Melis Berhe Tamirat, Lemma Lire, Alemayehu Addissu, Ajema Desalegn, Glagn Mustefa, Dessu Samuel
Wachamo University, College of Medicine and Health Science, Department of Public Health, Hosanna, Ethiopia.
Arba Minch University, College of Medicine & Health Sciences, Department of Public Health, Arba Minch, Ethiopia.
AIDS Res Treat. 2020 Nov 6;2020:7165423. doi: 10.1155/2020/7165423. eCollection 2020.
Human immunodeficiency virus-positive status disclosure is the process of informing one's HIV-positive status to others. It is the base for accessing care and treatment programs, attaining psychosocial support, reducing stigma, adhering to treatment, and promoting safer health. Even though different strategies were done in Ethiopia to increase the magnitude of HIV status disclosure among HIV-positive patients, the magnitude is still low. The magnitude of HIV-positive status disclosure was not assessed yet after initiation of the new strategy (test and treat strategy). The aim of this study is to assess the magnitude and factors associated with HIV-positive status disclosure among HIV-positive adults attending antiretroviral therapy clinic at the public health facilities of Butajira town.
Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 414 study participants were selected by systematic random sampling technique. Data were collected by using pretested interviewer-administered semistructured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis was used to identify factors associated with HIV-positive status disclosure. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistically significance was declared at value <0.05 and 95% CI.
The magnitude of HIV-positive status disclosure was 90%. Discussing about safer sex (AOR: 3.5; 95% CI: 1.3, 9.4), viral load suppression (AOR: 4; 95% CI: 1.5, 10.1), having good ART adherence (AOR: 6; 95% CI: 2.4, 14.0), receiving counseling (AOR: 2.5; 95% CI: 1.01, 6.3), and perceiving stigma (AOR: 0.25; 95% CI: 0.09, 0.60) were the independent factors associated with HIV-positive status disclosure.
Although the majority of the participants (90%) of them disclosed their HIV-positive status, lack of disclosure by few people can tackle HIV prevention and control programs. Health programs could improve disclosure of HIV-positive status by providing counseling service, strengthening adherence of antiretroviral therapy, suppressing viral load, and avoiding (reducing) stigma on HIV-positive patients by their community.
披露人类免疫缺陷病毒（HIV）阳性状态是指将个人的HIV阳性状况告知他人的过程。它是获得护理和治疗项目、获得心理社会支持、减少耻辱感、坚持治疗以及促进更安全健康的基础。尽管埃塞俄比亚采取了不同策略来提高HIV阳性患者中披露HIV状态的比例，但这一比例仍然较低。在新策略（检测与治疗策略）启动后，尚未对HIV阳性状态披露的比例进行评估。本研究的目的是评估在布塔吉拉镇公共卫生机构接受抗逆转录病毒治疗门诊的HIV阳性成年人中，HIV阳性状态披露的比例及其相关因素。
在布塔吉拉镇的公共卫生机构开展基于机构的横断面研究。通过系统随机抽样技术共选取414名研究参与者。使用经过预测试的访谈员管理的半结构化问卷收集数据。将收集到的数据录入EpiData3.1并导出到SPSS 23版。采用双变量和多变量逻辑回归分析来确定与HIV阳性状态披露相关的因素。分别通过双变量和多变量逻辑回归分析的粗比值比和调整后比值比来评估关联强度。当P值<0.05和95%置信区间时，宣布具有统计学意义。
HIV阳性状态披露的比例为90%。讨论安全性行为（调整后比值比：3.5；95%置信区间：1.3，9.4）、病毒载量抑制（调整后比值比：4；95%置信区间：1.5，10.1）、抗逆转录病毒治疗依从性良好（调整后比值比：6；95%置信区间：2.4，14.0）、接受咨询（调整后比值比：2.5；95%置信区间：1.01，6.3）以及感知耻辱感（调整后比值比：0.25；95%置信区间：0.09，0.60）是与HIV阳性状态披露相关的独立因素。
尽管大多数参与者（90%）披露了他们的HIV阳性状态，但少数人不披露会影响HIV预防和控制项目。卫生项目可以通过提供咨询服务、加强抗逆转录病毒治疗的依从性、抑制病毒载量以及避免（减少）社区对HIV阳性患者的耻辱感来提高HIV阳性状态的披露率。
