Disclosure of HIV results among discordant couples in Rakai, Uganda: A facilitated couple counselling approach

Robert M. Kairania, Ronald H. Gray, Noah Kiwanuka, Fredrick Makumbi, Nelson K. Sewankambo, David Serwadda, Fred Nalugoda, Godfrey Kigozi, John Semanda, Maria J. Wawer

Research output: Contribution to journalArticlepeer-review

Abstract

Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision in Rakai, Uganda. HIV-discordant couples and a random sample of HIV-infected concordant and HIV-negative concordant couples (to mask HIV status) were invited to sensitisation meetings to discuss the benefits of disclosure and couple counselling. HIV-infected partners were subsequently contacted to encourage HIV disclosure to their HIV-uninfected partners. If the index positive partner agreed, the counsellor facilitated the disclosure of HIV results, and provided ongoing support. The proportion of disclosure was determined. Eighty-one per cent of HIV-positive partners in discordant relationships disclosed their status to their HIV-uninfected partners in the presence of the counsellor. The rates of disclosure were 81.3% in male HIV-positive and 80.2% in female HIV-positive discordant couples. Disclosure did not vary by age, education or occupation. In summary, disclosure of HIV-positive results in discordant couples using facilitated couple counselling approach is high, but requires a stepwise process of sensitisation and agreement by the infected partner.

Original languageEnglish (US)
Pages (from-to)1041-1051
Number of pages11
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume22
Issue number9
DOIs
StatePublished - Sep 2010

Keywords

  • HIV disclosure
  • discordant couples
  • facilitated couple counselling

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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