Factors influencing disclosure of HIV positive status to spouses among people living with HIV in Kirinyaga County, Kenya

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.