Disclosure of Hiv status to sexual partners among people who ...

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whom they knew is HIV positive than to an HIV negative or partner with unknown sero- status. Simoni & Pantalone (2004) further suggest that HIV infected individuals are more likely to disclose and even have unsafe sex with a partner who they know is HIV positive because they feel less risk of rejection and less threat to the partner’s health. Duration of relationship and type of partner A prospective study conducted among pregnant women in Tanzania revealed that women who had been in a relationship longer (approximately 2 years) were more likely to disclose than those in a relationship of shorter duration (Antelman, Smith, Kaaya, Mbwambo, Msamanga, Hunter & Fawzi, 2001). Furthermore, other studies found that younger women (below 24 years), women of lower social economic status, women who had been in relationships for a longer period of time were more likely to disclose to their sexual partners (Galliard, Meilis, Mwanyumba, Claeys, Mwigai, Mandalay & Simoni, 2002). Disclosure also varies with type of partner; whether primary or casual sexual partners. Studies have observed that primary partners are more likely to disclose to their partners compared to casual partners (Green, 1994; Niccolai, Dorst, Myers & Kissinger, 1999). Consistent with earlier findings, a cross-sectional study measuring disclosure to sex partners found that disclosure occurred more frequently in primary heterosexual relationships than the casual partnerships (Niccolai, King, D’entremont & Pritchett, 2005). Notably, an inverse relationship between the number of partners one has and the likelihood of disclosure has been observed (Marks, Richardson & Maldonaldo, 1991). Moreover a qualitative study among methamphetamine dependent gay men revealed that HIV positive individuals reported that they felt a greater sense of responsibility to disclose to primary partners than casual (Larkins, Shoptaw & Veniegas, 2005). The above studies suggest that disclosure varies with type of partner and duration of relationship. 17
Length of time after testing Women who knew their results for more than one year were more likely to disclose than those who had known for less than one year (Kassaye, Lingerh & Dejens, 2005). A study in Tanzania found that disclosure to sexual partners increased from 22% within two months of diagnosis to 41% after nearly four years (Antelman et al., 2001). The study in Ethiopia (Deribe et al., 2008) also found that although about 73% of the women disclosed their HIV status to their partners on the day they received their results, others took as long as two years before they disclosed. In another study, Mansergh, Marks and Simoni (1995) observed that there is a positive correlation between the length of time since diagnosis and the likelihood of disclosure. These studies show that the number of people who disclose increases with time. Clinical stage of the disease Individuals in an early WHO clinical stage were less likely to disclose to a partner compared to those in advanced state of the disease (Deribe, et al., 2008). Parsons, et al, (2004) also found that individuals who had been living with HIV for longer periods of time and those with increased symptoms were more likely to disclose their HIV status. Deribe et al. (2008), Hays et al. (1993) and Marks et al. (1992) argued that delaying disclosure might be because individuals find that they require emotional or social support from family as the disease progresses or it might be that concealing their illness at a late stage becomes difficult. This implies that disclosure of one’s HIV status as a result of deteriorating health especially to sexual partners could be detrimental to HIV prevention. Level of Education Findings from a cross-sectional study among women living with HIV in South West Ethiopia (Kassaye, Lingerh & Dejens, 2005) showed that illiterate women were more likely to disclose their test results to sexual partners than educated women. However, this factor seems to vary depending on the context. A study in Burkina Faso found that women with higher education are more likely to disclose their HIV test result to their sexual partner than women who are illiterate (Issiaka, Cartoux, Ky-Zerbo, Tiendrebeogo, Meda, Dabis & Van de Perre, 2001). 18
Page 1 and 2: DISCLOSURE OF HIV STATUS TO SEXUAL
Page 3 and 4: ABBREVIATIONS AND ACRONYMS AIDS - A
Page 5 and 6: While strategies like HBHCT and cou
Page 7 and 8: ACKNOWLEDGEMENTS I am grateful to t
Page 9 and 10: 4.5.2 Fear of abandonment .........
Page 11 and 12: partners, behavioural dis-inhibitio
Page 13 and 14: engage in preventive behaviours as
Page 15 and 16: opportunistic infections and ART, i
Page 17 and 18: Mulago centre had registered 270 di
Page 19 and 20: 1.6 Problem Statement With the evid
Page 21 and 22: 2.2 Benefits of HIV Status Disclosu
Page 23 and 24: approaches including suggesting tha
Page 25: that people selectively disclose in
Page 29 and 30: clients who are on antiretroviral t
Page 31 and 32: Stigma and discrimination The stigm
Page 33 and 34: 2001) had fear of the partners’re
Page 35 and 36: gender based violence as well as du
Page 37 and 38: & Ezzy, 2005). This was relevant fo
Page 39 and 40: the personal experiences but also g
Page 41 and 42: participants was raised to the grou
Page 43 and 44: methods besides the data recorded,
Page 45 and 46: CHAPTER 4: RESULTS 4.1 Description
Page 47 and 48: The other common reason for taking
Page 49 and 50: Although most of the participants w
Page 51 and 52: 4.3.2 Timing of disclosure Disclosu
Page 53 and 54: I thought he would probably blame m
Page 55 and 56: 4.4.1. Desire for partner to get tr
Page 57 and 58: In the FGD a female participant who
Page 59 and 60: Some men particularly are afraid to
Page 61 and 62: Some male participants commented th
Page 63 and 64: so that she too could come and they
Page 65 and 66: [Female, 36 years, has a steady par
Page 67 and 68: [Female, 42 years, married] Even th
Page 69 and 70: consequences of disclosure among se
Page 71 and 72: esults (Maman et al., 2003; Kassaye
Page 73 and 74: fear of stigma and discrimination.
Page 75 and 76: them and emulate the good examples.
Page 77 and 78:
• Couples should be encouraged to
Page 79 and 80:
Brou, H., Djohan, G., Becquet, R. A
Page 81 and 82:
Greene, K., Derlega, V. J., Yep, G.
Page 83 and 84:
Kitzinger, J. (1994). The Methodolo
Page 85 and 86:
Mugenyi, K., Kabasinguzi, R., & Ali
Page 87 and 88:
Prevention with Positives Committee
Page 89 and 90:
Annual Report, 2007. Kampala, Ugand
Page 91 and 92:
choose not to. The research is tryi
Page 93 and 94:
Appendix 2 UNIVERSITY OF THE WESTER
Page 95 and 96:
A3. Date of interview: ____________
Page 97 and 98:
A2. Interviewee Identification Numb
Page 99:
The counsellors at the different TA
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