Partner Notification And Associated Factors Among Old People Living With HIV In Hunan Province

Objective(1)To describe the current status of sexual partner notification of old people living with HIV(OPLWH)in Hunan Province;(2)To understand the status of HIV/AIDS knowledge among OPLWH,sexual behavior and sexual partner’s serological status,self-perceived stigma,social medical support and self-efficacy for managing chronic disease;(3)To investigate the related factors with sexual partner notification among OPLWH in Hunan Province.Method This cross-sectional study was conducted from January 1,2021 to June 1,2021 in the first hospital of Changsha and the Public Health Hospital affiliated with Nanhua University.The face-to-face questionnaire survey was conducted among participants who met the inclusion criteria.The contents of the questionnaire included demographic characteristics,disease-related status,HIV-transmission knowledge,sexual behavior,sexual partner notification status,HIV self-perceived stigma,social medical support and self-efficacy for managing chronic disease.All statistical analyses were conducted with SPSS.18.0.The statistical methods included descriptive analysis,chi-square test,Fisher’s exact probability test,T-test and binary Logistic regression analysis;structural equation models were constructed using AMOS.24.0 software.Result(1)Among the 348 participants,the total partner notification rate was 41.4%(144/348).According to different types of sexual partners,the reporting rates were male/girlfriend(56.0%),spouse(54.8%),anonymous sexual partner(26.7%),and commercial partner(6.0%).(2)The average score of HIV-transmission knowledge among OPLWH was 6.73±1.94(the lowest score was 3,the highest score was 8).In this study,88.2% of participants could answer 6 or more questions correctly,and 88.9% of the informed group had good HIV-transmission knowledge significantly higher than 77.5% of the uninformed group(P=0.006).51.0%(99/194)of the subjects reported that their partner’s serological status was positive,and most of the infected did not know the serological status of their commercial and anonymous partners.When the partner’s serological status was positive,84.8%(84/99)of the participants reported that they had never used a condom during sexual intercourse with their sexual partner within the last year of the survey.61.9%(65/105)of respondents who did not know the serological status of their commercial partners reported that they had never used a condom during their last sexual intercourse.The total score of self-perceived stigma was35.41±6.47,and the average value of self-perceived stigma in the uninformed group(38.50)was significantly higher than that in the informed group(31.05)(P < 0.001).The total score of social medical support was 49.74±20.96,and the mean value of social medical support in the uninformed group(41.06)was significantly lower than that in the informed group(62.02)(P < 0.001).The proportion of high self-efficacy of chronic disease management in the informed group(84.03%)was significantly higher than that in the uninformed group(40.20%)(P <0.001).(3)Binary Logistic regression was used to analyze the related factors of sexual partner notification among OPLWH.The results showed that male(OR=2.57,95%CI=1.285.16),education level in primary school OR below(OR=2.05,95%CI=1.063.97),unmarried(OR=3.70,95%CI=1.688.13)and low self-efficacy in chronic disease management(OR=3.45,95%CI=1.627.29)increased the risk of OPLWH not being informed of sexual partners.Isolation(OR=0.41,95%CI=0.170.99)and sexual partner being a temporary partner(OR=0.21,95%CI=0.120.36)could reduce the risk of OPLWH not being informed of sexual partner.The risk of not being informed their sexual partners increased with the increase of self-perceived discrimination score(OR=0.81,95%CI=0.750.86).The results of SEM showed that depression had no significant effect on sexual partner notification(β=-0.058,P<0.001);Depression positively affected self-perceived stigma(β=0.428,P < 0.001);Self-perceived stigma negatively affected sexual partner notification(β=-0.439,P<0.001);Social medical support positively affected sexual partner notification(β=0.176,P=0.005).Social medical support significantly affected depression(β=-0.597,P=0.001);Social medical support significantly affected self-perceived stigma(β=-0.32,P=0.001).Conclusion(1)The low rate of sexual partner notification among OPLWH in Hunan indicates that the elderly infected people should be the key group to promote sexual partner notification.(2)There is still a gap between the rate of HIV-transmission knowledge among OPLWH and the requirements of the National Health Commission.(3)Most OPLWH have risky sexual behaviors,especially they do not use condoms when they have sex with commercial partners.(4)The factors influencing OPLWH sexual partner notification mainly include gender,residence form,educational level,marital status,sexual partner type,self-efficacy for chronic disease management and self-perceived stigma.(5)Depression has an indirect effect on sexual partner notification,social medical support has both direct and indirect effects on sexual partner notification.