Disclosure Of HIV Status Research Articles

Process evaluation of peer-to-peer delivery of HIV self-testing and sexual health information to support HIV prevention among youth in rural KwaZulu-Natal, South Africa: qualitative analysis

ObjectivePeer-to-peer (PTP) HIV self-testing (HIVST) distribution models can increase uptake of HIV testing and potentially create demand for HIV treatment and pre-exposure prophylaxis (PrEP). We describe the acceptability and experiences...

Voluntary HIV Counselling and Testing Amongst Trainee Nurses and Midwives in Ghana and their Perception of Disclosure of HIV Positive Status to Partners

Voluntary Counseling and Testing (VCT) is the best strategy for a successful HIV prevention, care, and support service implementation among HIV-negative and positive individuals. VCT is also recognized as a critical component in the reduction of risk among sexually active young people. This study aims to assess the voluntary HIV counseling, testing, and utilization amongst student nurses and midwives in Ghana and their perception of the disclosure of HIV-positive status to partners. This study used a cross-sectional quantitative descriptive survey amongst 98 nursing and midwifery students at the Nursing and Midwifery Training College, Koforidua. A simple random sampling was used in selecting the participants. Data collection was done using a structured questionnaire. Females dominated the study with the majority of respondents being single. VCT uptake among the respondents was low. Only 26.5% had ever undertaken VCT. It was observed that their willingness to accept VCT does not translate into actual testing. The majority (83%) of respondents perceived that HIV-infected persons should disclose their status to a sexual partner. Fear of stigma (96.0%), fear of loss of friends (98.0%), and fear of being abused (88.8%) were identified as the barriers to HIV status disclosure. To promote VCT services among trainees, these services need to be periodically included in school activities. A comprehensive VCT training module needs to be included in the school curriculum. More emphasis should be placed on the benefits of VCT so that students will understand the importance of implementing VCT services.

HIV Stigma, HIV status disclosure, and ART adherence in the context of an integrated opioid use disorder and HIV treatment setting in Dar es Salaam, Tanzania

ABSTRACT Little is known about social factors, including stigma, that affect antiretroviral therapy (ART) adherence among people enrolled in opioid use disorder treatment (OUDT) in the context of integrated OUDT and HIV treatment models. We qualitatively examined the relationship between HIV stigma, HIV status disclosure, and ART adherence among clients living with HIV at an OUDT clinic with integrated HIV services in Tanzania. We conducted in-depth interviews with 25 clients receiving HIV care at an OUDT clinic in Dar es Salaam, Tanzania between January and April 2020. HIV stigma, particularly anticipated stigma, and HIV status disclosure were key factors that affected ART adherence. Participants feared non-voluntary HIV status disclosure to and HIV stigma from their peers enrolled in OUDT. Most participants reported concealing their HIV status from peers at the OUDT clinic and not associating with other clients living with HIV at the clinic. Reducing HIV stigma and enhancing clinic structures and procedures to maintain privacy and confidentiality are essential to mitigating the effects of stigma on ART adherence.

"Facilitating HIV status adjustment: Qualitative insights from the Tambua Mapema proof-of-concept study in Kenya".

Systematic efforts are needed to prepare persons newly diagnosed with acute or chronic HIV infection to cope. We examined how patients dealt with this news, looking at how readiness to accept an HIV diagnosis impacted treatment outcomes, prevention of transmission, and HIV status disclosure. We examined vulnerability and agency over time and considered implications for policy and practice. A qualitative sub-study was embedded in the Tambua Mapema (“Discover Early”) Plus (TMP) study (NCT03508908), conducted in coastal Kenya between 2017 and 2020, which was a stepped wedge trial to evaluate an opt-out HIV-1 nucleic acid testing intervention diagnosing acute and chronic HIV infections. Diagnosed participants were offered antiretroviral therapy (ART), viral load monitoring, HIV partner notification services, and provision of pre-exposure prophylaxis (PrEP) to their uninfected partners. Data were analyzed using thematic approaches. Participants included 24 individuals who completed interviews at four time points (2 weeks and 3, 6, and 9 months after diagnosis), including 18 patients (11 women and 7 men) and 6 partners (1 woman, 5 men, of whom 4 men started PrEP). Acceptance of HIV status was often a long, individualized, and complex process, whereby participants’ coping strategies affected day-to-day issues and health over time. Relationship status strongly impacted coping. In some instances, couples supported each other, but in others, couples separated. Four main themes impacted participants’ sense of agency: acceptance of diagnosis and commitment to ART; positive feedback after attaining viral load suppression; recognition of partner supportive role and focus on sustained healthcare support whereby religious meaning was often key to successful transition. To support patients with acute or newly diagnosed chronic HIV, healthcare and social systems must be more responsive to the needs of the individual, while also improving quality of care, strengthening continuity of care across facilities, and promoting community support.

Talking to children about their HIV diagnosis: a discussion rooted in different global perspectives.

An online meeting was arranged with four professionals representing four countries to debate current practices and future steps in naming HIV to children (disclosing HIV status). This article considers the evidence and reports on the commentary and debate from the meeting. Naming HIV to children remains a challenge. Although studies identify some of the facilitators and barriers to informing children of their HIV diagnosis, further review of practice is required. This article presents a global perspective of naming practices from different settings. The article comprises commentary and a report of the online debate, along with supporting evidence. The four participating authors concluded that health professionals must work in collaboration with families to support early naming of HIV to children or having an open discussion about HIV in clinics. Naming when a child is younger reduces self-stigma and empowers children and young people to adhere to their medication, make informed decisions and share their own diagnosis appropriately. The authors concluded that health professionals play a key role in educating colleagues and the public to reduce stigma and discrimination. Professionals working with children and families living with HIV require support and resources to instil confidence in naming and facilitate naming of HIV status to a child.

Psychosocial and mental health challenges faced by emerging adults living with HIV and support systems aiding their positive coping: a qualitative study from the Kenyan coast

BackgroundIn sub-Saharan Africa, there is little data on the challenges faced by young people living with HIV transitioning into adult life. Adapting the socio-ecological framework, this qualitative study investigated the challenges faced by emerging adults living with HIV from a rural Kenyan setting. Additionally, the study explored support systems that aid positive coping among these young adults.MethodsIn April 2018, in-depth interviews were conducted with a convenience sample of 22 young adults living with HIV (12 females), 18–24 years old, from rural Kilifi, coast of Kenya. Data were analyzed thematically using NVIVO 11 software.ResultsYoung adults living with HIV from this setting face various challenges at different levels of the social ecosystem. At the individual level, key challenges they reported included acceptance of HIV positive status, antiretroviral adherence, economic burden associated with access to healthcare, building an intimate relationship, mental health problems, and HIV status disclosure. At the family level, death of parents, poverty, and being unaccepted were the commonly mentioned challenges. At the community level, socialization difficulties and long waiting time at the HIV clinic were highlighted. HIV stigma and discrimination were frequently reported across the different levels. Economic independence, social support (from families, friends, organizations, healthcare providers and peer meetings), and reliance on spirituality aided positive coping among these young adults amidst the challenges of living with HIV.ConclusionsIn this rural setting, emerging adults living with HIV face various challenges at the individual, family, and community level, some of which are cross-cutting. Our findings underscore the need for designing multi-level youth-friendly interventions that can address modifiable challenges encountered by emerging adults living with HIV in this and similar settings. Such interventions should incorporate appropriate context-specific support structures that may help these young people smoothly transit into adult life.

Causes of death and associated factors over a decade of follow-up in a cohort of people living with HIV in rural Tanzania

BackgroundNearly half of HIV-related deaths occur in East and Southern Africa, yet data on causes of death (COD) are scarce. We determined COD and associated factors among people living with HIV (PLHIV) in rural Tanzania.MethodsPLHIV attending the Chronic Diseases Clinic of Ifakara, Morogoro are invited to enrol in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO). Among adults (≥ 15 years) enrolled in 2005–2018, with follow-up through April 2019, we classified COD in comprehensive classes and as HIV- or non-HIV-related. In the subset of participants enrolled in 2013–2018 (when data were more complete), we assessed cause-specific mortality using cumulative incidences, and associated factors using proportional hazards models.ResultsAmong 9871 adults (65% female, 26% CD4 count < 100 cells/mm3), 926 (9%) died, among whom COD were available for 474 (51%), with missing COD mainly in earlier years. The most common COD were tuberculosis (N = 127, 27%), non-AIDS-related infections (N = 72, 15%), and other AIDS-related infections (N = 59, 12%). Cardiovascular and renal deaths emerged as important COD in later calendar years, with 27% of deaths in 2018 attributable to cardiovascular causes. Most deaths (51%) occurred within the first six months following enrolment. Among 3956 participants enrolled in 2013–2018 (N = 203 deaths, 200 with COD ascertained), tuberculosis persisted as the most common COD (25%), but substantial proportions of deaths from six months after enrolment onwards were attributable to renal (14%), non-AIDS-related infections (13%), other AIDS-related infections (10%) and cardiovascular (10%) causes. Factors associated with higher HIV-related mortality were sex, younger age, living in Ifakara town, HIV status disclosure, hospitalisation, not being underweight, lower CD4 count, advanced WHO stage, and gaps in care. Factors associated with higher non-HIV-related mortality included not having an HIV-positive partner, lower CD4 count, advanced WHO stage, and gaps in care.ConclusionIncidence of HIV-related mortality was higher than that of non-HIV-related mortality, even in more recent years, likely due to late presentation. Tuberculosis was the leading specific COD identified, particularly soon after enrolment, while in later calendar years cardiovascular and renal causes emerged as important, emphasising the need for improved screening and management.

The Paradoxes of PrEP: Rejection, Reluctancy, and Novel Gay Identities in Biomedical HIV Prevention in Serbia

This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men – who have achieved undetectable HIV status through a potent ARV therapy – and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia – "undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone’s HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.

The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China

ABSTRACT Disclosure of HIV status can encourage spouses of people diagnosed with HIV to prioritize HIV prevention. However, few studies have reported the HIV disclosure status of married men who have sex with men (MSM) and their female spouses. The purpose of this study was to describe the prevalence of HIV disclosure, and whether it was associated with spouses’ HIV testing uptake and unprotected vaginal intercourse within marriage for MSM living with HIV (HIV + MSM) in China. A cross-sectional study was conducted in three Chinese cities. Of 309 participants, only 31.1% of men had disclosed their HIV status to spouses. About 80% of participants reported that their spouses had been tested for HIV. A small proportion of men (9.1%) had unprotected sex with their spouse after HIV diagnosis. Multivariate analyses indicated HIV disclosure was positively associated with HIV testing uptake of spouses, but there was no significant association between HIV disclosure and unprotected marital sexual behaviors for HIV + MSM. The findings indicated that HIV disclosure to spouses is uncommon among married HIV + MSM in China, and HIV disclosure is associated with increased uptake of HIV testing among spouses of MSM, but it does not decrease the unprotected sexual behaviors in marriage.

Social support for mothers living with HIV: A pilot investigation of the beneficial roles of positive parenting and community cohesion

Mothers Living with HIV (MLH) are vulnerable to stressors associated with motherhood and chronic illness. Strong familial support is related to decreased risk for developing mental and physical health problems. While support systems of MLH are disproportionately comprised of their children, research on social support of MLH has primarily focused on HIV status disclosure to supportive networks, with limited work exploring other aspects of family social support. The current pilot study explored associations between familial social support and personal (spirituality, depressive symptoms), relational (parenting practices), and environmental (friend support, community cohesion) factors among 55 MLH. A three-step hierarchical regression model was examined and showed that greater positive parenting, less negative parenting, and greater community cohesion were significantly associated with higher familial social support. Findings highlight the importance of relational and environmental determinants of social support and suggest potential avenues for prevention and intervention among MLH.

The effect of pre-exposure prophylaxis (PrEP) on negotiating casual sex between gay men: disclosure, assumptions, and communication.

The disclosure of HIV status and pre-exposure prophylaxis (PrEP) use can be important in the negotiation of safe sex. With the rapid uptake of PrEP in Australia, norms and expectations about discussion and disclosure may have changed. We explored the disclosure of PrEP use, HIV status and communication with sex partners by HIV-negative gay men in Sydney, Australia. We conducted semi-structured interviews from October 2017 to May 2018 and analysed data using a codebook thematic analysis approach. Participants had a variety of expectations of what they should tell their partners and what they expected in return. For some participants, PrEP had negated the need for any discussion about HIV. Many participants assumed their partners would find information about their HIV status or PrEP use on their online profiles or that partners would ask, if necessary. Building a stronger, shared understanding among gay men that disclosure and discussion no longer automatically occur before sexual encounters may be useful.

Infant feeding practices and its associated factors among HIV positive mothers attending public health institutions at Gondar Town, Northwest Ethiopia, 2019: An institutional based cross-sectional study

IntroductionFour out of ten infants born become infected with the human immunodeficiency virus during pregnancy, childbirth and breastfeeding in developing countries. Several factors are responsible for these, including practising mixed feeding that contributes to mother-to-child transmission and is unpreventable. Besides, it can cause diarrhoea, pneumonia and malnutrition, leading to morbidity and mortality. ObjectivesThis study aimed to assessinfant feeding practices and associated factors among human immunodeficiency virus-positive mothers attending public health institutions in Gondar Town. MethodsAn institutional-based cross-sectional study was conducted. A census method was employed. Data were collected by using a structured questionnaire. The data were entered by Epi Info version 7 and analyzed with SPSS version 20. The data were analyzed by using binary logistic regression. Those variables with a P-value of ≤ 0.05 were considered significantly associated with infant feeding practice. ResultThe overall infant feeding practice was 94 % [95CI (91.4–96.3)]. Being in the age category of 18–24 years [AOR = 2.34,95 % CI(1.26–10.56)], rural residence [AOR = 8.08, 95 %CI (2.45–21.62)], having social support [AOR = 1.82, 95 %CI (1.43–6.55)], disclosing HIV status [AOR = 4.67, 95 %CI (1.67–20.88)], having no pregnancy-related problem [AOR = 2.61, 95 %CI(1.23–7.96)] were significantly associated. Conclusion and recommendationIn the current study, recommended infant feedingpracticeswereoptimal. Age, place of residence, social support, disclosure of HIV status, and absence of pregnancy-related problems during pregnancy were significantly associated with outcome variables. Mothers should follow recommended infant feeding practices andpayspecialattentiontourbandwellers.

A cross-sectional study on stigma and discrimination confronted by HIV positive patients in the economic capital of India.

HIV/AIDS is a serious public health, economic and social problem. Stigma is a common human reaction to disease and discrimination follows stigma. Stigma and discrimination act as impediments to uptake of HIV testing, treatment, care and adherence to treatment. The aim of this study was to estimate the prevalence of the stigma and discrimination faced by HIV positive patients receiving antiretroviral therapy (ART). A cross-sectional, observational study conducted at ART center of a tertiary care hospital in an urban area. Participants were selected by simple random sampling among HIV positive patients. A predesigned, pretested and self-administered, semi-structured questionnaire in local language was used to assess stigma and discrimination. The data were entered in Microsoft Excel and analyzed with SPSS version 20 statistical software. Simple proportions, mean, standard deviation, median, range and inter-quartile range were calculated. Of 336 participants, 170 were male, whereas 166 were females. The mean age was 36.42 years. The total mean scores for Berger's HIV stigma scale experienced was 122.82, whereas for individual subscale Personalized stigma, Negative self-image, public attitudes and disclosure of HIV status were 38.31, 27.46, 33.09 and 23.97, respectively. The maximum participants expressed the stigma regarding disclosure concerns (58.63%) followed by negative self-image stigma (43.45%). Stigma hurdles the delivery of effective medical social care. People Living with HIV and AIDS (PLWHA) need to have greater involvement in their care, support and treatment. Support groups of PLWHA need to be established so that stigma and discrimination at various levels can be challenged collectively.

HIV status disclosure among adults attending care and treatment clinic in Kilombero district, South-Eastern Tanzania

BackgroundDisclosing HIV serostatus is important for HIV prevention and in reducing HIV transmission among communities. The present study assessed HIV disclosure patterns and its associated factors among adults in Kilombero district, Tanzania. MethodsA cross-sectional study was conducted among people living with HIV who visited Care and Treatment Clinic in Ifakara Town Council from September 2018-February 2019. A structured questionnaire was used to collect data, and the analysis was done by SPSS Version 20. ResultsA total of 102 participated into this study, 63 (61.8%) females and 39 (38.2%) males. The mean age (±SD) of participants was 34.37 (±10.9) years and people living with HIV were mostly (68%) in age group between 18 and 38. Despite the high rate of HIV disclosure 81 (79.4%) only 58% had disclosed their HIV results to their partners. In addition, most partcipants delayed the disclosure for six months and above. HIV disclosure was significantly higher in married participants than in single individuals (81.8% vs 68.5%; p < 0.001), and in participants aged 39–59 years (p = 0.06). The major reasons for non-disclosure include fear of losing their partners, felt ashamed of being HIV positive and fears of stigma. ConclusionAlthough the disclosure of HIV serostatus among the participants was high, the disclosure to their sex partners was moderate. Moreover, the study observed negative attitudes and delayed disclosure longer than six months. Interventions to promote disclosure of HIV and discouraging stigma and discriminations should be given priority.

Quantitative Study on Individual Representations in Senegalese Patients Living with HIV (PLHIV)

Context: HIV infection is an infectious, viral, chronic disease described as a public health problem. It has an impact on bio-psycho-social well-being. Thus, the objective of our study is to decrypt the representations of HIV infection in our patients. Methodology: 31 consecutively recruited HIV-infected patients participated in our study. The completed questionnaire included socio-demographic characteristics, association membership, psycho-social aspects of HIV infection, mode of transmission and adherence to antiretroviral treatment. Secondly, we proceeded to an assessment of the psychological state of the patient. Results: Almost 77% of HIV patients do not date peers in an association. At the time of the study, more than half of patients or 19/31 with HIV had a positive image of the disease. Before the diagnosis of the disease, more than 2/3 of patients with HIV, i.e. 25/31, have a negative image of the disease. The 31 PLHIV have been aware of their positive HIV status for an average of 11 years with extremes of 2 years and 21 years. Almost 21/31 of PLHIV have shared their positive serological status. The main barrier in patient communication was the risk of disclosure of HIV status. Most of the patients (45.2%) thought of death when they announced their positive HIV status, and 19.4% thought of their children. In 80.6% of cases, relationships with family, friends and neighbors were normal and remained unchanged for 74% of patients. The patients thought they had been infected through sexual intercourse in 84% of cases. Our study showed that 6 of the 31 PLHIV experienced stigma. Among these 6 patients, 3 had psychological repercussions and a voluntary interruption of treatment. Conclusion: The representations are dynamic. In Senegal, the eradication of discrimination among people living with HIV must imperatively involve a reconstruction of individual, collective and social representations.

Implementation of a Psychosocial Support Intervention for Adolescents on Antiretroviral Treatment: Challenges and Experiences from Ehlanzeni District, South Africa.

Adolescents living with HIV (ALHIV) need support from family, peers and health workers to remain on antiretroviral therapy and achieve and sustain viral suppression. This paper qualitatively explores the implementation of a psychosocial support intervention (PSS) in five primary health care facilities in the Ehlanzeni district, South Africa. Data were collected through key informant interviews and focus group discussions with ALHIV on ART. Data analysis employed inductive thematic analysis. Informed consent was obtained prior to all data collection. The PSS intervention facilitated full disclosure of HIV status to adolescents, supported treatment adherence through health education, peer support, health care provider- and client relations, and quick access to health service delivery. However, COVID-19 restrictions and regulations challenged the implementation of the intervention. The PSS intervention showed promise to support adolescent’s adherence and retention in care. We recommend innovative approaches to account for systemic disruptions, as evidenced by the COVID-19 pandemic.

Determinants of non-disclosure to sexual partner among human immune virus infected adults on anti-retroviral therapy follow-up care at North Shewa zone public hospitals in Oromia Region, Ethiopia

BackgroundHIV positive status non-disclosure to sexual partner remains a challenge for HIV prevention and control. It leads to poor adherence to antiretroviral treatment and a high risk of transmission. The purpose of this study was to assess the determinants of HIV-positive status non-disclosure to sexual partner. MethodsAn institutional based case control study was conducted among 378 (94 cases and 284 controls) HIV-infected adults on Follow-Up Care. For data entry and analysis, Epi data version 3.1 and SPSS version 25 was used. To identify factors associated with non-disclosure to sexual partner, bivariable and multivariable logistic regression analyses were performed. ResultA total of 369 study participants were interviewed (92 cases and 277 controls), yielding a response rate of 97.5 %. Male sex (AOR: 0.25, 95 % CI: 0.13–0.47), ART duration < 36 months (AOR: 2.13, 95 % CI: 1.14–4.01), WHO clinical staging one (AOR: 3.00, 95 % CI: 1.26–7.12), having more than one lifetime sexual partners (AOR: 0.46, 95 % CI: 0.22–0.95) and not seeing person publicly disclosed HIV status (AOR: 3.12, 95 % CI: 1.47–6.65) were determinants of non-disclosure to sexual partner. ConclusionMale sex, ART duration of < 36 months, WHO clinical staging one, having more than one lifetime sexual partner, and not seeing person publicly disclosed HIV status were determinantal to sexual partner disclosure. As a result, continuous HIV disclosure counseling is required for females, those in WHO clinical staging one, ART duration < 36 months, and those with only one lifetime sexual partner.

FEARS AND CHALLENGES IN PARENTING WITH HIV STATUS AMONG CONCORDANT COUPLES IN PAKISTAN

HIV is known as one of the most life-threatening illnesses of the contemporary era and 240,000 individuals have been estimated to live with HIV in Pakistan. The current research paper intended to find out the child-bearing and rearing concerns among HIV concordant couples. The present research has inspired a four phase model of HIV by Tasker, 1992. The researcher used a phenomenological design of qualitative research with an in-depth interview technique. We have conducted interviews with 08 HIV concordant couples by using an interview guide. Field data was analyzed through NVIVO 11 and the thematic analysis technique was used to draw the themes from field data. The four key themes of the research paper were discussed in the results and discussion section. The researchers have used only four themes mentioned as, childbearing anxieties among couples, child-rearing and family maintenance, fears for parental disclosure of HIV status to children, stigmatization &amp; discrimination in medical treatment in the health care system. Furthermore, HIV individuals need familial, social, and governmental support to fight against HIV and give HIV-free generation to Pakistan. Keywords: HIV concordant couples, childbearing, child-rearing, family maintenance, fear of disclosure, stigmatization

Mediating Role of Loneliness on Stigma and Depressive Symptoms Among Older Persons Living With HIV

Studies have shown associations among stigma, loneliness, and depressive symptoms in older persons living with HIV (OPLWH) but research assessing the mediating pathway among these variables is lacking. As such, the aims of this study were to assess the association between stigma and depressive symptoms and to test the mediating effects of loneliness. A sample of 146 OPLWH (50 years of age and older) recruited from an outpatient HIV clinic in Atlanta, GA, completed a cross-sectional survey. Mediation analysis, guided by Baron and Kenny’s (1986) criteria, was conducted using Stata v14.2 to assess the direct and indirect effects of loneliness on the association between stigma and depressive symptoms while controlling for covariates (self-rated health [0=poor to fair, 1=good to excellent]; past unstable housing [0=No, 1=Yes]; and HIV disclosure status [0=to none; 1=to someone]). Loneliness mediated the association between stigma and depressive symptoms (β=0.79, SE=0.23, p < .001). The model reflected a very good fit (χ2=0.09, p=.765; CFI=1.00, TLI=1.09, RMSEA < 0.001) and explained 27% of the variance in loneliness and 33% of the variance in depressive symptoms. Stigma predicted higher loneliness, which in turn predicted more depressive symptoms. Findings suggest that addressing depressive symptoms in OPLWH may require multifaceted interventions targeting psychosocial and interpersonal factors including stigma and loneliness.

Does Sexual and Emotional Behavior Differ Between Sexual Partners That Do Not Disclose HIV Status?

Objective: The objective of the study was to analyze whether the disclosure of HIV serological status among sexual partners is associated with differences in sexual affective behavior. Methods: Cross-sectional study was carried out with 173 participants in a specialized assistance service on the treatment of people with the Human Immunodeficiency Virus. Data were collected through interviews. Results: Our results show that from the participants who did not disclose their HIV status and who were sexually active, most had multiple sexual partners (44.6%), used combined methods of prevention (75.4%), had casual partners (63.0%), used condoms (66.2%), and had sexual intercourse while under the influence of alcohol (56.9%). The variables i.e., number of partners (p = 0.010) and type of relationship (p &lt;0.001) showed statistical differences. Conclusion: Sexual affective behavior variables influenced the decision about disclosing HIV seropositivity to sexual partners that establish different forms of sexual partnerships.