HIV Disclosure Among Sexually Infected People Living With HIV:Prevalence,Influencing Factors,and Negative Outcomes

Sexual transmission is currently the primary route of HIV(Human Immunodeficiency Virus)transmission in our country.Informing family members,friends,spouses,and regular sexual partners is crucial for HIV-infected individuals.Disclosing HIV status to family,friends,spouses,and regular sexual partners can provide social support,alleviate psychological stress,reduce the occurrence of high-risk sexual behaviors,help maintain long-term treatment,and improve adherence to Antiretroviral Therapy(ART).It is a critical factor in reducing HIV transmission.However,disclosing HIV status can also lead to discrimination,insults,or even violence against HIV-infected individuals.The study employed a cross-sectional design using consecutive sampling technique.Data collection took place at the Disease Prevention and Control Center in S District,J City,Shandong Province.Face-to-face interviews were conducted to gather information from 1153 individuals infected with HIV through sexual transmission.The participants were asked to disclose their HIV status to family members,friends,spouses,and current regular sexual partners.Various factors such as sociodemographic characteristics,disease features,and social psychology were assessed.Binary logistic regression models were utilized to analyze the factors influencing HIV disclosure to family members,friends,spouses,and current regular sexual partners.Furthermore,the relationship between HIV disclosure and intimate partner violence(IPV)was examined,aiming to provide evidence for future interventions on HIV disclosure among HIV-infected individuals.Our results showed that 76.4%(881/1153)PLWHAs had disclosed someone a bout their HIV infection,the HIV disclosure rates among family members,friends,spouses,and current fixed partners of PLWHAs were 43.5%(501/1153),47.9%(552/1153),56.8%(129/227),and 43.2%(336/777),respectively.HIV disclosure was affecte d by socio-demographics,disease characteristics,and psycho-social factors and varie d among family members,close friends,spouses,and current fixed sexual partners.Age≤33 years(OR=1.79,95%CI:1.27～2.53),heterosexual infection route(OR=1.52,95%CI:1.06～2.17),HIV diagnosis time>36 months(OR=1.84,95%CI:1.30～2.59),wit h other chronic diseases(OR=1.87,95%CI:1.34～2.61),lower self-stigma(OR=4.03～4.36,95%CI:1.98～8.74),higher social support(OR=1.71～1.73,95%CI:1.03～2.83),no d epression(OR=1.54,95%CI:1.12～2.11),and no suicidal ideation(OR=1.79,95%CI:1.28～2.50)were all independently associated with increased likelihood of HIV disclosu re.HIV disclosure was associated with an increased risk of IPV among current fixe d sexual partners(OR=1.50,95%CI:1.06～2.12)and spouses(OR=3.34,95%CI:1.59～6.98).Our findings suggest that the HIV disclosure rate of PLWHAs is still low and is affected by multiple factors.There is an urgent need to design targeted and comprehensive interventions to improve HIV disclosure.IPV prevention should also be incorporated into the intervention system of HIV disclosure to ensure adequate and continuous support for PLWHAs.