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莫桑比克马普托地区与 HIV 血清阳性者向性伴侣隐瞒 HIV 血清状况相关的社会人口学因素。

Sociodemographic associated factors with non-disclosure of HIV sero-status to sexual partners in Maputo, Mozambique.

机构信息

I-TECH Mozambique "International Training & Education Center for Health", Bairro Sommershield, Avenue Cahora Bassa N# 106, Maputo City, Mozambique.

National STI/HIV/AIDS Program, Ministry of Health "MoH", Maputo City, Mozambique.

出版信息

Sci Rep. 2024 Sep 17;14(1):21736. doi: 10.1038/s41598-024-72430-y.

Abstract

The HIV prevalence in Maputo city is 16.2%. There is a lack of data describing associated factors with disclosure or non-disclosure of HIV-positive sero-status to sexual partners. This analysis describes associated factors of non-disclosure of HIV sero-status to sexual partners among people living with HIV (PLHIV) participating in a serostatus disclosure support program at three health facilities in Maputo, Mozambique. We used a cross-sectional design of PLHIV aged over 18 years. Datas were collected between December 2019 and September 2020. Univariate and multivariable logistic regression models were used to evaluate factors associated of non-disclosure of HIV sero-status. A total of 377 patients were enrolled in the HIV sero-status disclosure Program. Of these, nearly two-thirds (61.5%) were women, 52.9% had completed secondary school, 47.7% were 25-34 years old, 50.9% had informal employment with low income, and 73.2% were married. Univariate logistic regression model showed greater odds of non-disclosure among patients who had an employment contract with a maximum wage (Crude Odds Ratio [cOR] 2.02, 95% confidence interval [CI] 1.15-3.55, p = 0.015); were single (cOR 3.85, 95% CI 2.22-6.69, p < 0.001); were living with parents (cOR 2.30, 95% CI 1.07-4.93, p = 0.033); received financial support for their monthly household expenses from parents or a close relative (cOR 7.15, 95% CI 2.19-23.36, p = 0.001); or brought a parent/close relative and/or a friend as a confidant during HIV care(cOR 3.17, 95% CI 1.74-5.76, p < 0.001; and cOR 5.97, 95% CI 1.57-22.66, p = 0.009, respectively). Multivariable logistic regression model showed: from parents/close relative and from partner (Adjusted Odds Ratio [aOR] 8.19, 95% CI 1.44-46.46, p = 0.018; and aOR 4.34, 95% CI 1.05-17.17, p = 0.043), respectively); in those who brought a parent/close relative and/or a friend as a confidant during HIV care (aOR 8.86, 95% CI 2.16-36.31, p = 0.002; and 195 aOR 21.68, 95% CI 3.02-155.87, p = 0.002, respectively). Non-disclosure of serostatus is a critical issue for HIV care and treatment programs, given that non-disclosure of HIV serostatus increases risk of HIV transmission. Understanding the factors associated with non-disclosure is crucial for designing strategies to address these factors and end the HIV epidemic by 2030. Our findings suggest that HIV serostatus disclosure programs might target the sociodemographic factors strongly associated with non-disclosure.

摘要

马普托市的 HIV 感染率为 16.2%。目前缺乏描述与向性伴侣披露或不披露 HIV 阳性血清状态相关因素的数据。本分析描述了莫桑比克马普托的三个卫生机构中参与 HIV 血清状态披露支持计划的 HIV 感染者(PLHIV)向性伴侣不披露 HIV 血清状态的相关因素。我们使用了 18 岁以上的 PLHIV 的横断面设计。数据于 2019 年 12 月至 2020 年 9 月之间收集。使用单变量和多变量逻辑回归模型评估与不披露 HIV 血清状态相关的因素。共有 377 名患者参加了 HIV 血清状态披露计划。其中,近三分之二(61.5%)为女性,52.9%完成了中学教育,47.7%年龄在 25-34 岁之间,50.9%从事低收入的非正规就业,73.2%已婚。单变量逻辑回归模型显示,在与雇主签订最高工资合同的患者(粗比值比[cOR]2.02,95%置信区间[CI]1.15-3.55,p=0.015);单身(cOR 3.85,95%CI 2.22-6.69,p<0.001);与父母同住(cOR 2.30,95%CI 1.07-4.93,p=0.033);从父母或近亲处获得每月家庭开支的经济支持(cOR 7.15,95%CI 2.19-23.36,p=0.001);或在 HIV 护理期间带父母/近亲或朋友作为知己(cOR 3.17,95%CI 1.74-5.76,p<0.001;cOR 5.97,95%CI 1.57-22.66,p=0.009)。多变量逻辑回归模型显示:来自父母/近亲(调整比值比[aOR]8.19,95%CI 1.44-46.46,p=0.018);来自伴侣(aOR 4.34,95%CI 1.05-17.17,p=0.043));在那些在 HIV 护理期间带父母/近亲或朋友作为知己的患者(aOR 8.86,95%CI 2.16-36.31,p=0.002;aOR 195 21.68,95%CI 3.02-155.87,p=0.002)。血清状态不披露是 HIV 护理和治疗计划的一个关键问题,因为不披露 HIV 血清状态会增加 HIV 传播的风险。了解与不披露相关的因素对于设计解决这些因素的策略以在 2030 年前结束 HIV 流行至关重要。我们的研究结果表明,HIV 血清状态披露计划可能针对与不披露密切相关的社会人口因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c628/11408603/68420dabf4fb/41598_2024_72430_Fig1_HTML.jpg

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