HIV sero status disclosure and associated factors among people living with HIV/AIDS attending a care and treatment centre in Kisarawe district hospital, Tanzania

Abstract

Background: It is estimated that about 1.4 million people in Tanzania are infected with HIV, with 90,000 being infected annually. Previous studies in Africa on HIV status disclosure have documented low rates of disclosure that vary between countries. Limited data indicates that the disclosure rate in Tanzania ranges from 16.7% to 55%. PLWHA have difficulties in disclosing their HIV status to others for fear of negative consequences. This attitude affects the tempo of HIV prevention. Disclosure of HIV positive status in Tanzania has been focused on various areas but its association with social cultural factors remains unclear. Objective: To assess the magnitude of HIV status disclosure and explore determinants of disclosure among people living with HIV/AIDS (PLWHA) attending care and treatment centre at Kisarawe District Hospital. Materials and methods: A cross- sectional study design was employed where both quantitative and qualitative data were collected from consenting PLWHA. Univariate, bivariate and multivariate analyses were performed using SPSS statistical software. Results: A total of 402 PLWHA were recruited, among them, 132 (32.8%) were males. The mean age of the participants was 42.0 years (Standard deviation 9.9) with majority aged between 25-49. The overall disclosure rate to somebody was 98% while the disclosure to spouses was 56.3%. The greater number of study participants (43%) disclosed their status to five people and above. Males (74.2%) disclose more to their spouses than females (47.7%), (p<0.001). The main determinants of HIV status disclosure were gender (AOR 0.28; 95%CI 0.14-0.56) and receiving counseling (AOR 0.33; 95%CI: 0.10- 0.81). Qualitative findings also show that cultural beliefs and attitudes influence HIV status disclosure among PLWHA. Conclusion and recommendations Overall disclosure rate is high though relatively low among spouses. Male gender and counseling were the most important determinants of disclosure. Interventions that target women and expand counseling should be intensified.