title: Factors correlated with disclosure of HIV infection in the French Antilles and French Guiana: results from the ANRS-EN13-VESPA-DFA Study.
abstract: OBJECTIVE
  To determine the rate, patterns and predictors of HIV disclosure in the French Antilles and French Guiana.
  
  
  METHODS
  A cross-sectional survey was carried out among a 15% random sample (n=398) of the hospital caseload in hospitals providing HIV care. Determinants of disclosure to a steady partner and other members of the individual's social network were analysed using logistic regression.
  
  
  RESULTS
  From the time of diagnosis, 84.6% of those in a couple (n=173) disclosed their HIV-positive status to their steady partner, 55.6% disclosed to others, and 30.3% did not tell their status to anyone. Disclosure within a steady partnership was less likely among non-French individuals [Haitians: adjusted odds ratio (AOR) 0.11, 95% confidence interval (CI) 0.02-0.72; other nationalities: AOR 0.13, 95% CI 0.02-0.68]; and among those diagnosed with HIV after 1997 (AOR 0.21, 95% CI 0.05-0.86). Determinants of disclosure to others were found to be sex (women: AOR 2.04, 95% CI 1.24-3.36), age at diagnosis (>or=50 versus<30 years: AOR 0.42, 95% CI 0.19-0.90), nationality (Haitians versus French: AOR 0.39, 95% CI 0.19-0.77), transmission route (non-sexual versus sexual: AOR 3.38, 95% CI 1.12-10.23) and hospital inpatients (hospitalized versus non-hospitalized patients: AOR 1.98, 95% CI 1.17-3.37). After disclosing, social and emotional support from confidants was common and discrimination was infrequent.
  
  
  CONCLUSIONS
  One third of PLWHA had kept their HIV status secret. Interventions targeting the general population and social institutions, and support for PLWHA by healthcare staff are needed to improve the situation.
authors.affiliation: INSERM Research Unit 687-IFR69 Public Health and Epidemiology of the Social and Occupational Determinants of Health, Saint-Maurice, France.
authors.forename: Kim
authors.initials: K
authors.lastname: Bouillon
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.forename: Rémi
authors.initials: R
authors.lastname: Sitta
authors.forename: Annie
authors.initials: A
authors.lastname: Schmaus
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: Rosemary
authors.initials: R
authors.lastname: Dray-Spira
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D017691:Caribbean Region / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012737:Sex Factors; D014342:Truth Disclosure