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.