TUAC0104 - Oral Abstract Session
Impact of antiretroviral therapy on HIV-positive status disclosure in rural South Africa
Presented by Benjamin Bearnot (South Africa).
B. Bearnot1,2, L. Werner1, A. Kharsany1, S. Abdool Karim1,3, J. Frohlich1, Q. Abdool Karim1,3, CAPRISA060 Study Team
1CAPRISA, UKZN, Durban, South Africa, 2New York University, New York, United States, 3Columbia University, New York, United States
individuals risk transmission to uninfected sexual partners. This risk may
be elevated in the absence of disclosure of HIV status, but could be
ameliorated given several options to prevent sexual transmission once HIV
status is known. The purpose of this study was to assess the impact of
antiretroviral therapy (ART) on degrees of HIV status disclosure.
this prospective cohort study, we enrolled consenting, HIV-positive adults from
the CAPRISA Vulindlela AIDS Treatment programme into one of two arms: ART experienced
or ART naïve. Disclosure of HIV status was not a prerequisite for care or
treatment. Data were collected at two time points using structured
questionnaires including demographic, clinical, and HIV status disclosure
Results: Between June 2006-August 2009, 687 HIV-positive
individuals were enrolled; 73.3% were female. At enrollment, 414 participants (60.3%)
were on ART (median days on ART 54, IQR 11-167; median CD4 138/µL, IQR 86-199) and
273 (39.7%) were in care but not eligible for ART (median CD4 346/µL, IQR 254-476).
Disclosure was common in ART and non-ART groups, with ART experienced
participants more likely to have disclosed to at least one person than ART
naïve individuals (99% versus 83.3%; p< 0.001). Disclosure occurred soon after HIV diagnosis
(median: 0-1 day, respectively).
Disclosure rates to sexual partners were markedly lower
in both ART and non-ART groups (31.6% and 26.0%), and was less common among females
compared to males (23.7% versus 45.1%; p< 0.001). Low rates of further partner
disclosure persisted at a median of 4.4 months post-enrollment (Females 9.9%
versus Males 19.2%; p=0.003).
[Table 1 - revised]
on ART had higher rates of disclosure. HIV-positive individuals in both arms
readily disclosed to family members and wider social networks. Rates of
disclosure to sexual partners were much lower, particularly among female
participants. This represents an addressable risk for HIV transmission in
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