Background: The HIV epidemic continues to amplify in southern Africa and there is a growing need for HIV prevention interventions among people who have tested HIV positive.
Methods: Anonymous surveys were completed by 413 HIV-positive men and 641 HIV-positive women sampled from HIV/AIDS services; 73% were <35 years old, 70% Black African, 70% unemployed, 75% unmarried, and 50% taking antiretroviral treatment.
Results: Among the 903 (85%) participants who were currently sexually active, 378 (42%) had sex with a person to whom they had not disclosed their HIV status in the previous 3 months. Participants who had not disclosed their HIV status to their sex partners were considerably more likely to have multiple partners, HIV-negative partners, partners of unknown HIV status and unprotected intercourse with non-concordant sex partners. Not disclosing their HIV status to partners was also associated with having lost a job or a place to stay because of being HIV positive and feeling less able to disclose to partners.
Conclusions: HIV-related stigma and discrimination are associated with not disclosing HIV status to sex partners, and non-disclosure is closely associated with HIV transmission risk behaviours. Interventions are needed in South Africa to reduce the AIDS stigma and discrimination and to assist people with HIV to make effective decisions on disclosure.
- ARV, antiretroviral
- PLWHA, people living with HIV/AIDS
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Published Online First 21 June 2006
Funding: This research was supported by grants from the British Department for International Development (DFID), the Canadian International Development Agency (CIDA) and The Netherlands Government’s Department of Foreign Affairs’ Division of Research and Communication (DGIS). LCS and SCK were also supported by grant R01 MH74731 from the US National Institute of Mental Health (NIMH).
Competing interests: None declared.
LCS conceptualised the study, directed the research and contributed substantially to the manuscript; SCK assisted with conceptualising the study, contributed to measurement development, conducted the data analyses, and contributed substantially to the manuscript; AS contributed substantially to the study design and project management; AC contributed substantially to the study design, field work and project management; NH contributed substantially to the study design, field work and project management; AM contributed substantially to the study design, field work and project management.