Abstract
HIV/AIDS remains a global public health problem. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome” has become one of the world’s most serious health and development challenges. A critical element of reducing HIV transmission risk is disclosure of HIV sero status by HIV positive individuals. Disclosure is recommended during post-test counseling since it supports risk reduction behaviours and facilitates access to prevention, care and treatment services for people living with HIV/AIDS (PLWHA), their partner(s) or infant(s).6
This study aimed to determine preferred audience of HIV status disclosure among HIV positive individuals, compare preferred audience of HIV status disclosure among HIV positive individuals and to assess and compare reasons for HIV status disclosure to preferred audience among HIV positive individuals in urban and rural areas of Cross River State.
Material and Method: The study was cross-sectional descriptive among 160 HIV positive individuals each from urban and rural areas of Cross River State selected by multi-stage sampling technique. A pre-tested interviewer-administered questionnaire was used to collect information on sociodemographic, HIV status disclosure and audience of disclosure.
Results: The highest number of married/cohabiting respondents reported they disclosed to their spouse (31.1%. This was higher in the urban compared with rural (36.2% versus 25.0%). This was followed by disclosure to biological relative also higher in urban than rural (31.3% versus 23.6%). More respondents reported disclosure to their mother in rural than urban (12.5% versus 7.7%). Audience of disclosure to whom the least number of respondents disclosed their HIV status to in both study area was work colleague (2.0%) by urban and (0.5%) by rural respondents. Reasons for HIV status disclosure in the urban area were to get encouragement, advice or to encourage others, to help their spouse/sex partner go for test. Among the rural respondents, the highest reason reported was to enable them take their HAART freely.
References
- Joint United Nations Programme on HIV/AIDS (UNAIDS). 2014 Epidemiological slides-GAP Report; 2014. Accessed December 24th 2014 from kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic.
- Bunnell R, Ekwaru JP, Solberg P, Wamai N, Bikaako-Kajura W. Changes in sexual behaviour and risk of HIV transmission after antiretroviral therapy and prevention intervention in rural Uganda. AIDS. 2006;20(1):85–92.
- Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20(10):1447–50.
- Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005;16(6):33–47.
- Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A. Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Transm Infect. 2007;83(1):29–34.
- Kalichman SC, Nachimson N. Self-efficacy and disclosure of HIV-positive serostatus to sex partners. Health Psycho. 1999;18:281–7.
- Ciccarone DH, Kanouse DE, Collins RL, Miu A, Chen JL, Morton SC. Sex without disclosure of positive HIV serostatus in a US probability sample of persons receiving medical care for HIV infection. Am J Public Health. 93(6):949–54.
- Derlega VJ, Winstead BA, Oldfield IE, Barbee AP. Close relationships and social support in coping with HIV: a test of sensitive interaction systems theory. AIDS Behav. 2003;7(2):119–29.
- Zea MC, Reisen CA, Poppen PJ, Diaz RM. Asking and telling: communication about HIV status among Latino HIV-positive gay men. AIDS Behav. 2003;7(2):143–52.
- Holt R, Court P, Vedhara K, Nott KH, Holmes J, Snow MH. The role of disclosure in coping with HIV infection. AIDS Care. 1998;10(1):49–60.
- Kalichman SC, DiMarco M, Austin J, Luke W, Difonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32.
- Medley A, Garcia-Moreno C, McGill S, Maman S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bull World Health Organ. 2004;82(4):299–307.
- Serovich JM. A test of two HIV disclosure theories. AIDS Education and Prevention. 2001;13(4):355–64.
- Opening up the HIV/AIDS epidemic. Guidance on encouraging beneficial disclosure, ethical partner counselling and appropriate use of HIV case-reporting. Geneva Switzerland; 2000:8-10.
- Almeida NA. Prevalence and factors affecting HIV status disclosure among pregnant women receiving PMTCT services in Dares Salaam. 2005:13-4.
- Vyavaharkar M, Moneyham L, Corwin S, Tavakoli A, Saunders R, Annang L.. HIV disclosure, Social support and Depression among HIV infected African American Women Living in the Rural Southeastern United States. AIDS Education and Prevention. 2011;23 (1):78–90.
- Counselling and HIV/AIDS. UNAIDS best practices collection. Geneva; 1997:3-4.
- Centre for Diseases Control and Prevention. Revised guidelines for HIV counselling, testing and referral. Morbidity and Mortality weekly report. 2002;50:1–57.
- Kadowa I, Nuwaha F. Factors influencing disclosure of HIV positive status in Mityana district of Uganda. African Health Sciences. 2009;9(1):9(1):26-33.
- Mohammed H, Kissinger P. Disclosure of HIV serostatus to sex partners in rural Louisiana. AIDS Care. 2006;18 Suppl 1:62–9.
- Ogundahunsi OA, Daniel OJ, Oladapo OT. Adherence to antiretroviral drugs among AIDS patients in Sagamu, Nigeria. International Journal of Biomedical and Health Sciences. 2008;(2):4-9.
- Derlega VJ, Metts S, Petronio S, Margulis ST. Self-disclosure. Newbury Park. CA: Sage. 1993:152-8.
- Makin JD, Forsyth BW, Visser MJ, Sikkema KJ, Neufeld S, Jeffery B. Factors Affecting Disclosure in South African HIV-Positive Pregnant Women. AIDS Patient Care and STDs. 2008;22(11):907–16.
- Lugalla J, Yoder S, Sigalla H, Madihi C. Social context of disclosing HIV test results in Tanzania. Culture, Health and Sexuality. 2011;19:32-9.
- Deribe K, Woldemichael K, Njau BJ, Yakob B, Biadgilign S, Amberbir A. Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users. Journal of Social Aspects of HIV/AIDS. 2010;7(1):30–9.
- Adejumo A. The influence of psychosocial factors and the effectiveness of behavioural techniques on HIV sexual risk behaviour among adolescents in Ibadan, Nigeria. IFE PsychologIA. 2004:211–31.
- National Agency for the Control of AIDS (NACA), Federal Republic of Nigeria. GLOBAL AIDS RESPONSE. Country Progress Report Nigeria. 2014. Accessed 24th December 2014 from unaids.org/en/dataanalysis.
- Mucheto P, Chadambuka A, Shambira G, Tshimanga M, Gombe N, Nyamayaro W. Determinants of nondisclosure of HIV status among women attending the prevention of mother to child transmission programme, Makonde district, Zimbabwe. Pan Afr Med J. 2011;8:51-59.
- Suzanne M, Amy M. Gender Dimensions of HIV Status Disclosure to Sexual Partners: Rates, Barriers and Outcomes. WHO review paper, 2004: 5-8. Accessed August 2nd 2014 from htt://www.who.int/gender/documents/en/
- Grey RH, Kiwanuka N, Quinn TC, Sewankambo NK, Serwadda D, Wabwire-Mangen F. Male circumcision and HIV acquisition and transmission: Cohort studies in Rakai, Uganda. AIDS. 2001; 14(15): 2371-81.
- Wong LH, Rooyen HV, Modiba P, Richter L, Gray G, Paeds Fl. Test and Tell: Correlates and Consequences of Testing and Disclosure of HIV Status in South Africa (HPTN 043 Project Accept). Journal of Acquired Immune Deficiency Syndrome. 2009;50(2):215–22.
- Patel R, Ratner J, Gore-Felton C, Kadzirange G, Woelk G, Katzenstein D. HIV disclosure patterns, predictors, and psychosocial correlates among HIV positive women in Zimbabwe. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV. 2012;24 (3):358–68.
- Salami AK, Fadeyi A, Ogunmodede JA, Desalu OO. Status disclosure among people living with HIV/AIDS in Ilorin, Nigeria. West Afr J Med. 2011; 30(5):359-63.
- Amoran OE. Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in Ogun State, Nigeria. Niger J Clin Pract. 2012;15(4):385–90.
- Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005; 16(6):33-47.
- Akani CI, Erhabor O. Rate, pattern and barriers of HIV serostatus disclosure in a resource-limited setting in the Niger Delta of Nigeria. Tropical Doctor. 2006;36 (2):87–9.
- Mayfield AE, Rice E, Rotheram-Borus BM. HIV disclosure among adult living with HIV.AIDS care. 2008;20:20(1):80–92.
- Parker RG, Parrott R. Patterns of self-disclosure across social support networks: elderly, middle-aged and young adults. Int J Aging Hum Dev. 1995;41 (4):281–97.
- Kangwende RA, Chirenda J, Mudyiradima RF. HIV status disclosure among people living with HIV/AIDS at FASO, Mutare, Zimbabwe. Cent Afr J Med. 2009;55(1-4):1–7.
- Ssali SN, Atuyambe L, Tumwine C , Segujja E, Nekesa N, Nannungi . Reasons for disclosure of HIV status by people livimg with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care STDS. 2010;24(10):675–81.
- Olagbuji BN, Ezeanochie MC, Agholor KN, Olagbuji YW, Ande AB, Okonofua FE. Spousal disclosure of HIV serostatus among women attending antenatal care in urban Nigeria. J Obstet Gynaecol. 2011;31(6):486–8.
- Gari T, Habte D, Markos E. HIV positive status disclosure among women attending ART clinic at Hawassa University Referral Hospital, South Ethiopia. East Afr J Public Health. 2010;7(1):87–91.
- Sullivan K, Voss J,Li D. Female disclosure of HIV-positive serostatus to sex partners: a two-city study. Women Health. 2010;50(6):506–26.
- Deribe K, Woldemichael K, Njau BJ, Yakob B, Biadgilign S, Amberbir A. Gender differences regarding barriers and motivators of HIV status disclosure among HIV-positive service users. Journal of Social Aspects of HIV/AIDS. 2010;7(1):30–9.
- Kairania R, Gray R, Kiwanuka N, Makumbi F, Sewankambo N. Disclosure of HIV results among discordant couples in Rakai, Uganda: A facilitated couple counseling approach. AIDS Care. 2010;22(9):1041–51.
- Tadese AE, Benihun M, Mamo W. Predictors of HIV status disclosure to sexual partners among people living with HIV/AIDS in Ethiopia.
- Issiaka S, Cartoux M, KY-Zebro O, Tiendrebeogo S, Meda N. Living with HIV: women’s experience in Burkina Faso, West Africa. AIDS Care. 2001;13:123–8.
- Ezegwui HU, Nwogu-Ikojo EE, Enwereji JO, Dim CC. HIV serostatus disclosure pattern among pregnant women in Enugu, Nigeria. J Biosos Sci. 2009;41(6):789-98.
- Anglewicz P, chintsanya J. Disclosure of HIV status between spouses in rural Malawi. AIDS Care. 2011;23(8):998–1005.
- Bouillon K, Lert F, Sitta R, Schmaus A, Spire B, Dray-Spira R. Factors correlated with disclosure of HIV infection in the French: Antilles and French Guiana: results from the ANRS-EN13-VESP-ADFA Study. AIDS. 2007;21(1):89–94.
- Ndiaye C, Boileau C, Zunzunegui MV, Koala S, Aboubacrine SA, Niamba P. Gender-related factors influencing HIV serostatus disclosure in patients receiving HAART in West Africa. World Health Popul. 2008;10(3):43–54.
- Titilope AA, Adediran A, Umeh C, Akinbami A, Unigwe O, Akanmu AS. Psychosocial Impact of disclosure of HIV Serostatus in heterosexual relationship at the Lagos University teaching Hospital, Nigeria. Niger Med J. 2011;52:55–9.
- Daniel OJ, Oladapo OT. Self-disclosure of HIV sero-status to sexual partner in Nigeria. Sexual Health Matters. 2004; 40:30-35.
- Shacham E, Small E, Onen N, Stamm K, Overton ET. Serostatus disclosure among adults with HIV in the era of HIV therapy. AIDS Patient Care STDS. 2012; 26(1):29-35.
- King R, Katuntu D, Lifshay J, Packel L, Batamwita R, Nakayiwa S. Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda. AIDS Behav. 2008;12(2):232-43.
- Miller AN, Rubin DL. Motivations and methods for self-disclosure of HIV seropositivity in Nairobi, Kenya. Journal of AIDS Behav. 2007;11(5):687-97.
- National Population Commission (NPC). NATIONAL CENSUS Nigeria2006.
- Kirkwood BR, Steane JAC. Calculation of required sample size. In Essential medical statistics. 2nd Editio. Oxford Blackwell publishing company; 2006: 413–28.
- Amy NM, Chopra SK. Factors related to HIV disclosure in 2 South African Communities. AmJ Public Health. 2007;97(10):1775–81.
- Antelman G, Smith Fawzi MC, Kaaya S, Mbwambo J, Msamanga GI, Hunter Predictors of HIV-1 serostatus disclosure: a prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania. AIDS. 2001;15(14):1865-1874.
- Erah P, Arute J. Adherence of HIV/AIDS patients to antiretroviral therapy in a tertiary health facility in Benin City. African Journal of Pharmacy and Pharmacology. 2008;2(7):145-52.
- Agu KA, Okojie O, Oqua D, King RC, Omonaiye O, Onuoha C, et al. Medication Adherence and Risk factors for Non-adherence among Patients taking Highly Active Antiretroviral Therapy West African Journal of Pharmacy 2011;22(1):19 - 26.
- Da Silveira V, Drachler Mde L, Leite J, Pinheiro C. Characteristics of HIV antiretroviral regimen and treatment adherence. Brazilian Journal of Infectious Disease. 2003;7(3):194-201.
- Iliyasu I, Kabir M, Abubakar I, Babashani M, Zubair Z. Complianceto antiretroviral therapy among AIDS patients in Amino Kano Teaching Hospital, Kano, Nigeria. Nigerian Journal of 2005;14 (3):290-4.
- Cauldbeck MB, O'Connor C, O'Connor MB, Saunders JA, Rao B, Mallesh VG, et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Research and Therapy 2009;6(7):1-8.
- Mansergh G, Marks G, Simoni JM. Self-disclosure of HIV infection among men who vary in time since seropositive diagnosis and symptomatic status. AIDS. 1995;9(6):639-644.
- Skogmar S, Shakely D, Lans M, Dannell JK, Andersson R, Tshandu N. Effect of antiretroviral treatment and counseling on disclosure of HIV serostatus in Johannesburg, South Africa. AIDS Care. 2006;18(17):725-730.
Corresponding Author
Iwasam Elemi Agbor
Senior Consultant, Department of Community Medicine, Faculty of Medicine and Dentistry, University of Calabar, Calabar, Cross River State, Nigeria
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.107
