12 Failure to disclose has been attributed to fear of abandonment, broken relationships, physical and emotional abuse, discrimination and loss of economic support. 2 Despite these disclosure-related fears, studies from both developed and developing countries [2][3][4][5][6][7] , Nigeria inclusive [8][9][10][11][12][13] , have revealed predominant positive or supportive reactions to disclosure, with 50-100% of sexual partners eliciting positive reactions following disclosure. The few reports of negative reactions such as disruption of relationships, violence and discrimination were more commonly reported among unmarried sexual partners and sero-discordant couples, as well as among people from low economic status and in those with history of violence in their relationships.…”

Section: Introductionmentioning

confidence: 99%

Types and predictors of partner reactions to HIV status disclosure among HIVinfected adult Nigerians in a tertiary hospital in the Niger Delta

Ogoina¹,

Ikuabe²,

Ebuenyi³

et al. 2015

Afr H. Sci.

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Background and objective: Our aim was to describe the types and determinants of partner reactions to HIV-status disclosure among adults attending an antiretroviral therapy-(ART) clinic in the Bayelsa State, Nigeria Methods: A cross-sectional study was undertaken between January and March 2013 among consecutive adult patients who had disclosed their HIV-status to their current sexual partner. Sociodemograhic data and types of initial and subsequent partner reactions to disclosure were obtained using interviewer-administered standardized-questionnaire. Independent determinants of reactions to disclosure were ascertained by unconditional logistic regression. Results: Out of 123 study participants, 57.7% were females, 92% were receiving ART and 86.1% were currently married. Majority of the participants reported predominant positive or supportive initial (72.4%) and subsequent (89.5%) partner reactions to disclosure, with significant increase in positive reactions over time. Positive initial partner reactions were independently associated with prior post-test counselling-(Odds ratio [OR]-6.5, 95% Confidence interval [CI]-1.3-31.6-p=0.02), age>35years-(OR-5.8, 95% CI-1.6-20.9-p=0.008) and being healthy at time of disclosure-(OR-7.8, 95% CI-1.7-35.4-p=0.008). Subsequent positive partner reactions were significantly associated with receiving antiretroviral therapy and having only one lifetime sexual partner. Conclusion: Our results indicate that partner reactions to HIV-status disclosure are predominantly supportive. Disclosure counselling and early initiation of ART may be effective in improving HIV-status disclosure in Nigeria.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2008

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Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context. Abstract Uptake of VCT remains low in many subSaharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.

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High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners: Reasons for Cautious Optimism from a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

Cited by 131 publications

References 20 publications

Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users

Types and predictors of partner reactions to HIV status disclosure among HIVinfected adult Nigerians in a tertiary hospital in the Niger Delta

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

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