Gender Differences Regarding Barriers and Motivators of HIV Status Disclosure among HIV-Positive Service Users

ABSTRACT

There are inconsistent findings about the relation between gender and HIV status disclosure. We conducted a facility-based crosssectional study; using qualitative and quantitative data collection methods; to explore gender differences in HIV-positive status disclosure among service users in south-west Ethiopia. Among 705 participants; an equal number of men and women (94.6men v. 94.3; women) indicated that they had disclosed their result to someone; and the majority (90.9men v. 90.7women) to their current main partner. `It is customary to tell my partner everything' was the most frequently cited reason for disclosing (62.5men v. 68.5women). Reasons for non-disclosure varied by gender men were concerned about their partner's worry and exposure of their own unfaithfulness. Women feared physical violence; and social and economic pressure in raising their children. Factors that influenced disclosure also indicated gender variation. For men; disclosure of HIV results to a sexual partner was positively associated with knowing the partner's HIV status and discussion about HIV testing prior to seeking services; while for women it was associated with knowing the partner's HIV status; advanced disease stage; having no more than primary education; being married; and perceiving the current relationship as long-lasting. There was no significant difference in the proportion of HIV status disclosure among men and women. However; the contextual barriers and motivators of disclosure varied by gender. Therefore it is important that clinicians; counsellors; and health educators underscore the importance of gender-specific interventions in efforts to dispel barriers to HIV status disclosure