DETERMINANTS OF HIV SEROSTATUS DISCLOSURE AMONG PEOPLE LIVING WITH HIV/AIDS IN MSAMBWENI COUNTY REFERRAL HOSPITAL, KWALE COUNTY, KENYA.

Abstract

ABSTRACT Kenya is projected to have 1.5 million people living with HIV, with 42,000 new adult infections occurring each year. Anticipated prevalence of HIV in Kenya, namely in the areas of Kwale and Msambweni, are said to be 4.9%, 4.2%, and 5.7%, correspondingly. Based on current empirical investigations about the disclosure of HIV status among adult sexual partners, it has been shown that the worldwide prevalence of HIV disclosure varies considerably, spanning from 16.7% to 100%. Numerous researches pertaining to HIV/AIDS have been undertaken within the geographical context of Kenya. Nevertheless, there is a dearth of knowledge about the determinants that impact the disclosure of one's HIV status among individuals who are HIV-positive. The main aim of this study was to investigate the impact of cultural beliefs, attitudes, stigma, and the accessibility of counselling services on the act of revealing one's HIV serostatus among persons who are affected by HIV/AIDS at Msambweni County Referral Hospital in Kwale County, Kenya. The investigators employed a cross-sectional study strategy to gather data of qualitative as well as quantitative nature. SPSS version 26 was used for descriptive analysis, which included frequencies, percentages, mean, composite mean, and standard deviation. From a sample frame of 881 PLHIV, a sample size of 253 PLHIV getting care at the facility was calculated using the Israel, 1992 sample size calculation formula. There were also 12 nurses attending PLHIV. Simple random sample method was utilised to recruit PLHIVs into the trial through the delivery of labelled and folded papers, with those who chose yes being included in the study and the exercise continuing throughout the study period, whereas purposive sampling was employed for nurses. Before consenting, the subjects were informed about the research's objective, risks, rights, confidentiality, and benefits. To collect data, structured questionnaires and interview guides were used. According to the quantitative findings, 55.1% of the 253 primary subjects in the study were female, while 45.1% were male. The majority (52.5%) were between the ages of 25 and 34. Regarding educational background, a large proportion of patients (36.8%) or (35.2%) had completed primary or secondary education, and the majority (49.4%) had lived with HIV for 2–5 years. Key statements that positively encouraged disclosure were: “I believe that revealing my HIV serostatus within my cultural group can contribute to greater awareness and education regarding my HIV serostatus” (M=3.39, SD=1.37), attitude statements: "I believe that medical professionals should play a role in encouraging and promoting HIV serostatus disclosure" (M=4.31, SD=0.88); "I believe people who come forward about their HIV serostatus should be encouraged and offered resources to improve their health." (M= 4.11, SD = 1.10); Stigma: "I believe that individuals who reveal their HIV serostatus should receive gratitude and encouragement from healthcare professionals" (M = 3.85, SD = 1.47); "I believe that individuals who provide their HIV serostatus should be accorded compassion and understanding" (M = 4.06, SD = 0.96); and "I feel that open conversations about HIV serostatus assist in combating stigma and encourage empathy" (M = 3.87, SD = 1.1); Counselling services: “Counselling services play a crucial role in supporting humans who are considering disclosing their HIV serostatus” ( M = 4.20, SD = 0.94), “I believe that counselling services can help people cope with the emotional obstacles associated with disclosing their HIV serostatus” (M = 4.41, SD = 0.73), “Counselling services should offer information and resources to individuals on legal rights and safeguards related to HIV serostatus disclosure” (M = 4.06, SD = 1.01), “I feel that counselling services should collaborate with other healthcare professionals to ensure comprehensive support for people disclosing their HIV serostatus” (M = 4.17, SD = 1.11). From Qualitative findings, key themes included "misconceptions", "stigma", "polygamy relationships,", "rejection", "mental health" and "mental health". Supporting HIV counselling and testing programs and fostering community perspectives on disclosure is crucial. This study's findings will aid both PLHIV and unaffected individuals in navigating testing and reporting, ultimately reducing HIV transmission risks.