Abstract
The study investigated the motivation to disclose or the decision to withhold one’s HIV serostatus to one’s partners and assessed the implications of non-disclosure on young peoples’ sexual behaviour and access to treatment. This was a cross-sectional survey conducted with 253 youth aged 18–25 years receiving antiretroviral therapy in a health district in North West Province, South Africa. The majority were female (75%), the mean time since the HIV diagnosis was 22 months, 40% did not know their partner’s HIV status, 32% had more than two sexual partners, and 63% had not used a condom during the last sexual act. The prevalence of disclosure was 40%, 36% delayed disclosure for over a year, and most disclosed to protect the partner from HIV transmission, to receive support, and to be honest and truthful. The prevalence of non-disclosure was high, as 60% withheld disclosure due to fear of abandonment, stigma and discrimination, accusations of unfaithfulness, and partner violence. Over half (55%) had no intentions to disclose at all. The lower disclosure rates imply that HIV transmission continues to persist among sexual partners in these settings. The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in South Africa.
Highlights
The HIV epidemic continues to be a major challenge in developing countries, with young people bearing the highest HIV burden
The findings suggest that high levels of perceived stigma impact on disclosure and HIV treatment, which increases the risk of on-going HIV transmission among youth receiving long-term antiretroviral therapy (ART) in Keywords: South Africa; non-disclosure; youth; motivation; sexual behaviour; partner reaction; disclosure outcome; implications
The study found a low rate of HIV disclosure to sexual partners, with over half the participants delaying disclosure to over a year after the HIV-positive test results
Summary
The HIV epidemic continues to be a major challenge in developing countries, with young people bearing the highest HIV burden. Many factors put young people at an elevated risk of HIV infection. Social, and economic factors that render young people vulnerable to HIV, early sexual activity and unplanned coerced sexual relationships increase the vulnerability of the youth to HIV infection [2]. Individuals diagnosed with HIV have substantial difficulties in telling others that they are infected [4]. This is true with disclosure to sexual partners. Evidence suggests that it is common for people with HIV to not disclose their HIV status to sexual partners [5]. HIV serostatus disclosure is an important component of HIV prevention, with potential benefits for the individual
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