Prevalence for the Disclosure of HIV Status to Sexual Partners and Its Determinants among Adults under cART in Amhara Region, Northwest Ethiopia

Abstract

Background. Globally, the transmission of HIV from one individual to another causes 1.8 million new infections each year, 36.7 million people living with HIV, and one million people died from HIV-related illnesses. The objective of this study was to determine the prevalence of the disclosure of HIV status to sexual partners and its determinants among adults under cART in the Amhara Region, northwest Ethiopia. Methods. A retrospective study design was conducted on 792 randomly selected samples. The study was conducted in the Amhara Region, from 2015 to 2020. A binary logistic regression modeling was used for data analysis. The data were collected using a stratified random sampling technique where the residential areas were considered strata. Data were collected by trained health practitioners in the ART section in Felege Hiwot Teaching and Specialized Hospital. The hospital is a referral in which many patients from different districts and zonal hospitals in the region are referred to this hospital. Results. The rate of disclosure of HIV status to sexual partners in this study was 21%, which is very low compared to the average rate of disclosure in developing countries. Among the predictors, age of patients (AOR = 1.02, 95% CI:(1.001,1.120); $p$ -value = 0.004); number of baseline CD4 cell count (AOR = 0.980; 95% CI: (0.764, 0.991); $p$ -value<0.01); number of hospital visits (AOR = 1.01; 95% CI: (1.001, 1.034); $p$ -value < 0.01); marital status (living with partner) (AOR = 1.01; 95% CI: (1.003, 1.112); $p$ -value = 0.006); female HIV-positive adults (AOR = 1.01; 95% CI: (1.001, 1.021); $p$ -value = 0.007); rural residence (AOR = 0.98; 95% CI: (0.96, 0.99); $p$ -value = 0.004); non-educated adult patients (AOR = 0.950, 95% CI: (0.92. 0.98); $p$ -value = 0.003); cART non-adherent adult patients (AOR = 0.940, 95% CI: (0.61. 0.97); $p$ -value < 0.001); non-opportunistic infectious diseases (AOR = 1.062, 95% CI: (1.049. 1.191); $p$ -value = 0.002); and non-existence of social violence (AOR = 1.012, 95% CI: (1.008, 1.); $p$ -value < 0.01) significantly affected the variable of interest. Of these, the number of CD4 cell count, male HIV-positive adults, rural residence, and existence of social violence negatively affected the variable of interest. Conclusions. Some groups of HIV patients did not disclose their level of HIV status to their sexual partners. Health-related education is recommended for patients who did not disclose their HIV status to sexual partners. This helps to reduce the transmission of HIV from infected individuals to noninfected ones and from mother-to-child HIV transmission.