CONSEQUENCES OF DISCLOSURE AMONG ADULT PEOPLE LIVING WITH HIV REGISTERED AT GENERAL HOSPITAL IKOT EKPENE, AKWA IBOM STATE, NIGERIA

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Author

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Department of Medicine

ABSTRACT
HIV/AIDS is a disease of public health concern with 36.7 million people living with the disease worldwide. Sub-Saharan Africa accounts for 70% of the global burden. In Nigeria 3.5 million people are living with the disease. The prevalence in Akwa Ibom state is 6.5% more than double the national average (3.17%). The World Health Organization encourages all people living with HIV to disclose their status in order to improve adherence and the use of preventive practices. Non-disclosure of one‘s positive HIV status is criminal under Nigerian law. People living with HIV are often reluctant to disclose their HIV status fearing stigma and discrimination. The consequences of disclosure reflect the interplay between fear and hope, risks and benefits. This study aimed to: determine the knowledge of HIV disclosure among people living with HIV, the proportion of them that had disclosed, the patterns of HIV status disclosure, the determinants of non-disclosure, as well as the barriers and consequences of HIV disclosure. The study was conducted in General hospital Ikot Ekpene, 300 respondents were recruited. Data were collected, entered, cleaned, coded and stored in password protected. Using EPI INFO: data were analysed to determine frequencies and proportions, bivariate and multivariate analysis was done to determine associations and binary logistic regression was done to adjust for confounders. The proportion of PLHIV with good knowledge on the importance of HIV disclosure was 84%. The proportion of PLHIV that had disclosed their status was 70.3%.The factors associated with non-disclosure were being unmarried [adjusted odds ratio (AOR): 2.68, CI: 1.4-5.1], belonging to religions other than Christianity or Islam (AOR: 8.37,CI: 1.3-50.6), having secondary education and below (AOR: 2.86, CI:1.2 - 7.1), knowing one‘s status for twelve months or less (AOR: 3.1, CI:1.5-5.9), absence of TB co-infection(AOR:14.4, CI:1.7-123)and not thinking HIV status disclosure was important (AOR: 6.3, CI: 3.0-13.4). xvi The barriers to HIV status disclosure were fear of the unknown, fear of stigma and fear of loss of confidentiality, shame, time not being right and fear of divorce. The consequences of HIV status disclosure were predominantly positive. Initial positive outcomes were 52% compared to the anticipated 21%. Subsequent outcomes were 95% positive. Other positive consequences of disclosure were: Disclosure of HIV status helped 94% respondents to adhere to anti-retroviral therapy and keep hospital appointments .Disclosure of HIV status reduced feelings of stress in 92% respondents. Disclosure of HIV status helped 79% of the respondents practice preventive measures. Knowledge of importance of HIV status was high. The determinants of non-disclosure were socio-demographic, HIV-related and related to disclosure information. The greatest barrier to disclosure was fear of the unknown. The consequences of disclosure were mostly positive. It is recommended that: health workers encourage people living with HIV to disclose their HIV status. Data on disclosure be collected by national HIV/related surveys, more research be done on stigma and discrimination of people living with HIV. Keywords: HIV/AIDS, Disclosure, Barriers, outcomes, people living with HIV.