Factors associated with disclosure of HIV serostatus to sexual partners of patients receiving HIV care in Kabale, Uganda

OBJECTIVE: To evaluate factors independently associated with disclosure of HIV serostatus in the era of widespread access to antiretroviral agents (ARVs) among individuals receiving HIV care in Uganda. METHODS: Between January 1 and August 31, 2009, 403 HIV-positive individuals attending Kabale Hospital in southwestern Uganda were interviewed about their sociodemographic characteristics; sexuality; contraceptive use and sexual behavior; and disclosure of HIV serostatus to sexual partners. Data regarding disclosure versus nondisclosure were analyzed to identify factors independently associated with disclosure of serostatus. RESULTS: The study participants were predominantly female (74.0%). In all, 82.5% of the patients were receiving ARVs. Disclosure of HIV serostatus to regular sexual partners was reported by 50.9% of the participants, while 49.1% had chosen not to disclose their serostatus. Factors independently associated with nondisclosure were marital status; current use of ARVs; having children who had died (from any cause); being sexually active in the previous 6 months; and the number of sexual partners during the previous 6 months (P<0.05 for all associations). Fear of stigma was the main reason for nondisclosure of HIV serostatus. CONCLUSION: Despite receiving treatment with ARVs, many of the study participants neither disclosed their own HIV serostatus nor knew the HIV serostatus of their sexual partners.