Barriers and facilitators to human immunodeficiency virus sero-status disclosure in a tertiary health facility in Kano, Nigeria

Abstract

Disclosure of Human Immunodeficiency Virus (HIV) sero-status to sexual partners, family and friends is essential in preventing HIV transmission. An array of benefits has
been associated with disclosure; such as early referral to care and treatment, reduced stigma and increased social support. Objectives: We determined the prevalence, barriers and facilitators to HIV sero-status disclosure among clients attending the Antiretroviral (ARV) clinic in AminuKano-Teaching Hospital, Kano. Method: A descriptive cross-sectional study was conducted among 231 HIV positive patients attending ARV clinic at AKTH using a systematic sampling technique. Interviewer-administered semi-structured questionnaire was used to obtain respondent's socio-demographic characteristics, disclosure status, barriers and facilitators of HIV sero-status disclosure. We conducted univariate, bivariate and multivariate analysis using SPSS version 22, and a p- value ≤0.05 was considered as the level of significance. Results: The mean age of the respondents was 35 ± 8.64 years with a male to female sex distribution of 53% to 47 % respectively. Majority were not married (74.0%) and two thirds (67%) were Muslims. This study found that 60% of the respondents had disclosed their HIV sero-status and 97% of them had done so voluntarily. The fear of divorce/neglect (p<0.01, aOR=0.017, 95% CI=0.02-0.15) and fear of stigma (p<0.01, aOR=0.03, 95% CI= 0.00-0.03) were found as barriers to HIV sero-status disclosure. Financial difficulties (p<0.01, aOR=3.03, 95% CI=1.16-5.61) and the need for improved access to necessary medical care (p=0.04, aOR=6.52, 95% CI=1.85-23.15) were found to facilitate HIV sero status disclosure. Conclusion: The study found a low HIV sero-status disclosure in Kano. Disclosure being major recommendation by World Health Organisation and the Centres for Disease Control and Prevention requires strengthening during patients counselling and education sessions.