Non-disclosure of HIV serostatus to sexual partners: Prevalence, risk factors and clinical impact in patients with HIV

Abstract

Objective: To determine the prevalence, risk factors and impact of non-disclosure of HIV serostatus to sexual partners among HIV-positive patients at Siriraj Hospital, Bangkok. Methods: We conducted a prospective observational study to enrol HIV-positive adults with one or more regular sexual partners during the past 3 months. We obtained personal information via anonymous questionnaire and clinical data of those receiving antiretroviral therapy (ART) for ≥12 months via chart-review. Results: A total of 328 HIV-positive participants were enrolled. Approximately half were female and in the symptomatic HIV stage at diagnosis, with an average age 44.08 ± 8.59 years. Approximately one-third of participants (35.7%) reported that they had not disclosed their HIV serostatus to their sexual partners. The non-disclosure group had a higher rate of poor ART adherence owing to fear of revealing their HIV serostatus to their partner (12.0% vs. 1.9%; P < 0.001), as compared with the disclosure group. Rates of immunological and virological failure did not differ between groups. Multivariate analysis [adjusted odds ratio (OR); 95% confidence interval (CI); P-value] revealed having an occupation as a teacher (4.08; 1.40–16.61; P = 0.01) and reporting acquisition of HIV infection through blood transfusion (4.08; 1.31–12.68; P = 0.02) were independent risk factors. Furthermore, a longer duration of the sexual relationship (0.997; 0.994–0.999; P = 0.02), having a seropositive sexual partner (0.57; 0.33–0.99; P = 0.04), living in their partner’s house (0.53; 0.31–0.90; P = 0.02) and having a higher mean Pictorial Thai Self-Esteem Scale (PTSS) score (0.62; 0.38–0.99; P = 0.05) were identified as independent protective factors. Conclusions: We found a high prevalence of HIV serostatus non-disclosure, which was associated with poorer ART adherence. Appropriately focusing interventions on high-risk populations with aforementioned risk factors is important for improved HIV care.