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

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Abstract<br />

The increased number <strong>of</strong> new infections in Uganda necessitates HIV prevention<br />

programmes that address risky behaviours especially <strong>among</strong> hetero<strong>sexual</strong> populations.<br />

The AIDS Support Organisation (TASO) is the largest indigenous HIV/AIDS agency<br />

serving Uganda and the Great Lakes Region. TASO endeavours <strong>to</strong> empower <strong>sexual</strong>ly<br />

active clients <strong>to</strong> disclose their sero-<strong>status</strong> <strong>to</strong> their <strong>sexual</strong> <strong>partners</strong> and promotes partner<br />

testing for HIV. In spite <strong>of</strong> these efforts, only 12% <strong>of</strong> 2,071 <strong>sexual</strong>ly active clients in<br />

Mulago centre had disclosed by the end <strong>of</strong> 2006.<br />

This study aimed <strong>to</strong> explore the fac<strong>to</strong>rs that influence clients’ decisions <strong>to</strong> disclose their<br />

HIV <strong>status</strong> <strong>to</strong> their <strong>partners</strong> in TASO Mulago, Kampala, Uganda.<br />

The study used a qualitative approach. Fourteen (14) in-depth interviews were conducted<br />

with English and Luganda speaking adult male and female clients on antiretroviral<br />

treatment (ART), in TASO Mulago. A focus group discussion (FGD) was conducted<br />

with 8 purposively selected ART clients <strong>who</strong> were considered <strong>to</strong> be ‘expert’ clients in<br />

TASO Mulago. These participants were expert clients/ peer educa<strong>to</strong>rs, <strong>who</strong> were open<br />

about their HIV <strong>status</strong> and have been involved in HIV/AIDS education and advocacy.<br />

The individual interviews and the focus group discussion were transcribed verbatim, and<br />

subjected <strong>to</strong> thematic and content analysis.<br />

Male and female participants <strong>who</strong> were married (primary relationship) disclosed their<br />

sero-<strong>status</strong> <strong>to</strong> their <strong>sexual</strong> <strong>partners</strong>, while few <strong>of</strong> those cohabiting or in steady relationship<br />

(only one) disclosed <strong>to</strong> their <strong>partners</strong>. Enabling fac<strong>to</strong>rs <strong>to</strong> disclose <strong>to</strong> current <strong>sexual</strong><br />

<strong>partners</strong> included: desire for partner <strong>to</strong> get treatment, need for the partner’s support,<br />

having prior knowledge <strong>of</strong> partner’s HIV <strong>status</strong>, out <strong>of</strong> anger, and having anxiety about<br />

the future. Some <strong>of</strong> the barriers <strong>to</strong> disclosure included: fear <strong>of</strong> blame and disappointing<br />

the partner, fear <strong>of</strong> abandonment, fear <strong>of</strong> stigma and discrimination.<br />

Participants suggested that couple counselling and testing, economic independence, peer<br />

support and involvement <strong>of</strong> the TASO staff in disclosure should be considered <strong>to</strong><br />

facilitate or promote disclosure <strong>to</strong> <strong>sexual</strong> <strong>partners</strong>.<br />

iv

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