Determinant factors of HIV positive status disclosure among adults in Axum Health Facilities, Northern Ethiopia: Implication on treatment adherence

Abstract

Disclosure of HIV positive status to sexual partners, friends or relatives is crucial for HIV prevention and care implementation strategies. Hence, it is important to explore factors determining individuals to disclose their HIV positive status in order to achieve a goal of zero new HIV infection. Facility based mixed cross-sectional study was conducted from July to August, 2013 among 361 HIV positive adults attending Axum Health Facilities. They were selected through systematic random sampling. Data were collected by trained counselors and ART nurses and then entered into SPSS version 20 databases. Bivariate and multivariable logistic regression models were used to identify predictors of HIV positive status disclosure at 95% confidence intervals and p-value of less than 0.05. Among 361 respondents, 289 disclosed their HIV status to someone and 151(41.8%) to intimate partners. In the multivariate logistic regression analysis, variables significantly associated at p-value <0.05 were married; knowing partner’s HIV status and membership in an HIV-Support Group were positive predictors of disclosure. These findings were supported by qualitative study in which fear of discrimination, fear of breaking confidentiality and fear of families make them to conceal their status. The rate of HIV positive status disclosure among HIV positive adults has remained low. Marital status of respondents, knowledge of partners’ HIV status and being member in Anti- HIV/AIDS Association were identified as predictors of HIV positive status disclosure. Addressing the issues of disclosure was recommended to encourage free disclosure and coping with negative reactions, which is a crucial way for adherence to treatment. Key words: Adult, Axum health facilities, Ethiopia, HIV positive disclosure.