HIV Status Disclosure to Sexual Partner(s) and Associated Factors Among Young Adults, A Mixed Methods Study

With a documented HIV prevalence among adults of 12.6% with disparities by sex; 15.7% and 9.3% among women and men respectively, Namibia is one of the first countries reported to be nearing epidemic control for HIV. Namibia has been very successful in ensuring universal treatment access for people living with HIV. For prevention interventions, the importance of HIV status disclosure among HIV-infected individuals, particularly to their sexual partners cannot be over emphasized. We used a mixed methods approach on a combined sample of 185 HIV positive young adults attending comprehensive care departments at selected referral hospitals in Namibia. For quantitative data, the chi-square test and multiple regression analysis were employed for data analysis. Qualitative data was transcribed, coded and analysed to build themes in line with study objectives. Of the 185 participants; only 35 were included in the qualitative component of the study with stratification by gender and age. Multiple logistic regression found HIV post-test counselling plus age were the only factors associated with disclosure status whilst adjusting for other study variables. Three major themes were built from the qualitative data. Theme one showed fear to be an important barrier to disclosure (fear of being rejected and violence). Theme two showed revealed lack of knowledge on importance of disclosure to sexual partner if not married or cohabitating. Theme three showed one main motivation for disclosure was having been tested together or discussed with sexual partner prior to testing. The importance of HIV post-test counselling remains an important factor affecting HIV status disclosure. In the advent of new HIV interventions such as HIV self-testing, findings from our study may be used to guide policies for these new interventions and strengthen post-test counselling to ensure HIV status disclosure to sexual partner(s). Health education on importance of testing as couples or with sexual partner needs to be strengthened.