Barcelona 2013
Barcelona 2013
Abstract book - Abstract - 163
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Abstract #163  -  Disclosure
Session:
  37.4: Disclosure (Parallel) on Tuesday @ 14.30-16.00 in Mirador Chaired by George Palattiyil,
Ashraf Kagee

Authors:
  Presenting Author:   Dr Annabel DESGREES du LOU - IRD, France
 
  Additional Authors:  Mr. Michael Olaogbebikan,  
Aim:
For people living with HIV, the disclosure of HIV status to the entourage is an important challenge: the friends or family members informed can be very supportive, or at the contrary may use this information to stigmatize the person HIV positive. We decided to compare how men and women deal with this challenge, since gender relationships create opportunities and difficulties that may be different for both sexes.
 
Method / Issue:
The study was conducted among HIV positive adults who were enrolled in the Temprano randomized trial in Côte d?Ivoire, aiming to compare very early ART versus ART initiation as per WHO current guidelines. All participants in this trial were asked questions on HIV status disclosure at enrollment and after 12 months and 24 months of follow-up. Univariate and multivariate analyses were performed to look for factors associated with disclosure within the household, outside the household, and to the regular partner for patients living in couple.
 
Results / Comments:
By December 2012, 1304 of the 2076 Temprano trial participants had been enrolled and followed at least 24 months, of whom 55% had disclosed their serostatus to at least one person outside their household. Of these 1304 patients, 855 declared they had a regular partner, of whom 66% had disclosed their status to their partner (31% if HIV status of the partner is unknown, 86% if partner is HIV-, 96% if partner is HIV+) ; 1220 were not living alone, of whom 58% had disclosed their status to at least one person in their household. Men disclosed more than women within the household (68% vs. 56%, p<0.01; ORa 1.66 [1.20-2.29]) and disclosed less than women outside the household (47% vs. 57%, p=0.002 ; ORa 0.66 [0.50-0.88]). Women disclosed more than men to their children, their siblings, their friends. Among those living in couple, men tended to disclose more than women to their spouse (73% vs. 64%, p=0.01), but this association was not significant after adjustment on age and level of instruction (ORa=1.21 [0.82-1.79]). Factors related to disclosure were different between men and women: among men, age and level of instruction were not related to disclosure to the spouse, whether women aged more than 35 and of high level of instruction disclosed more to their partner, after adjustment on other factors.
 
Discussion:
In this population of HIV-infected adults living in Côte d?Ivoire, the pattern of disclosure of serostatus seems to be gendered: men reveal more their HIV status to their close family, and women to their confidents, friends or sisters. For both, the spouse is the more frequent confident when in couple. Sharing their serostatus seems more difficult for young and uneducated women, underlining their vulnerability.
 
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