Outcomes and barriers of disclosure of HIV serostatus among infected women in Kilifi District Hospital (KDH).

Abstract

OBJECTIVE To assess outcomes and barriers of Disclosure of HIV serostatus among infected women in Kilifi District. METHODS This was a qualitative study conducted at Comprehensive Care and Research Centre of Kilifi District Hospital in Kenya. The study recruited and interviewed 20 women who were selected by mixed purposeful sampling among all clients attending the clinic. Data transcription, coding, categorization and lastly theme formation were done in the process of data analysis. RESULTS Mixtures of positive and negative outcomes were reported from individual clients. The different outcomes of disclosure were grouped into two categories. These were Patient's relationship with different social groups and Community care and support for HIV positive patients. The positive outcomes were strengthened partner relationship, social care, financial support, and encouragement to ARV drug adherence. The negative outcomes were family separation, abandonment, refusal of the husbands to get tested for HIV and suicidal attempts. The reported barriers to disclosure were stigma, religion, and fear of family violence, fear of loosing jobs, gossiping and fear of accusation of infidelity. CONCLUSION Disclosure of HIV serostatus is a complex process; it is not a single night event but a process that can take weeks, months, even years with a lot of positive and negative outcomes and some of the negative outcomes being very devastating to the client. Also the Concept of "Anticipated outcomes Vs Real outcomes" of disclosure was found to be valid to the majority of clients. Lastly, the issue of concern to many clients was the question; "Should I disclose or disappear?" If this question could be well addressed, it will positively influence the disclosure of HIV serostatus and thus open doors for easy accessibility to the available free medical care for HIV patients and encourage ARV drug adherence especially in the developing countries.