HIV This Week

Bouillon K, Lert F, Sitta R, Schmaus A, Spire B, Dray-Spira R. Factors correlated with disclosure of HIV infection in the French Antilles and French Guiana: results from the ANRS-EN13-VESPA-DFA Study. AIDS 2007;21(Suppl 1):S89-S94.

Bouillon and colleagues determined the rate, patterns and predictors of HIV disclosure in the French Antilles and French Guiana. The authors conducted a cross-sectional survey among a 15% random sample (n=398) of the hospital caseload in hospitals providing HIV care. Determinants of disclosure to a steady partner and other members of the individual's social network were analysed using logistic regression. From the time of diagnosis, 84.6% of those in a couple (n=173) disclosed their HIV-positive status to their steady partner, 55.6% disclosed to others, and 30.3% did not tell their status to anyone. Disclosure within a steady partnership was less likely among non-French individuals (Haitians: OR 0.11, 95% CI 0.02-0.72; other nationalities: OR 0.13, 95% CI 0.02-0.68); and among those diagnosed with HIV after 1997 (OR 0.21, 95% CI 0.05-0.86). Determinants of disclosure to others were found to be sex (women: OR 2.04, 95% CI 1.24-3.36), age at diagnosis (≥ 50 versus < 30 years: OR 0.42, 95% CI 0.19-0.90), nationality (Haitians versus French: OR 0.39, 95% CI 0.19-0.77), transmission route (non-sexual versus sexual: OR 3.38, 95% CI 1.12-10.23) and hospital inpatients (hospitalized versus non-hospitalized patients: OR 1.98, 95% CI 1.17-3.37). After disclosing, social and emotional support from confidants was common and discrimination was infrequent. The authors conclude that one third of people living with HIV had kept their HIV status secret. Programmes targeting the general population and social institutions, and support for people living with HIV by healthcare staff are needed to improve the situation.

Editors’ note: In this study, although 85% of those with steady partners had disclosed, overall a third of people diagnosed with HIV had not disclosed. Women, younger people, French nationals, hospital inpatients or those infected through non-sexual transmission routes were more likely to disclose. Studying the determinants of disclosure in a given setting is important in determining which people may need additional counselling and support to experience the beneficial aspects of disclosure.