HIV-positive status disclosure in patients in care in rural South Africa: implications for scaling up treatment and prevention interventions
Abdool Karim, Q.; Dellar, R.C.; Bearnot, B.; Werner, L.; Frohlich, J.A.; Kharsany, A.B.M.; Abdool Karim, S.S.
Aids and Behavior 19(2): 322-329
2015
ISSN/ISBN: 1090-7165 PMID: 25677128 DOI: 10.1007/s10461-014-0951-4Document Number: 625786
A nuanced understanding of HIV-positive status disclosure is urgently needed to inform the implementation of prevention interventions, including TasP and PrEP. To provide such understanding for the high HIV-burden setting of rural KwaZulu-Natal, we conducted a prospective cohort study to characterize determinants and trends in HIV-positive status disclosure. 687 consenting HIV-positive individuals (73.2 % female; 60.3 % ART initiated) were enrolled. Reports of any incidence of disclosure to either a family member or sexual partner at enrollment and follow-up visits (median 4.4 months post-enrolment) were common (91.0 %); however, reports of disclosure specifically to sexual partners were relatively rare (34.1 %), especially in women (29.8 %). Participants not engaged in a stable partnerships, not ART-imitated, and/or who had disclosed to their family were at risk of non-disclosure to sexual partners. These data highlight both an urgent need to empower HIV-positive individuals, and the significant barriers to targeting sero-discordant couples for HIV prevention in this setting.
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