Barriers to Disclosure of Hiv Positive Status to Sexual Partner(S) in the Central Region, Ghana.

ABSTRACT

Background: It is estimated that 224,488 persons made up of 189,931 adults and 34,557 children (15%) are living with the Human Immunodeficiency Virus (HIV) in Ghana (Ghana AIDS Commission, 2013). Disclosure to sexual partner (s) is one of the key strategies in HIV prevention as it may promote safer sex practices, prevents new infections to partner (s), reduces the risk of mother-to child transmission, increases social  support  and  reduces  depression.  Studies in Africa on HIV status disclosure have documented varying low rates among countries. People Living with HIV/AIDS (PLWHA) have difficulties in disclosing their HIV status to others for fear of negative consequences.  HIV status disclosure has far reaching implications on the future course of the disease. In Ghana there is limited data on HIV status disclosure and the barriers to HIV status disclosure among sexual partners remain unclear.  Objective: To determine the prevalence of and barriers to HIV status disclosure to a regular sexual partner among HIV positive clients attending Antiretroviral Clinics in the Central Region.  Materials and Methods: This was a cross- sectional study. A structured, pre-tested questionnaire was administered to consenting HIV positive adults in 7 randomly selected treatment sites. Frequencies, proportions and Odds Ratios were calculated with STATA SE 13.  Results: A total of 461 HIV positive clients were recruited. Most (65.5%, n=302) respondents were females. The mean age of the respondents was 33.9 (±7.4) years. Most respondents were aged between 20-35 (35.6%, n=164,) years. The overall prevalence of disclosure to a sexual partner was 41.2 %( n=190).The prevalence and odds of disclosure were greater in males (44%, n=70). The main determinants of HIV status disclosure include age 20-35 (AOR: 5.49; 95% CI,1.87-16.14), knowing a partner’s status (AOR: 6.89; 95%CI, 2.81-16.88), knowing the relevance of disclosure (AOR: 227.0; 95% CI, 46.13-1116.9), and having a treatment adherence monitor (AOR: 17.25; 95% CI, 6.30-47.21). Fear of a negative outcome of disclosure such as divorce or blame were major barriers to disclosure. Conclusion: The rate of HIV positive status disclosure among sexual partners in the seven (7) study sites in the Central Region of Ghana is 41.2%. Recommendation: Special emphasis should be placed on disclosure counselling after receiving HIV positive result. This should be an effective, on-going practice which should result in behavioural change towards disclosure. Also advocacy needs to be scaled up to increase condom use.