Abstract
Background:Disclosure of HIV status is crucial to the adoption of preventive behaviors for HIV transmission. This study was conducted to investigate HIV status disclosure and its impact on sexual practices among HIV-positive women in Nairobi, Kenya.Methods:A cross-sectional study was conducted among HIV-positive women seeking care at two hospitals in Nairobi. A questionnaire and known self-efficacy scales were administered to eligible women to collect information on sociodemographic factors, HIV disclosure and beliefs, healthcare provider advice on disclosure, sexual practices, and self-efficacy.Results:Of 497 women who were included in this analysis, 95.8% had disclosed their HIV status to someone. Women who disclosed were more likely to be in a relationship (p 0.0017) and to be the heads of their households (p 0.0042). Women who reported that their healthcare provider advised them to disclose and told them of ways to disclose were significantly more likely to have disclosed (p=0.0237 and p=0.0294, respectively). The belief that HIV status disclosure is important for HIV prevention and control and that the benefits of disclosure outweigh the risks was also significantly associated with disclosure (p<0.0001 for both).Conclusion:The prevalence of disclosure among HIV-positive individuals’ in hospital settings in Nairobi is high. These findings indicate that encouraging and suggesting ways to disclose by healthcare providers and individuals’ beliefs about the benefits of disclosure can increase the rate of HIV disclosure. Prospective studies to assess these observations would provide reliable guidance on how to increase disclosure by all women.
Highlights
Human Immunodeficiency Virus (HIV) status disclosure is a sensitive and complicated process due to social, financial, and personal consequences that can result; yet, disclosure is critical to the prevention of HIV and care of those infected [1,2]
34% of the women reported that they had disclosed their HIV status to their main sexual partner, 54% had disclosed to a religious leader, 7% to a family member other than their spouse/sexual partner, and 2% had disclosed to a friend
Most of the 21 women who had not disclosed (85.7%) said they did not have a partner and the other 14.3% said they were in a relationship (p 0.0017)
Summary
Human Immunodeficiency Virus (HIV) status disclosure is a sensitive and complicated process due to social, financial, and personal consequences that can result; yet, disclosure is critical to the prevention of HIV and care of those infected [1,2]. Studies on HIV status disclosure in Africa indicate that it is highly variable depending on the source and recipient of the disclosed information; rates of disclosure to sexual partners is highly variable (10-80%) [1,3,4,5,6,7,8,9]. HIV disclosure among women may impact the rates of HIV infection among the general population, yet it is not commonly done in many areas of sub-Saharan Africa [16,17,18]. This study was conducted to investigate HIV status disclosure and its impact on sexual practices among HIV-positive women in Nairobi, Kenya
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