HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Abstract
Background: Disclosure of HIV status supports risk reduction and facilitates access to prevention and care services,
but can be inhibited by the fear of negative repercussions. We explored the short and long-term outcomes of
disclosure among clients attending an urban HIV clinic in Uganda.
Methods: Qualitative semi-structured interviews were administered to a purposeful sample of 40 adult HIV clients
that was stratified by gender. The information elicited included their lived experiences and outcomes of disclosure
in the short and long term. A text data management software (ATLAS.ti) was used for data analysis. Codes were
exported to MS Excel and pivot tables, and code counts made to generate statistical data.
Results: Of the 134 short-term responses elicited during the interview regarding disclosure events, most responses
were supportive including encouragement, advice and support regarding HIV care and treatment. The results show
on-disclosing to spouse, there was more trust, and use of condoms for HIV prevention. Only one third were negative
responses, like emotional shock and feeling of distress. The negative reactions to the spouses included rejection, shock
and distress in the short term. Even then, none of these events led to drastic change such as divorce. Other responses
reflected HIV prevention and call for behavioural change and advice to change sexual behaviour, recipient seeking HIV
testing or care. Women reported more responses of encouragement compared to men. Men reported more preventive
behaviour compared to women. Of the 137 long-term outcomes elicited during disclosure, three quarters were positive
followed by behavioral change and prevention, and then negative responses. Men reported increased care and support
when they disclosed to fellow men compared to when women disclosed to women. There was better or not change
in relationship when women disclosed to women than when women disclosed to men.
Conclusions: There is overwhelming support to individuals that disclose their HIV status, especially in the long term.
Besides, gender appears to influence responses to HIV disclosure, highlighting the need for gender specific disclosure
support strategies.
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Keywords
HIV/AIDS, Disclosure, Outcome, Uganda
Citation
Atuyambe, L. M., Ssegujja, E., Ssali, S., Tumwine, C., Nekesa, N., Nannungi, A., ... & Wagner, G. (2014). HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda. BMC Health Services Research, 14(1), 1-11.