Issues Surrounding HIV Status Disclosure: Experiences of Seropositive Women in Lagos, Nigeria

BACKGROUND: Disclosure of human immunodeficiency virus (HIV) seropositivity by infected women is crucial in HIV control. To determine the rates, patterns, effects, and determinants of disclosure of status among HIV-positive women in Lagos, Nigeria. METHODS: This was a descriptive cross-sectional study. Simple random sampling method was used to select 364 HIV-positive women accessing care in HIV treatment centers in Lagos Island. Data were collected using interviewer-administered questionnaires and analyzed with Epi Info (version 3.5.3). Inferential statistics done was Chi-square test and level of statistical significance was set at <5%. RESULTS: Mean age of respondents was 37.3 ± 3 years, and most were married or cohabiting in monogamous families. The disclosure rates were 81.9% to anyone (excluding a health care professional); 60.4% to spouse/sexual partners; and 67.7% disclosed on the same day of diagnosis. Main reasons for disclosure were failing health (49.3%) and a sense of responsibility to the spouse/sexual partner (33.6%). Major reasons for nondisclosure were negative public opinion (84.8%) and fear of losing relationships (40.3%). Positive reactions following disclosure were mostly acceptance: 75.2% (family member) and 72.3% (spouse/sexual partner) while blame was the main negative outcome. Longer duration of diagnosis significantly improved disclosure to anyone (P < 0.001). Older age (P < 0.001) and awareness of spouse/sexual partner's HIV status (P < 0.001) significantly improved disclosure to spouse/sexual partner. CONCLUSIONS: Many respondents had not disclosed their status and require support and counseling to do so. Community education regarding stigmatization should be intensified.