Predictors of HIV status disclosure among PLHIV in the Volta region of Ghana: the disclosure conundrum and its policy implications.

Abstract

Background Globally, over 40 million lives have been claimed by HIV/AIDS. In Ghana, more than 350,000 people are currently living with HIV with 66% of them being females; out of this number, 71% know their status and 99% of the people diagnosed with HIV in Ghana received sustained antiretroviral therapy (ART), and 79% on ART have achieved viral suppression. Non-disclosure of HIV status is a major barrier to HIV/AIDS eradication; yet, little is known on the determinants of HIV status disclosure among the adult population of people living with HIV (PLHIV) in Ghana. Objective Determine the predictors of HIV status disclosure among the adult population of PLHIV and stimulate national policy discourse on support systems for self-disclosure in Ghana. Methods The study is a descriptive cross-sectional design among PLHIV (n = 181) in a tertiary hospital in the Volta region of Ghana. Bivariate analysis with Pearson Chi-square and Fisher’s Exact tests were run alongside stepwise forward logistic regression to determine factors associated with HIV status disclosure among PLHIV at 95% confidence level. Results HIV status disclosure was reported by 50% of the respondents; nearly 65% disclosed their status to non-family members. HIV status disclosure was significantly associated with marital status (p = 0.000), level of education (p = 0.035), divorce due to HIV (p = 0.000), monthly income (p = 0.019), occupation (p = 0.010) and partner being HIV positive. The odds of disclosing HIV status was higher among single/never married persons (OR = 0.012; p-value = 0.017, 95% [CI = 0.000 0.447), persons of Catholic denomination (OR = 0.060; p-value = 0.057, 95% [CI = 0.003 1.089), persons with monthly income of approximately (USD 44–88) (OR = 0.068; p-value = 0.011, 95% [CI = 0.009 0.543]) and persons adherent to ART (OR = 6.161; p-value = 0.058, 95% [CI = 0.937 40.490]). Conclusions HIV status disclosure is low in Ghana due to socio-economic and religious factors. There is the need for a national debate on policy guidelines for HIV status disclosure for PLHIV; targeted support systems for vulnerable groups within PLHIV would also help ameliorate their predicaments.