Positive Status Disclosure and Sexual Risk Behavior Changes among People Living with HIV in the Northern Region of Ghana.

Abstract

To investigate sexual behavior changes adopted by People Living with Human Immunodeficiency Virus (PLHIV) on Antiretroviral therapy (ART) in the Northern Region of Ghana. We employed a cross-sectional survey with a questionnaire to collect data from 900 clients from 9 major ART centers within the region. Chi-square and logistic regression analyses were applied to the data. More than 50% of PLHIV on ART use condoms, reduce sexual partners, practice abstinence, reduce unprotected sex with married/regular partners, and avoid casual sex. Fear of others getting to know patients' HIV-positive status (χ2 = 7.916, p = 0.005), stigma (χ2 = 5.201, p = 0.023), and fear of loss of family support (χ2 = 4.211, p = 0.040) significantly predict non-disclosure of HIV-positive status among the participants. Change in sexual behavior is influenced by the following: "to avoid spreading the disease to others" (R2 = 0.043, F (1, 898) = 40.237, p < 0.0005), "to avoid contracting other STIs" (R2 = 0.010, F (1, 898) = 8.937, p < 0.0005), "to live long" (R2 = 0.038, F (1, 898) = 35.816, p < 0.0005), "to hide HIV-positive status" (R2 = 0.038, F (1, 898) = 35.587, p < 0.0005), "to achieve good results from ART treatment" (R2 = 0.005, F (1, 898) = 4. 282, p < 0.05), and "to live a Godly life" (R2 = 0.023, F (1, 898) = 20. 880, p < 0.0005). High self-disclosure rate of HIV-positive status was identified, with participants disclosing to their spouses or parents. Reasons for disclosure and non-disclosure differed from person to person.