The University of Sydney Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Myungsung Medical College, Addis Ababa, Ethiopia.
PLoS One. 2019 Feb 15;14(2):e0211967. doi: 10.1371/journal.pone.0211967. eCollection 2019.
Disclosure of HIV status to sexual partners can help HIV prevention efforts and enable HIV positive people to receive social support, as well as increasing access and adherence to treatment. This study was conducted to determine the rate, processes, outcomes, and correlates of HIV status disclosure to sexual partners among HIV positive individuals.
A cross-sectional study was conducted between September and November 2015 at two HIV outpatient clinics in Addis Ababa, Ethiopia. Data were collected using an interviewer- administered semi-structured questionnaire. Logistic analysis was used to determine the independent correlates of serostatus disclosure.
Of 742 participants, (371 men and 371 women), 727 (98%) were on antiretroviral therapy and 676 (91.1%) had at least one sexual partner since their HIV diagnosis, of whom 558 (82.5%) had disclosed their HIV status to their most recent sexual partner. Of those who reported having disclosed their status to their most recent sexual partner, 82 (14.7%) had at least one unprotected sexual encounter with the partner, after HIV diagnosis but prior to disclosure. The most commonly reported initial outcome of disclosure was gaining emotional and/or financial support. Some (11.3%) also reported that their disclosure immediately initiated their partner for HIV testing. Negative outcomes to disclosure, such as stigma and discrimination, were more common among females (26.2%) compared to males (12.7%). In the multiple regression analysis, disclosure was associated with greater condom use, greater social support, knowing the partner's HIV status, having a good relationship with the partner, and cohabiting with the partner.
HIV disclosure was common amongst participants, although sometimes delayed, with possible consequences for onward transmission. Fear of negative outcomes, such as verbal abuse and physical violence, were major barriers to disclosure. Efforts to support disclosure have the potential to contribute to HIV control and prevention by encouraging safer sexual practice, initiating partners for HIV testing, and enhancing support for people living with HIV.
向性伴侣披露 HIV 状况有助于 HIV 预防工作，并使 HIV 阳性者获得社会支持，同时增加获得和坚持治疗的机会。本研究旨在确定 HIV 阳性者向性伴侣披露 HIV 状况的比率、过程、结果和相关因素。
这是一项 2015 年 9 月至 11 月在埃塞俄比亚亚的斯亚贝巴的两家 HIV 门诊进行的横断面研究。数据通过访谈者管理的半结构式问卷收集。逻辑分析用于确定血清学检测结果披露的独立相关因素。
在 742 名参与者中（371 名男性和 371 名女性），727 名（98%）正在接受抗逆转录病毒治疗，676 名（91.1%）自 HIV 诊断以来至少有一名性伴侣，其中 558 名（82.5%）向最近的性伴侣透露了 HIV 状况。在报告向最近的性伴侣透露其状况的参与者中，在 HIV 诊断后但在披露之前，有 82 名（14.7%）至少与该伴侣发生过一次无保护的性行为。披露的最常见初始结果是获得情感和/或经济支持。有些人（11.3%）还报告说，他们的披露立即促使伴侣进行了 HIV 检测。与男性（12.7%）相比，女性（26.2%）更常报告披露后的负面结果，如耻辱和歧视。在多变量回归分析中，披露与更大的 condom 使用、更大的社会支持、了解伴侣的 HIV 状况、与伴侣保持良好关系和与伴侣同居有关。
参与者中 HIV 披露很常见，尽管有时会延迟，但可能会对传播产生影响。对负面结果的恐惧，如言语虐待和身体暴力，是披露的主要障碍。支持披露有可能通过鼓励更安全的性行为、促使伴侣进行 HIV 检测以及增强对 HIV 感染者的支持，为 HIV 控制和预防做出贡献。
