Factors Associated with Disclosure of HIV Status within Relationships: The Case of Persons Living with HIV in the Tema Metropolitan Area

Abstract

This study is a survey which examines and clarifies the determinants of disclosure of HIV status among individuals who are known to be aware of their sero-positive status. Although the African region has a high HIV prevalence there is a dearth of research on the complex process of disclosure of HIV infection in most African nations including Ghana. Addressing issues of non- disclosure and increased risky behavior is a crucial mechanism to help stop the spread of HIV and reduce new HIV infections in Ghana, this study therefore is relevant as it explores and unearths key issues associated with disclosing a positive sero status. Data was collected from 155 respondents in four HIV support associations within the Tema Metropolitan Area of the Greater Accra Region through a multi staged sampling technique. Data was collected by both quantitative and qualitative methods, using questionnaires, FGDs and in depth interviews. Disclosure rates among PLHIV were high, as two-thirds of the PLHIV had disclosed their HIV status to a relation. PLHIV most likely to disclose were females aged 25-34 years, married individuals, employed individuals , individuals who had received secondary education and those who had known their HIV status for at least six months to one year. Those less likely to disclose were males, persons aged 15-24 years, separated, divorced or single PLHIVs, unemployed, Christians (among both males and females Pentecostals were least likely to disclose), those with basic education and PLHIV who had known their status for a year or more. It is important to note however, that none of these characteristics were statistically associated with disclosure. Interestingly, perceived fear of stigmatization and discrimination affected disclosure decisions however PLHIVs who actually disclosed did not feel stigmatized by relations after disclosing their positive sero status. As to who among family relations is most likely to be a disclosure recipient, sexual partners were mentioned as most likely to receive news of a partner’s positive sero status. This is followed by parents especially mother and aunts, siblings, other family members. Some recommendations made are that prevention workers in Ghana must incorporate the promotion of a sense of individual responsibility and duty to others with regard to disclosure. Another recommendation is that the National AIDS Control Programme considers safe disclosure as a fourth arm for the process of counseling and testing for HIV where trained PLHIVs can also serve as models and actively play a role in assisting colleagues with safe disclosure as part of post test counseling support.