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

financial consequences (Issiaka et al., 2001). In a qualitative study conducted by
Sigxaxhe and Mathews (2000) among 28 pregnant women in South Africa, the barriers
women cited were fear of rejection, fear of discrimination, fear of verbal abuse and
concerns about public ignorance of the disease. Notably, a study in Tanzania on
women’s barriers to HIV testing and disclosure found that HIV positive results, fear for
partner’s reaction and whether there had been discussion prior to the test influenced the
decision to disclose to the partner (Maman et al., 2001).
A woman’s disclosure of her HIV infection to a sexual partner may trigger violent
results. Fear of violence can have strong impact on the decision to disclose particularly
amongst HIV positive women in relation to their male sexual or drug injecting partners
(Gien, Campo, Faden & Eke, 1997). The same study found that one fourth of women in
the study had experienced negative consequences of disclosure that included rejection,
abandonment and verbal and physical abuse. Studies by Temmerman, Ndinya-Achola,
Ambani and Piot (1995) and Gien et al. (1997) found that a significant proportion of
women had negative experiences of disclosure that included physical violence. Research
in Tanzania found that one woman in five who disclosed her HIV status to her partner
was abandoned (Simoni et al. (1995). In contrast, men in Tanzania reported being little
concerned with anticipating their wives’ responses to news of their HIV status (Maman et
al., 2001).
Gender and power Relations
The women’s gender positioning and economic status in society, particularly in the home,
limits their negotiating power in decisions related to having safe sex, condom use and
accessing healthcare ( Hausermann & Danziger, 1991). Women’s dependence on men,
their inability to make certain decisions and the effects of social and cultural factors on
them, increase their risk and vulnerability to HIV exposure and at the same time limiting
their chances for seeking health services. The social-cultural and economic determinants
of women’s HIV infections greatly differ from those of men because of the central
positions and roles of men in relationships and families (WHO, 2003). While disclosure
for the men was not troublesome, the women in the study in Tanzania (Maman et al.,
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