SEROSTATUS DISCLOSURE AND SEXUAL BEHAVIOUR AMONG ADULT HIV POSITIVE INDIVIDUALS ATTENDING THE ANTIRETROVIRAL CLINIC AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Serostatus disclosure to sexual partners by HIV-positive persons is one of the recommended practices for the prevention of HIV infection. The influence of this practice on the sexual behaviour of HIV positive individuals has not been well investigated in Nigeria. The study was therefore aimed at assessing the practice of serostatus disclosure, sexual behaviour and knowledge of disclosure and safe sex practices among HIV seropositive individuals attending the President`s Emergency Plan for AIDS Relief (PEPFAR) Clinic at the University College Hospital, lbadan. Systematic random sampling technique was used to select 392 out of 1500 HIV positive consenting adults who were receiving care at the PEPFAR clinic from January to February, 2009. Data were collected using a validated interviewer-administered questionnaire which contained a 12-point knowledge scale. Descriptive statistics, Chi-square and t-test were used to analyse the data. The mean age of respondents was 35.6 ± 9.6 years. Majority (69.9%) were females and 59.4% were married. Most of the respondents (97.4%) had received HIV post-test counseling while 88.8% received counseling on notification of sexual partners. The overall mean safe sex knowledge score of the respondents was 8.3±2.4. There was no significant difference between the mean knowledge score for males (8.3 ±2.1) and females (8.3 ± 2.5). Majority (70.9%) were aware that serostatus disclosure to a partner before having sex could lead to reduction in HIV transmission. while 92.7% were aware that consistent and correct use of condom could prevent the spread of HIV. Seventy-nine percent of respondents had ever disclosed their HIV status to someone, while 19.0% had done so to all their sexual partners. More married respondents (48.5%) disclosed their serostatus compared with the unmarried (27.0%) (p<0.05). The proportions of females and males who disclosed their serostatus were 40.3% and 37.1% respectively. There was a significant relationship between counselling on disclosure to partners and the practice only among the female respondents. The factors hindering disclosure included: fear of stigmatization (46.4%), fear of abandonment (26.4%) and divorce (8.4%). There was no significant relationship between any of these factors and the practice of serostatus disclosure. Majority of respondents (75.5%) who had disclosed their status to all sexual partners practiced safe sex than those who had not disclosed (24.5%) (p<0.05). Many respondents (62.8%) were favourably disposed to the disclosure of one's serostatus to sexual partners. Majority of the males (79.7%) and females (79.2%) considered mandatory serostatus disclosure to sexual partners as desirable. Positive attitude towards safe sex was exhibited by 58.4% who expressed the view that it was necessary to use condom with every sexual partner. Non-usage of condom was more among the unmarried (38.6%) than the married (23.2%) (p<0.05), while it was more among females (33.8%) than males (28.7%). (p<0.05). Respondents had positive attitude and high level of knowledge of the importance of serostatus disclosure to sexual partners. However, instances of non-disclosure and unsafe sexual practices were noted. HIV/AIDS educational programmes and media campaigns should be intensified to promote the adoption of serostatus disclosure and safe sexual practices among HIV positive persons.