Factors influencing HIV status disclosure

[摘要] ENGLISH ABSTRACT: Understanding the incidence and prevalence of HIV/AIDS is important in addressingthe ongoing epidemic. Understanding which factors influence the rate oftransmission of the virus is critical in attempting to contain and ultimately eradicatethe disease.Determining which factors influence a person's decision to disclose his/her positivestatus to others, particularly the sexual partner, is essential in understanding thiscomplex process and thereby improving disclosure rates.The aim of the study was to investigate which factors influence the disclosure ofsomeone's HIV positive status.The objectives were to determine whether aspects such as socio-demographicfactors, stigma and discrimination, religion, culture, fear of abandonment andrejection as well as knowledge of the disease influences disclosure rates.These objectives were met through an in-depth descriptive correlational researchdesign with a quantitative approach. The target population (N = 1200/100%)consisted of all the HIV infected clients who attended a Community Health Clinic(CHC) for HIV management in the Cape Metropolitan area. The conveniencesampling method was used to select the sample of participants (n = 150/12.5%) whomet the criteria and voluntarily agreed to participate in the study.A self-administered questionnaire was used consisting of mainly closed-endedquestions, with a limited number of open-ended questions.Ethics approval for the study was obtained from the Health Research EthicsCommittee at the Faculty of Health Sciences, Stellenbosch University. Permissionwas obtained from the City of Cape Town: City Health, to conduct the research.Informed consent was obtained from each participant.Reliability and validity were supported by a pilot study which was conducted on(n=15/10%) of participants at this CHC to assure the feasibility of the study. The data was analysed with the support of a statistician and was presented withhistograms and frequency tables. Statistical associations were determined betweenthe various variables. The qualitative data obtained from the open-ended questionswere grouped in trends and analysed thematically and then these trends werequantified.The results show that there are numerous factors which influenced HIV statusdisclosure.The fear of stigmatisation was identified as a factor which influences HIV disclosureto others, especially among the male participants. The results revealed that this wasthe major reason for delayed or non-disclosure, as well as the fear of rejection andblame.The results showed that awareness of the sexual partner's HIV status remainedrelatively low (n = 64/43%), with awareness of the partner's status highest amongmarried participants.The recommendations were to assure that HIV positive individuals have access tosupport groups and are given an opportunity to attend multiple counselling sessions.Community based initiatives are needed to reduce stigmatisation of individuals withHIV and to improve access to social support systems.It was concluded that disclosure is a multifaceted process and one particular factordoes not necessarily influence disclosure of a HIV positive status but most often acombination of factors.

[发布机构] Stellenbosch University