title: Partner Disclosure and Early CD4 Response among HIV-Infected Adults Initiating Antiretroviral Treatment in Nairobi Kenya.
abstract: BACKGROUND
  Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response.
  
  
  METHODS
  We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner. Analysis of CD4 response at 6 and 12 months post-ART was stratified by age group.
  
  
  RESULTS
  Among 615 adults newly initiating ART with partner disclosure data and 12 month follow-up, mean age was 38 years and 52% were male; 76% reported that they had disclosed their HIV-status to their partner. Those who disclosed were significantly younger and more likely to be married/cohabitating than non-disclosers. At baseline, median CD4 counts were similar between disclosure groups. Among younger adults (< 38 years) those who disclosed had higher CD4 recovery than those who did not at 6 months post- ART (mean difference = 31, 95% CI 3 to 58 p = 0.03) but not at 12 months (mean difference = 17, 95% CI -19 to 52, p = 0.4). Among older adults (≥ 38years) there was no observed difference in CD4 recovery at 6 or 12 months between disclosure groups.
  
  
  CONCLUSIONS
  Among younger adults, disclosure of HIV status to partners may be associated with CD4 recovery following ART.
authors.affiliation: Department of Global Health, University of Washington, Seattle, Washington, United States of America.|Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.
authors.forename: T Tony
authors.initials: TT
authors.lastname: Trinh
authors.affiliation: Coptic Hospital, Nairobi, Kenya.
authors.forename: Nelly
authors.initials: N
authors.lastname: Yatich
authors.affiliation: Coptic Hospital, Nairobi, Kenya.
authors.forename: Richard
authors.initials: R
authors.lastname: Ngomoa
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States of America.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: McGrath
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington, United States of America.
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.affiliation: Coptic Hospital, Nairobi, Kenya.
authors.forename: Samah R
authors.initials: SR
authors.lastname: Sakr
authors.affiliation: US Center for Disease Control and Prevention, Nairobi, Kenya.
authors.forename: Agnes
authors.initials: A
authors.lastname: Langat
authors.affiliation: Department of Global Health, University of Washington, Seattle, Washington, United States of America.|Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.|Department of Pediatrics University of Washington, Seattle, Washington, United States of America.
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
authors.affiliation: Department of Global Health, University of Washington, Seattle, Washington, United States of America.|Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007630:Kenya; D008297:Male; D012189:Retrospective Studies; D012747:Sexual Partners; D016896:Treatment Outcome; D014342:Truth Disclosure
chemical_list: D019380:Anti-HIV Agents