Date of Conferral

2016

Degree

Ph.D.

School

Public Health

Advisor

Frazier Beatty

Abstract

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV status disclosure (OR = 1.038, CI = 1.022, 1.053, p = .000); (b) no significant correlation between high scores on HIV knowledge scale and HIV status disclosure (OR = .992, CI =.921, 1.067, p = .822); and (c) high stigma scale scores significantly predicted disclosure of HIV status in an inverse association (OR =.982, CI = .968, .997, p = .020). Independent t test analysis demonstrated that the gender difference in disclosure rates (females, 67.7%; males, 64.9%) was statistically nonsignificant at t (301) = -504, .614, p > .05. Multivariate analyses found marital status, length of relationship, knowledge of partners HIV status, and duration of HIV diagnosis as disclosure predictors. This study, which established a disclosure rate of 66.7%, and a discordance rate of 40.9%, may promote timely HIV-positive status disclosure and prevent secondary HIV transmission at the local level, resulting in the control of HIV epidemic at a global level.

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