Test and tell: correlates and consequences of testing and disclosure of HIV status in South Africa (HPTN 043 Project Accept).
BACKGROUND
As the numbers of HIV-positive diagnoses rise in South Africa, it is important to understand the determinants and consequences of HIV disclosure.


METHODS
Cross-sectional survey from random community samples of men and women in urban and rural South Africa (n = 217 HIV-positive individuals, 89% female).


RESULTS
Two thirds of all known HIV-infected adults in these communities had disclosed their status to sexual partner(s). On average, individuals who disclosed were 2 years older, higher in socioeconomic assets, and had known their HIV status 7 months longer than those who had not told their sexual partner(s). The "need for privacy" was the most cited reason (45%) for nondisclosure among those who had never disclosed. People who eventually disclosed their HIV status to sexual partner(s) were significantly more likely to report always or more frequently using condoms, reducing their number of sexual partners, and/or becoming monogamous. Among individuals who disclosed their HIV status, 77% reported increases in social support, with families providing the most support.


CONCLUSIONS
Disclosure is associated with reports of consequent safer sexual behavior and greater social support. Interventions might be informed by the costs and benefits of disclosure and differences in disclosure to sexual partner vs. to one's social network.
Wong
Lauren H
LH
Department of Psychology, University of California, Los Angeles, CA 90095-1563, USA. lhwong@ucla.edu
Rooyen
Heidi Van
HV
Modiba
Precious
P
Richter
Linda
L
Gray
Glenda
G
McIntyre
James A
JA
Schetter
Christine Dunkel
CD
Coates
Thomas
T
D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012424:Rural Population; D012650:Self Disclosure; D012747:Sexual Partners; D012944:Social Support; D013019:South Africa; D013240:Stereotyping; D014505:Urban Population; D055815:Young Adult