HIV Positive status disclosure to sexual partners: a qualitative study to explore experiences and challenges among clients attending HIV care services in North-Western Tanzania

ABSTRACT

HIV status disclosure rates to sexual partners are low in Tanzania, despite the benefits it confers to both partners. This qualitative study drew on the Disclosure Decision Model to explore the decision by people living with HIV (PLHIV) to disclose, or not, their HIV status to their partner. Six focus group discussions and thirty in-depth interviews were conducted in Mwanza, Tanzania in 2019 with PLHIV. Topics covered decision-making around disclosure and disclosure experiences. Thematic content analysis was conducted. Most respondents reported having disclosed their status to their partners. Disclosure was reported to facilitate or hinder the attainment of social goals including having intimate relationships, raising a family, relief from distress and accessing social support. Decisions made by PLHIV about whether to disclose their status were made after weighing up the perceived benefits and risks. The sense of liberty from a guilty conscious, and not “living a lie” were perceived as benefits of disclosure, while fears of stigma, family break-up or abandonment were perceived as risks. Many participants found disclosure was beneficial in promoting their adherence to treatment and clinic appointments. Interventions to support PLHIV with disclosure should include enhanced counselling, strengthening HIV support groups and enhanced assisted partner notification services.

KEYWORDS:

• HIV
• disclosure
• Tanzania
• qualitative research
• sexual partners

Acknowledgements

The authors are very thankful to all study participants and staff from CICADA project and the management of NIMR-Mwanza Research Centre for their support. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust, the UK government or Ministry of Foreign Affairs of Denmark. None of the funders had any role in the study design, data collection and analysis, decision to publish results or preparation of the manuscript. We also thank the Tanzania Commission for Science and Technology (COSTECH) for providing training on writing scientific papers in 2020.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data will be made available after the data sharing request is approved by the Medical Research Coordinating Committee at NIMR.

Additional information

Funding

This work was supported through the DELTAS Africa Initiative - African Academy of Sciences (AAS) grant # DEL-15-011 to THRiVE-2 and the Ministry of Foreign Affairs of Denmark and administered by Danida Fellowship Centre (grant: 16-P01-TAN). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust grant # 107742/Z/15/Z and the UK government.