Sociodemographic predictors of non-disclosure of HIV sero-status to sexual partners in suburban area of southern Mozambique
Authors: Nacarapa Edy , Mudender Florindo , Paredes Zulmira , Maiela Adelina , Vio Ferruccio , Amane Guita , Paude Edna , Couto Aleny , Mamudo Allend , Uamir Restano , Bello Stephanie , Ruano Maria , Wate Joaquim 
Published: November 2023

Abstract

The HIV prevalence in Maputo city is 16.2%. There is a paucity of data describing factors associated with disclosure or non-disclosure of HIV-positive sero-status to sexual partners. This study aims to describe predictors of HIV sero-status- disclosure to sexual partners among people living with HIV (PLHIV) as per analytical study carried-out at three health facilities in the suburban area of Maputo, Mozambique.
We used prospective cohort study design of PLHIV aged over 18 years in suburban area of Maputo. Data were collected between December 2019 and December 2020. Crude and adjusted logistic regression were used to analyze and model predictors of non-disclosure of their HIV sero-status.
A total of 377 patients were enrolled in the HIV sero-status disclosure study. Of these, nearly two-thirds 61.5% were women, 52.9% had secondary school, 47.7% were aged between 25-34 years, 50.9% had informal employment with low income, 73.2% were married. The proportion of patients regarding gender was significantly different, women were higher in contrast to men, in those aged 15-24 years (23.3% [95% CI: 18.2 – 29.0] vs 2.1% [95% CI: 0.5 – 5.4] , p=0.000); employment contract with maximum wage(43.1% [95% CI: 36.8 – 49.5] vs 22.8% [95% CI: 16.3 – 30.1], p=0.000); single civil status (29.7% [95% CI: 24.1 – 35.8] vs 19.4% [95% CI: 13.2 – 26.5], p=0.020. 70 (18.6%, 95% CI: 22.7) of overall did not disclose their HIV sero-status to the sexual partner after 12 months of follow up. Crude logistic regression showed higher likelihood of non-disclosure in those who had an employment contract with maximum wage (Crude Odds Ratio [cOR] 2.02, 95% confidence interval [CI] : 1.15 – 3.55, p=0.015); were single (cOR 3.85, 95% CI: 2.22 – 6.69, p=0.000); were living with parents (cOR 2.30, 95% CI: 1.07 – 4.93, p=0.033); received financial support for their monthly household expenses from parents or a close relative (cOR 7.15, 95% CI: 2.19 – 23.36, p=0.001); or brought a parent/lose relative and/or a friend as a confidant during enrollment period of Program Confidant (cOR 3.17 , 95% CI: 1.74 – 5.76, p=0.000; and cOR 5.97, 95% CI: 1.57 – 22.66, p=0.009, respectively). From parents/close relative and from partner (Adjusted Odds Ratio [aOR] 8.19, 95% CI: 1.44 – 46.46, p=0.018; and aOR 4.34, 95% CI: 1.05 – 17.17, p=0.043), respectively); in those who brought a parent/close relative and/or a friend as a confidant during enrollment period of Program (aOR 8.86, 95% CI: 2.16 – 36.31, p=0.002; and 195 aOR 21.68, 95% CI: 3.02 – 155.87, p= 0.002, respectively).
Factors independently associated with non-disclosure of HIV-positive sero-status were employment contract with medium/high income, single status, living with parents, received financial support for their monthly household expenses from parents/close relatives, brought a parent/close relative and/or a friend as a confidant during enrollment period of study. This information should help to support a social intervention strategy to improve HIV sero-status disclosure in PLHIV, which is urgent within suburban society.