Prevalence, patterns, and correlates of HIV disclosure among TB-HIV patients initiating antiretroviral therapy in Lesotho

Disclosure of HIV-positive status has important implications for patient outcomes and preventing HIV transmission, but has been understudied in TB-HIV patients. We assessed disclosure patterns and correlates of non-disclosure among adult TB-HIV patients initiating ART enrolled in the START Study, a mixed-methods cluster-randomized trial conducted in Lesotho, which evaluated a combination intervention package (CIP) versus standard of care. Interviewer-administered questionnaire data were analyzed to describe patterns of disclosure. Patient-related factors were assessed for association with non-disclosure to anyone other than a health-care provider and primary partners using generalized linear mixed models. Among 371 participants, 95% had disclosed their HIV diagnosis to someone other than a health-care provider, most commonly a spouse/primary partner (76%). Age, TB knowledge, not planning to disclose TB status, greater perceived TB stigma, and CIP were associated with non-disclosure in unadjusted models (p < .1). In adjusted models, all point estimates were similar and greater TB knowledge (adjusted odds ratio [aOR] 0.59, 95% confidence interval [CI] 0.39-0.90) and CIP (aOR 0.20, 95% CI 0.05-0.79) remained statistically significant. Among 220 participants with a primary partner, 76% had disclosed to that partner. Significant correlates of partner non-disclosure (p < .1) in unadjusted analyses included being female, married/cohabitating, electricity at home, not knowing if partner was HIV-positive, and TB knowledge. Adjusted point estimates were largely similar, and being married/cohabitating (aOR 0.03, 95% CI 0.01-0.12), having electricity at home (aOR 0.38, 95% CI 0.17-0.85) and greater TB knowledge (aOR 0.76, 95% CI 0.59-0.98) remained significant. In conclusion, although nearly all participants reported disclosing their HIV status to someone other than a health-care provider at ART initiation, nearly a quarter of participants with a primary partner had not disclosed to their partner. Additional efforts to support HIV disclosure (e.g., counseling) may be needed for TB-HIV patients, particularly for women and those unaware of their partners' status

Confidence interval · Family medicine · Odds ratio · Spouse · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Internal Medicine

• Prevalence and correlates of non-disclosure of maternal HIV status to male partners

  Open Access•John Kinuthia, Benson Singa et al.•BMC Public Health•2018

  Incluir item

• Concerns about starting antiretroviral treatment among pregnant women in Lesotho

  Open Access•Relebohile Nthati Katiso Morojele•Global Public Health•2021

  Incluir item

• Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/Aids in Western Kenya

  Open Access•Patrick O Monahan, Enbal Shacham et al.•Journal of General Internal…•2009

  Incluir item

• The PHQ-9

  Kurt Kroenke, Robert L Spitzer et al.•Journal of General Internal…•2001

  Incluir item

• Development of reliable and valid short forms of the marlowe-crowne social desirability scale

  Open Access•William M Reynolds•Journal of Clinical Psychology•1982

  Incluir item

• The START Study to evaluate the effectiveness of a combination intervention package to enhance antiretroviral therapy uptake and retention during TB treatment among TB/HIV patients in Lesotho

  Open Access•Andrea A Howard, Yael Hirsch-Moverman et al.•Global Health Action•2016

  Incluir item

• Disclosure of HIV serostatus among pregnant and postpartum women in sub-Saharan Africa

  Melanie Tam, Anouk Amzel et al.•AIDS Care•2015

  Incluir item

• Social constraints to TB/HIV healthcare

  Amrita Daftary, Nesri Padayatchi•AIDS Care•2012

  Incluir item

• Serostatus disclosure to sexual partners among people living with HIV

  Sarahmona Przybyla, Sarahmona M Przybyla et al.•AIDS Care•2013

  Incluir item

• Gender differences in HIV disclosure, stigma, and perceptions of health

  Cindy Geary, Cindy Waszak Geary et al.•AIDS Care•2014

  Incluir item

• HIV serostatus disclosure in the treatment cascade

  Joachim Ostermann, Brian W Pence et al.•AIDS Care•2015

  Incluir item

• HIV-positive status disclosure among men and women receiving antiretroviral treatment in eastern Ethiopia

  Ayalu A Reda, Sibhatu Biadgilign et al.•AIDS Care•2013

  Incluir item

• Barriers and outcomes

  Muatale Chileshe, Virginia Bond et al.•AIDS Care•2010

  Incluir item

• HIV testing and disclosure

  Amrita Daftary, Nesri Padayatchi et al.•AIDS Care•2007

  Incluir item

• HIV disclosure patterns, predictors, and psychosocial correlates among HIV positive women in Zimbabwe

  Rena C Patel, Rena Patel et al.•AIDS Care•2012

  Incluir item

• HIV status disclosure to families for social support in South Africa (Nimh Project Accept/HPTN 043)

  Suzanne Maman, Heidi Van Rooyen et al.•AIDS Care•2014

  Incluir item

• Disclosure of HIV status

  Hirut Gebrekristos, Mark N Lurie et al.•African Journal of AIDS Research•2009

  Incluir item

• Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment

  Open Access•Mekdes K Gebremariam, Gunnar A Bjune et al.•BMC Public Health•2010

  Incluir item

• The Role of HIV Serostatus Disclosure in Antiretroviral Medication Adherence

  Open Access•Michael J Stirratt, Robert H Remien et al.•AIDS and Behavior•2006

  Incluir item

• HIV-Positive Status Disclosure in Patients in Care in Rural South Africa

  Open Access•Quarraisha Abdool Karim, Rachael Dellar et al.•AIDS and Behavior•2015

  Incluir item

• Disclosure of HIV Status to Sex Partners Among HIV-Infected Men and Women in Cape Town, South Africa

  Open Access•Lung Vu, Katherine Andrinopoulos et al.•AIDS and Behavior•2010

  Incluir item

• Men usually say that HIV testing is for women’

  Abby L Dicarlo, Abby DiCarlo et al.•Culture Health & Sexuality•2014

  Incluir item

• Facilitating HIV Disclosure Across Diverse Settings

  Carla Makhlouf Obermeyer, Parijat Baijal et al.•American Journal of Public Health•2011

  Incluir item

• Development of the Alcohol Use Disorders Identification Test (Audit)

  Open Access•Jennifer B Saunders, John B Saunders et al.•Addiction•1993

  Incluir item

• Disclosure of HIV Status

  Open Access•Minrie Greeff, Rene Phetlhu et al.•Qualitative Health Research•2008

  Incluir item

• HIV and tuberculosis

  Open Access•Amrita Daftary•Social Science & Medicine•2012

  Incluir item