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WEPEC275
STIGMATIZATION, STATUS DISCLOSURE AND SUPPORT AMONG HIV POSITIVE WOMEN IN THE KUMASI METROPOLIS, GHANA: A MIXED METHOD STUDY
Daniel Boateng1, 2, Dan Yedu Quansah3, Gold Dokuaa Kwapong,4 Isaac Amankwaa5, Albert Opoku6, Olivia Nyarko Mensah6
1School 2Julius
of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Global Health, University Medical Center, Utrecht University, The Netherlands
3Graduate School of
Public health, Seoul National University, Seoul, South Korea
4
Kumasi South Government Hospital, Kumasi, Ghana
5Garden
6
City University College, Kumasi, Ghana
Nursing and Midwifery Training College, Kumasi, Ghana
#AIDS2016 | @AIDS_conference
Background • HIV-related stigma and discrimination have been acknowledged as impediments to mitigating the HIV epidemic, with women being mostly affected • Stigma enhances secrecy and denial, which are also catalysts for HIV transmission • Inability to disclose HIV status prevents HIV positive women from seeking supports and thereby unable to fully access ART • There is however limited documentation of women’s experiences of stigma and how it relates to supports and adherence to ART in the study area • This study explored stigmatization and status disclosure among HIV positive women and how this affects their access to ART Rankin et al. PLoS Medicine. 2005; 2(8): 247 #AIDS2016 | @AIDS_conference
Methods • Parallel mixed method study – conducted in three ART centers in the Kumasi metropolis of Ghana
• 206 HIV positive women on ARVs for treatment or prophylaxis, aged 18-49 years and on ART >3 months and 14 health workers recruited – Sampling was systematically random
• Quantitative data were collected using semi-structured questionnaires • Univariable associations were tested using Pearson chi-square and one-way ANOVA depending on the type of variable
•
A logistic regression analysis was done to estimate the influence of sociodemographic characteristics and health worker support on status disclosure and treatment adherence
• The qualitative study involved 3 focus group discussions and 14 in-depth interviews
#AIDS2016 | @AIDS_conference
Results- Quantitative •
About 88% had disclosed their status to a partner or a family member
•
24% of those who had not disclosed status had no support
•
Being single or never married negatively influenced disclosure of HIV status (AOR=0.1; 95% CI=0.02-0.6) Table 2 Results of influence of status disclosure and family/partner support on access to ART % Defaulted (N=55)
p-value $
Disclosed status No Yes
42.9 24.2
Family/partner support No Yes
38.0 20.7
Variables
Logistic regression Univariable OR [95%CI]
Multivariable AOR§ [95%CI] Model 1
0.038
1.0 0.4 [0.2, 0.9]*
1.0 0.3 [0.1, 0.9]* Model 2
0.016
1.0 0.4 [0.2, 0.9]*
1.0 0.5 [0.2, 1.7]
$ Based on chi-square test §Adjusted for age, length of treatment, OUTCOME=Default ART appointment; marital status, education, occupation, religion and health worker support; *p
