Akani C I, Erhabor O
Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, P.M.B. 6173 Port Harcourt, Nigeria.
Trop Doct. 2006 Apr;36(2):87-9. doi: 10.1258/004947506776593378.
The disclosure of HIV serostatus is a difficult emotional task creating opportunity for both support and rejection. In this study, we evaluated the rate, patterns and barriers to HIV serostatus disclosure. A pre-tested interviewer-administered questionnaire from 187 HIV infected people residing in a resource-limited setting in the Niger Delta of Nigeria was analysed. Of the 187 HIV seropositive patients studied, 144 (77.0%) had disclosed their HIV-serostatus while 43 (23.0%) had not. Results showed that the patients had disclosed their HIV-serostatus to: parents (22.3%), siblings (9.7%), pastors (27.8%), friends (6.3%), family members (10.4%) and sexual partners (23.6%) (P = 0.004). Females were more likely (59.7%) to disclose their HIV serostatus compared with males (40.3%) (P = 0.003). Mothers were twice as likely (65.6%) to be confided in compared with fathers. Barriers to HIV serostatus disclosure included fear of stigmatization, victimization, fear of confidants spreading the news of their serostatus and fear of accusation of infidelity and abandonment (P = 0.002). Married respondents were more likely to disclose their status. Better-educated respondents with tertiary education were more likely to disclose their HIV-serostatus. Expectation of economic, spiritual, emotional and social support was the major reason for disclosure. The ratio of disclosure to non-disclosure among patients with non-formal education was (2.6:1.0), primary education (2.3:1.0), secondary education (3.3:1.0) and tertiary education (10.0:1.0). Disclosure of HIV serostatus can foster economic social and economic support. There is need for the re-intensification of interventional measure that combines provider, patients and community education particularly in the aspect of anti-stigma campaign, partner notification and skill building to facilitate appropriate HIV serostatus disclosure.
披露艾滋病毒血清学状态是一项艰巨的情感任务，既带来了获得支持的机会，也存在被拒绝的可能。在本研究中，我们评估了艾滋病毒血清学状态披露的比率、模式及障碍。对来自尼日利亚尼日尔三角洲资源有限地区的187名艾滋病毒感染者进行了预先测试、由访谈员实施的问卷调查分析。在187名接受研究的艾滋病毒血清阳性患者中，144人（77.0%）披露了其艾滋病毒血清学状态，43人（23.0%）未披露。结果显示，患者向以下对象披露了其艾滋病毒血清学状态：父母（22.3%）、兄弟姐妹（9.7%）、牧师（27.8%）、朋友（6.3%）、家庭成员（10.4%）和性伴侣（23.6%）（P = 0.004）。与男性（40.3%）相比，女性更有可能（59.7%）披露其艾滋病毒血清学状态（P = 0.003）。与父亲相比，母亲被倾诉的可能性高出一倍（65.6%）。艾滋病毒血清学状态披露的障碍包括害怕被污名化、受伤害、担心知己传播其血清学状态的消息以及害怕被指责不忠和被抛弃（P = 0.002）。已婚受访者更有可能披露其状态。受过高等教育的受访者更有可能披露其艾滋病毒血清学状态。期望获得经济、精神、情感和社会支持是披露的主要原因。未受过正规教育的患者中披露与未披露的比例为（2.6:1.0），小学教育程度者为（2.3:1.0），中学教育程度者为（3.3:1.0），高等教育程度者为（10.0:1.0）。披露艾滋病毒血清学状态可促进经济社会和经济支持。有必要重新加强结合医疗服务提供者、患者和社区教育的干预措施，特别是在反污名运动、性伴侣通知和技能培养方面，以促进适当的艾滋病毒血清学状态披露。
