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-socioeconomic 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.