Factors Associated with Sero-Status Disclosure among PLWHA In La-Nkwantanang-Madina Municipality, Greater Accra Region of Ghana

Abstract

Background: One of the biggest psychological obstacles PLWHA (People Living with HIV and AIDS) are confronted with is disclosing their HIV status. At the Pentecost Hospital, data analysis in 2023, revealed that out of the 494 HIV Clients currently receiving ART at the facility, only 4% have disclosed their status (Pentecost Hospital, Annual Report,2023). This study seeks to determine factors associated with sero-status disclosure among PLWHA at the Pentecost Hospital in La-Nkwantanang-Madina Municipality (LANMMA), Greater Accra Region of Ghana. Methods: The study included all PLWHA, above 18 years who attend ART clinic at Pentecost Hospital. The sample frame was 494 PLWHA attending ART clinic at the Pentecost Hospital. The study used proportionate sampling technique to select 176 females and 56 males from a sampling frame of 494 PLWHA with 375 (76%) females and 119 (24%) males respectively. The required number of people from each stratum was selected using the simple random sampling technique. A pretested questionnaire made up of six (6) sections, was administered to each participant. Analysis of the data was done using STATA version 17. Binary logistic regression model and multivariate analysis was used to identify the factors that are associated with sero-status disclosure. Results: Two-hundred and thirty-two (232) PLWHA participated in this study. The proportion of sero-status disclosure was 121/232 (52.2%), (95% CI: 45.79%, 58.61%). For socio-demographic characteristics, marriage and income were associated with sero-status disclosure. The results showed that married participants had 2.64 increased odds of disclosing their sero-status compared to single participants, (OR=2.64, 95% CI: 1.45, 4.93, p= 0.002). In terms of income, individuals with a monthly income of GH₵500- GH₵1000 had a 23% chance of disclosing their HIV status (OR=0.23, 95% CI: 0.05-0.85, p-value=0.039). The study also revealed that the odds of disclosing sero-status was 77% lower among those who disagreed discussing HIV in the community (OR=0.26, 95% CI: 0.11, 0.57, p-value=0.001). Health facility factors were not associated with sero-status disclosure. Conclusion: This study found 52.2% self reported disclosure rates among PLWHA in the La Nkwantanang Madina Municipality. The study revealed that being married is associated with sero status disclosure as well as receiving a monthly income of GH₵500- GH₵1000. For community factors, participants who disagreed discussing HIV within the community were associated with sero-status disclosure. However, no significant association was found with health facility factors to sero-status disclosure.