Factors Influencing HIV Positive Status Disclosure among Sexual Partners in the Volta Region of Ghana

Abstract

Background: The highest incidence of HIV infection in Sub-Saharan Africa is typically due to heterosexual transmission. In Ghana, it is estimated that 250,232 persons made up of 101,995 males and 148,237 females are living with HIV. HIV partner disclosure forms a key public health strategic approach to reduce incidence of HIV infections and improve HIV treatment and care. Several Studies in developing countries have revealed low disclosure rates ranging from 16.7% to 86%. However, disclosing ones HIV sero status to a sexual partner is still a difficult decision for HIV-infected people due to high level of HIV-related stigma, discrimination and fear of divorce. The effect of nondisclosure of HIV status is unparalleled. It results in increased potential of exposing partners, children and other people to HIV and other sexually transmitted infections. In Ghana, data on HIV status disclosure among sexual partners remain limited and blurred. Objective: To determine the factors influencing HIV positive status disclosure among sexual partners in the Volta Region of Ghana Materials and Methods: The study was a descriptive cross sectional study involving four hundred and twenty-three (423) participants. A multi stage sampling technique made of two stages was used to select a representative sample for the study. The analysis was performed using STATA version 14.1. Chi-square was used to determine associations between disclosure and demographic characteristics (age, educational level) and other psychosocial, illness and negative factors. Odds ratios were determined to assess the magnitude of the association. Results: This study observed 40.2% (n=170) disclosure of HIV status among respondents attending selected ART centers in the Volta Region. Respondents’ age ranged from 18 to 79 with a mean age of 41.7 (±12.6) years. Fear of partner withdrawal (87%, n=220) was the primary reason for non-disclosure. Age (X2 =82.74, p<0.001), sex (X2 =16.88, p<0.001), employment status (X2 =28.56, p<0.001), educational level (X2 =36.09, p<0.001), marital status (X2 =15.48, p<0.004), religious affiliation (X2 =15.09, p<0.001) and settlement type (X2 =7.81, p<0.002) were associated with disclosure. The main determinants of disclosure were as follows: The likelihood of males divulging their HIV positive status to their sexual partners is 11.6 times higher as compared to females (AOR: University of Ghana http://ugspace.ug.edu.gh iv 11.69; 95% CI, 2.12-64.24, p<0.05). Respondents with primary level of education were 1.6 times more likely to divulge their HIV positive status to their sexual partners (COR: 1.61; 95% CI, 0.02-0.65, p<0.05). Respondents who had one sexual partner were about 6 times more likely to divulge their HIV positive status to their sexual partners (AOR: 5.95; 95%CI, 1.58-22.38, p<0.05). Respondents who were urban dwellers were 6% less inclined to divulge their HIV positive status to their partners (COR: 0.06; 95%CI, 0.01-0.34, p<0.001). Respondents who were not aware of the significance of disclosure were 15% less disposed to reveal their HIV positive status to their partners (AOR: 0.15; 95%CI, 0.00-0.23, p<0.05). Respondents who always used condoms during sexual intercourse with their partners were 14% less inclined to divulge their HIV positive status to their partners (AOR: 0.14; 95%CI, 0.03-0.60, p<0.05). Conclusion: The HIV positive status disclosure in the 7 select districts is 40.2% with a 95% CI: 35.5% -44.9%. Demographic characteristics such as age (X2 =82.74, p<0.001), sex (X2 =16.88, p<0.001), employment status (X2 =28.56, p<0.001), educational level (X2 =36.09, p<0.001), marital status (X2 =15.48, p<0.004), religious affiliation (X2 =15.09, p<0.001), settlement type (X2 =7.81, p<0.002) and income level of respondents were associated with HIV positive status disclosure to a sexual partner. Intensifying health facility and media education on HIV status disclosure among partners might improve the rate of disclosure and reduce spread of the infection. University of Ghana http://ugspace.ug.edu.