Abstract:
HIV status disclosure is critical to HIV prevention and access to health care and
treatment. Thus disclosing ones HIV positive status to one’s spouse is crucial in HIV
prevention. Failure to disclose one's HIV positive status compromises risk reduction
and exposes one’s sexual partner(s) or spouse to infection if they are not already
infected.This study investigated factors influencing the disclosure of HIV positive
status to a spouse in Kirinyaga County, in Kenya. The study also investigated the role
of perceived communication behaviour of a spouse on disclosure, methods of
disclosure, challenges in disclosure and preventive behaviours adopted by the people
living with HIV (PLWHIV).The Communication Privacy Management theory was used
to provide a guiding framework to understand how individuals manage private
information. The research adopted a qualitative approach. The sample consisted of both
male and female PLWHIV attending selected comprehensive care centres (CCC) in
Kirinyaga County. Data was collected from a convenience sample of 98 PLWHIV and
seven key informants using semi-structured in-depth interviews. The data was analysed
using thematic analysis. The study found that disclosure plays an important role in risk
reduction and HIV prevention as most PLWHIV who had disclosed their HIV positive
status to their spouses found it easier to discuss HIV prevention and safe sex practices
with their spouses. The study found that perceived spousal communication behaviours
influenced the decision to disclose or conceal a HIV positive status. The study
concludes that disclosure is influenced by different factors which either result in the
PLWHIV loosening control of their privacy boundaries and disclosing or tightening
control and concealing their HIV positive status. The study recommends that couples
should be encouraged to test together thus easing the process of disclosure. It also
recommends increasing couple communication where couples can increase openness
with each other especially in HIV disclosure. A key contribution of this study is the role
of spousal communication in disclosure.
