Factors Associated with HIV Status Disclosure among Individuals in a Sero-Discordant Relationship at the Defence Forces Memorial Hospital in Nairobi, Kenya

Abstract

The Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome stigma is a great public health concern in Sub-Saharan Africa (SSA) where majority of the infections and deaths occur. Human Immunodeficiency Virus status disclosure is likely to improve HIV testing uptake, increase HIV care enrollment, treatment and support services, and reduce stigma and psycho-socio-economic challenges. The study objective was to determine the factors associated with HIV status disclosure among individuals in a HIV sero-discordant relationship at Defence Forces Memorial Hospital (DFMH). A descriptive cross-sectional study was conducted at DFMH-Nairobi. A semi-structured researcher-administered questionnaire was used to collect quantitative data while Focus Group Discussion (FGD) guide was used to collect qualitative data. The data was entered in Microsoft Access and exported to Statistical Package for Social Sciences (SPSS) and results analyzed using SPSS 21.0. Binary logistic regression analysis was used to measure the association between independent variables on HIV status disclosure. Level of significance was fixed at 0.05 (p=0.05) with a 95% confidence interval. Majority (55.2%) of the 315 study participants were male with more than half (63.8%) being above 40 years while the rest (36.2%) were below 40 years old. Adjusting for other factors, there was a significant association between sex of the participant and HIV status disclosure. Females were 4.55 [95% CI: 1.92 - 10.33, p<0.001] times more likely to disclose their status compared to their male counterparts. Participants with high HIV transmission knowledge were 4.19[95% CI: 1.65 - 8.16, p<0.001] times more likely to disclose their HIV status compared to those with low HIV transmission knowledge. Participants with high HIV prevention knowledge were 7.10[95% CI: 2.79 - 12.47, p=0.014] times more likely to disclose their HIV status compared to those with low HIV prevention knowledge. Participants who used a condom regularly during sexual intercourse were 4.09[95% CI: 1.52 - 7.25, p=0.002] times more likely to disclose their HIV status compared to those who didn’t use a condom with their partners. This study concludes that factors associated with HIV status disclosure among sero-discordant individuals included age, sex, region of duty station and period of stay in a station, HIV prevention and transmission knowledge, risky sexual practices to include condom use and alcohol abuse. Human Immunodeficiency Virus status disclosure is a key intervention that would minimize the transmission of the virus in turn reducing the incidence and prevalence of HIV. The study recommends that healthcare workers increase HIV prevention interventions with emphasis on age, sex, region of duty station and period of stay in a station in addition to increasing awareness on the need for consistent and correct condom use and avoidance of sexual intercourse with multiple partners.