Longitudinal Analysis of HIV Disclosure Intention: The Implication of Duration of Diagnosis Knowledge and CD4 Counts Among Asymptomatic Treatment-seeking People Living with HIV/AIDS

Abstract

Introduction: The spate of non-disclosure among individuals diagnosed with Human-Immunodeficiency-Virus and Acquired-Immune-Deficiency-Syndrome (HIV/AIDS) has continually been a primary global concern, especially in developing countries. Meta-analysis findings in Nigeria reported poor disclosure rates of 12.5% - 39.5%, which were far below the average disclosure benchmark of 79.0% standard stipulated for developing nations by the World Health Organization. There is no consensus regarding the roles of CD4 counts in disclosure intention. In Nigeria, there is a paucity of literature providing detailed understanding of the predictors of disclosure intention by the duration of diagnosis knowledge and CD4 counts. Methods: This study, therefore, investigated the implication of duration of diagnosis knowledge and CD4 counts in the prediction of HIV disclosure intention among people seeking HIV treatment. Longitudinal survey research designs were adopted. 390 participants were purposively selected to respond to HIV Self-Disclosure Intention Index (α=0.92), while information on CD4 counts and Duration of Diagnosis Knowledge was obtained from the selected respondents’ case files periodically. Binomial logistic regression analysis was used to analyze data at 0.05. Respondents’ mean age was 39.5±10.5 years. Results: Findings revealed that the duration of diagnosis knowledge and CD4 counts interactively predicted the outcome of disclosure intention among treatment-seeking PLHIV. (χ2 = 12.78, df = 2, p < 0.001) and further showed that the likelihood of disclosing HIV positive status increases by 13% between Time 1 (OR = -0.49, p < 0.01; 95%CI = 01.14-12.74) and Time 2 (OR = -0.36, p < 0.05; 95%CI = 01.11-10.93). Increase in CD4 counts was also found to increase the likelihood of HIV self-disclosure by 15% between Time 1 (OR = - 0.84, p < 0.01; 95%CI = 01.09-03.06) and Time 2 (OR = - 0.99, p < 0.01; 95%CI = 00.29-03.06). Conclusion: It was concluded that the duration of diagnosis knowledge and CD4 counts have significant implications in determining the intention to disclose HIV positive status. The study limitations and recommendations were further discussed.