Department of Epidemiology, Mailman School of Public Health, Columbia, University, New York, NY.
ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY.
J Acquir Immune Defic Syndr. 2020 Jul 1;84(3):242-252. doi: 10.1097/QAI.0000000000002334.
HIV disclosure benefits people living with HIV, their partners, and HIV programs. However, data on the prevalence of disclosure and associated correlates have come largely from patients already in HIV care, potentially overestimating disclosure rates and precluding examination of the impact of disclosure on HIV care outcomes.
We used data from an implementation study conducted in Maputo City and Inhambane Province, Mozambique. Adults were enrolled at HIV testing clinics after diagnosis and traced in the community 1 and 12 months later when they reported on disclosure and other outcomes.
We examined patterns of participants' disclosure to their social networks (N = 1573) and sexual partners (N = 1024) at both follow-up assessments and used relative risk regression to identify correlates of nondisclosure.
Disclosure to one's social network and sexual partners was reported by 77.8% and 57.7% of participants, respectively, at 1 month and 92.9% and 72.4% of participants, respectively, at 12 months. At both time points, living in Inhambane Province, being single or not living with a partner, having high levels of anticipated stigma, and not initiating HIV treatment were associated with increased risks of nondisclosure to social networks. Nondisclosure to sexual partners at both follow-up assessments was associated with being women, living in Inhambane Province and in a household without other people living with HIV, and reporting that posttest counseling addressed disclosure.
Although reported disclosure to social networks was high, disclosure to sexual partners was suboptimal. Effective and acceptable approaches to support partner disclosure, particularly for women, are needed.
艾滋病毒披露对艾滋病毒感染者、他们的伴侣和艾滋病毒防治规划有益。然而，有关披露的普遍性及其相关因素的数据主要来自已经接受艾滋病毒护理的患者，这可能高估了披露率，并排除了披露对艾滋病毒护理结果的影响的审查。
我们使用了在莫桑比克马普托市和伊尼扬巴内省开展的一项实施研究的数据。在诊断后，成年人在艾滋病毒检测诊所登记，并在 1 个月和 12 个月后在社区中接受追踪，报告他们的披露情况和其他结果。
我们检查了参与者在两个随访评估中向其社交网络（N=1573）和性伴侣（N=1024）披露的模式，并使用相对风险回归来确定不披露的相关因素。
分别有 77.8%和 57.7%的参与者在 1 个月时向其社交网络和性伴侣披露，分别有 92.9%和 72.4%的参与者在 12 个月时向其社交网络和性伴侣披露。在这两个时间点，居住在伊尼扬巴内省、单身或不与伴侣同住、预期耻辱感高、未开始艾滋病毒治疗与向社交网络隐瞒的风险增加相关。在两次随访评估中，向性伴侣隐瞒都与女性、居住在伊尼扬巴内省以及与没有其他艾滋病毒感染者同住的家庭以及报告测试后咨询涉及披露有关。
尽管报告向社交网络的披露率很高，但向性伴侣的披露率不理想。需要采取有效和可接受的方法来支持伴侣披露，特别是对女性。
