For people living with HIV, disclosure of HIV status is an important challenge : informed friends or family members can be supportive, or on the contrary can stigmatise the HIV-positive person. We aimed to compare HIV status disclosure among men and women, since gender relationships create different opportunities and difficulties for both sexes.
The study was conducted among HIV-positive adults enrolled in the TEMPRANO randomized trial in Côte d’Ivoire, which aims to compare very early antiretroviral treatment versus treatment initiation as per WHO current guidelines. All participants in this trial were asked questions on HIV status disclosure after 24 months of follow-up. Univariate and multivariate analyses were performed to compare disclosure patterns among men and women, disclosure to people living inside and/or outside the household, and in particular to the spouse or regular partner, and to identify the factors associated with disclosure.
HIV status disclosure was frequent (more than 80%) among HIV patients, with no difference between men and women (p=0.45). For both, the regular partner was the most frequent confidant. But patterns of disclosure were different : men more frequently disclosed to a regular partner than women (74.1% vs 64.9%, p=0.004), because they were more likely to live with a regular partner (58.6% of men vs 35.8% of women). Men and women living with a regular partner reported similar levels of disclosure to the spouse (82.1% for men and 82.4% for women). Women disclosed more often than men to their children, siblings and mother. For both, the confidants were more often women (sisters, mother) than men (brothers, father).
Our study shows that differences in the living conditions of men and women living with HIV and differences in gender roles induce gendered differences in HIV disclosure that should be considered in the care of the patient.
HIV disclosure ; gender ; Côte d’Ivoire ; couple ; early ART.