Mental health and experience of partner violence among women who disclose hiv serostatus at Muhimbili health information centre, Dar es salaam

Abstract

HIV and violence are two of the major health problems affecting the lives of millions of women worldwide an important component of HIV voluntary counseling and testing (VCT) programs is encouraging clients to inform partners of their serostatus. Yet many clients do not disclose results to partners due to negative consequences such as stigma, anxiety and depressive symptoms, intimate partner violence, loss of intimacy, and threats to personal well-being. Building on a previous study this study explored the links between violence, mental health and HIV serostatus disclosure among women attending VCT at MHIC. METHODOLOGY: From September 2011 to March 2012 stand-alone VCT facility-based cohort follow up study was conducted and quantitative method for data collection was used to identify the magnitude and factors associated with mental health and experience of partner violence among women who disclose HIV serostatus at Muhimbili Health Information Centre, Dar es Salaam (n= 607) women who met inclusion criteria for study were interview at baseline and after three month. Every client was screened for the anxiety- depressive symptoms and assessed for intimate partner violence using Hopkins Symptoms Checklist 25 (HSCL-25) for anxiety and depression and Conflict Tactic Scale (CTS) respectively. Both tools have been validated for use in the Tanzania context. Simple descriptive analysis was done to determine the magnitude of HIV serostatus disclosure, violence and mental health. Bivariate, student T-test and logistic regression mode were applied to determine the significant associations and factors independently associated with HIV serostatus disclosure. vi RESULTS: A total of 607 participants were enrolled at baseline while 523 were re-interviewed at three month post HIV test. 84 were lost to follow up; the characteristic which was found to differ from those who were followed up was significant baseline history of sexual violence. 440 (84%) disclosed their HIV serostatus to their primary partners within three month post HIV test. Among those who disclosed 216 (49.1%) experienced physical violence (p=0.000), 170/440 (38.6%) reported to have low level of anxiety symptoms, while 109/440 (24.8%) reported to experienced high level of depressive symptoms (p=0.00). Among non disclosure 35(43.2%) did not share results due to fear of partner reaction. CONCLUSION; Eight out of ten women who received VCT service shared their HIV serostatus with their primary partners. Prior communication with partner about VCT service predicts the tendency for HIV serostatus disclosure. During HIV serostatus disclosure nearly five out of ten of women experience physical violence from their partner while two to three experience high level of depressive symptoms. Despite high encouragement for HIV serostatus disclosure during VCT services two out of ten women did not share their HIV serostatus result due to fear of partner reaction, most mentioned they feared physical abuse and abandonment.