DOI: 10.3886/e182866v1-157294
title: HIV status disclosure and care engagement in rural Kenya and Uganda_2022

description: We sought to explore experiences with and correlates of disclosure among people living with HIV (PLHIV) participating in a study of population mobility. Survey data were collected from 1081 PLHIV from 2015-16 in 12 communities in Kenya and Uganda participating in a test-and-treat trial (SEARCH, NCT#01864603). Pooled and sex-stratified multiple logistic regression models examined associations of disclosure with risk behaviors controlling for covariates and community clustering. The dataset contains socio-demographic variables (including age, sex, educational attainment, marital status, and occupational HIV risk categories), migration and mobility patterns (any migration in the past 5 years, any past 1 year and past 2 year migration, any past 6 month work travel, any past 6 month non-work travel, any past 6 month overnight travel), sexual behavior variables (any condom use in the past 6 months, any higher-risk partnerships between 2015-2016, and any concurrent partnerships in the past 6 months), and HIV care engagement variables (currently receiving HIV care, ever enrolled in antiretroviral (ART) program, currently taking ART, attending a clinic for HIV care, and ever missed appointments/dropped out of care). Among those who had disclosed their HIV status, the dataset contains variables that capture the types of individuals to whom PLHIV first disclosed their HIV status, other people to whom PLHIV would like to disclose their HIV status, but felt they could not, and reasons for not disclosing further. Among those who had not disclosed their HIV status, the dataset contains variables that capture the reasons for non-disclosure.
description: The Understanding Mobility and Risk in SEARCH Communities (R01MH104132) study examined mobility, sexual behavior and HIV outcomes in a longitudinal cohort of 2,750 adults in 12 communities participating in a large-scale test-and-treat trial, the Sustainable East Africa Research in Community Health (SEARCH) study (NCT# 01864603), in Kenya and Uganda. Methods are described in detail elsewhere [ https://www-sciencedirect-com.ucsf.idm.oclc.org/science/article/pii/S1353829219301042?via%3Dihub ]; in summary, a stratified random sampling design was used to select the sample of ∼200 individuals from each of 12 SEARCH communities, composed of eight roughly equally-sized groups of sex-specific, HIV-positive and HIV-negative, mobile (away from household six months or more in past 12 months and fewer than half of nights spent in household in past four months) and residentially stable (non-mobile), men and women. HIV-positive individuals and mobile individuals were oversampled to achieve the desired sample size in each stratum. In this dataset, we have baseline survey data collected from 1081 people living with HIV (PLHIV) for whom information on HIV status disclosure were available. HIV status disclosure was defined as PLHIV who reported voluntary disclosure of their HIV-positive status to at least one person.
description: HIV-positive and HIV-negative men and women living in 12 rural communities in Kenya and Uganda.
description: on-site questionnaire; An interviewer-administered survey was used to collect information on household residence(s) and composition, income and livelihoods, histories of migration during childhood and adulthood, patterns of mobility in the past six months (including destinations, reasons, duration and frequency of trips), sexual behavior (including sexual partnership histories over the past five years, using a calendar approach adapted from prior research studies, and among PLHIV only, experiences with HIV stigma, disclosure, and engagement in HIV care and treatment<b>.</b> A detailed relationship history calendar permitted measurement of patterns and frequency of condom use, sexual partnership concurrency, and higher-risk partnerships (i.e. any report of a casual partner, commercial sex worker/client, one-night stand, or inherited partner (referring to the Luo practice of widow “inheritance” in which a widow and her children are retained in the family/lineage of her deceased husband; cultural practices include sexual contact with the inheritor), over defined time-periods. Mobility was defined as any overnight travel in the past 6 months. Data collection was conducted from February 2015-November 2016 by trained research assistants. Surveys were originally developed in English and then translated and administered (using portable tablets) in the local languages (Lusoga, Lugwere, Ateso, Runyankole, and Dholuo) of the research participants, following procedures for the protection of privacy and confidentiality. Surveys took 30 to 90 minutes to complete, were administered in a private area, and participants and interviewers were gender-matched to maximize comfort with sharing sensitive information. Participants were compensated the equivalent of $5 USD for their time and/or transport reimbursement, which is standard procedure in the region.