Open Access Pub publishes peer-reviewed, free-to-read open-access articles. Showing
articles matching Disclosure — open any to read the full text,
or download the PDF or XML.
Jun 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5559
Gamba PerryCorresponding author
Background HIV status disclosure is a complex process influenced by multiple factors beyond health system support. Understanding these factors is essential for developing comprehensive interventions to promote disclosure and improve HIV prevention and care outcomes. Methods A descriptive cross-sectional study was conducted in 10 health facilities offering comprehensive HIV/AIDS care in Mukono district, Uganda. Data was collected from 317 clients through interview-guided questionnaires. Data was entered using EPI data and analyzed using SPSS version 16, including logistic regression to identify factors associated with disclosure. Results Multiple factors influenced HIV status disclosure. Individual factors included knowledge about HIV (OR=2.34, 95% CI: 1.45-3.78), self-efficacy (OR=3.12, 95% CI: 1.87-5.21), and psychological readiness (OR=2.89, 95% CI: 1.76-4.75). Relationship factors included relationship quality (OR=3.56, 95% CI: 2.13-5.94), communication patterns (OR=2.78, 95% CI: 1.65-4.69), and anticipated partner reaction (OR=4.23, 95% CI: 2.54-7.05). Community factors included perceived stigma (OR=0.34, 95% CI: 0.21-0.56), cultural norms (OR=0.45, 95% CI: 0.27-0.75), and religious beliefs (OR=1.87, 95% CI: 1.12-3.14). Structural factors included economic dependence (OR=0.38, 95% CI: 0.23-0.63) and access to support services (OR=2.45, 95% CI: 1.47-4.08). Conclusions HIV status disclosure is influenced by a complex interplay of individual, relationship, community, and structural factors. Effective interventions to promote disclosure must address these multiple levels of influence, going beyond health system support to create enabling environments for disclosure at the individual, relationship, community, and structural levels.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author
Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-74
Madiba SphiweCorresponding author
School of Public Health, Faculty of Health Sciences, University of Limpopo, Medunsa Campus, South Africa
HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.
Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5613
de Dieu Harerimana JeanCorresponding author
Background Domestic violence among HIV discordant couples poses significant public health challenges, affecting treatment adherence and HIV transmission risks. This study examined factors contributing to domestic violence among HIV discordant couples in Kicukiro District, Rwanda. Methods A cross-sectional study was conducted among 384 HIV discordant couples from eleven health centers using stratified systematic sampling. Data were collected through structured face-to-face interviews and analyzed using descriptive statistics and bivariate analysis. Results Domestic violence prevalence was 41.1% physical violence, 34.2% sexual coercion, and 52.3% emotional abuse. Key socio-demographic risk factors included female gender (56% vs. 29% males, p<0.001), older age (61% in ≥55 years vs. 32% in 18-24 years, p=0.004), unemployment (55% vs. 34% formal employment, p=0.014), and financial hardship (63% vs. 25% comfortable situations, p=0.002). Behavioral factors included alcohol use (58% vs. 38%, p=0.021), substance abuse (62% vs. 35%, p<0.001), and poor conflict resolution (72% vs. 25%, p<0.001). Contextual factors like hostile HIV disclosure reactions (68% vs. 34%, p<0.001) and HIV-related stigma (60% vs. 35%, p<0.001) significantly increased violence risk. Conclusions Domestic violence among HIV discordant couples is multifactorial, driven by socio-economic, behavioral, and HIV-related factors. Integrated interventions addressing economic empowerment, conflict resolution skills, stigma reduction, and couple-centered counseling are urgently needed.
Dec 2012 DOI 10.14302/issn.2324-7339.jcrhap-12-68
Tumwine ChristopherCorresponding author
Infectious Diseases Institute, Makerere University, P.O. Box 22418, Kampala-Uganda
New research suggests that people living with HIV have the potential to be strong advocates for HIV prevention by passing on HIV prevention messages within their social networks. However, there is a paucity of research into the nature and prevalence of HIV prevention behaviours engaged in by HIV clients, and the psychosocial correlates of such advocacy, which are the goals of this analysis. We examined engagement in HIV prevention advocacy among 602 new HIV clients at two clinics in Uganda. Eighty nine percent reported encouraging others to get tested for HIV, 79% told people they know to use condoms when they have sex, and 61% reported discussing HIV more generally with friends and family. A client was classified as fully engaged in HIV prevention advocacy if they reported engaging in all three of the measured HIV prevention advocacy behaviors. In the bivariate analysis, being from the rural study site (p<0.001), higher levels of HIV disclosure to friends (p<0.001), greater hopefulness (p<0.001), and lower levels of depression (p<0.001) and internalized HIV stigma (p<0.001) were associated with full engagement in HIV prevention advocacy. In the multivariate analysis, being from the rural study site (OR=5.461, 95% CI=3.11-9.61), lower levels of internalized HIV stigma (OR=0.524, 95% CI=0.39-0.70) and higher levels of HIV status disclosure to friends (OR=2.040, 95% CI=1.23-3.38) remained significantly associated with full engagement in prevention advocacy. These data suggest that psychosocial adjustment and functioning may play a key role in empowering HIV clients to be advocates for prevention.