title: HIV disclosure patterns, predictors, and psychosocial correlates among HIV positive women in Zimbabwe.
abstract: Disclosure of positive HIV status in Sub-Saharan Africa has been associated with safer sexual practices and better antiretroviral therapy (ART) adherence, but associations with psychosocial function are unclear. We examined patterns and psychosocial correlates of disclosure in a Zimbabwean community. Two hundred HIV positive women at different stages of initiating ART participated in a cross-sectional study examining actual disclosures, disclosure beliefs, perceived stigma, self-esteem, depression, and quality of life. Ninety-seven percent of the women disclosed to at least one person, 78% disclosed to their current husband/partner, with an average disclosure of four persons per woman. The majority (85-98%) of disclosures occurred in a positive manner and 72-95% of the individuals reacted positively. Factors significantly correlated with HIV disclosure to partners included being married, later age at menses, longer duration of HIV since diagnosis, being on ART, being more symptomatic at baseline, ever having used condoms, and greater number of partners in the last year. In multivariate analysis, being married and age at menses predicted disclosure to partners. Positive disclosure beliefs, but not the total number of disclosures, significantly correlated with lower perceived stigma (ρ = 0.44 for personalized subscale and ρ = 0.51 for public subscale, both p<0.0001), higher self-esteem (ρ = 0.15, p=0.04), and fewer depressive symptoms (ρ = -0.14, p=0.05). In conclusion, disclosure of positive HIV status among Zimbabwean women is common and is frequently met with positive reactions. Moreover, positive disclosure beliefs correlate significantly with psychosocial measures, including lower perceived stigma, higher self-esteem, and lower depression.
authors: Department of Internal Medicine, Stanford University, Palo Alto, USA. rcpatel@stanford.edu
authors: Rena
authors: R
authors: Patel
authors: Jamie
authors: J
authors: Ratner
authors: Cheryl
authors: C
authors: Gore-Felton
authors: Gerard
authors: G
authors: Kadzirange
authors: Godfrey
authors: G
authors: Woelk
authors: David
authors: D
authors: Katzenstein
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D011584:Psychology; D012649:Self Concept; D012650:Self Disclosure; D012747:Sexual Partners / Q000523:psychology; D057545:Social Stigma; D055815:Young Adult; D015030:Zimbabwe
chemical_list: D044966:Anti-Retroviral Agents