Disclosure of HIV Positive Status and Network Characteristics Among a Cohort of People Living with HIV in Western Kenya

Abstract

Disclosure of HIV serostatus is critical in managing the health and well-being of people living with HIV/AIDS (PLWHA), yet the decision to disclose is shaped by complex interpersonal and contextual factors. The purpose of this study was to examine patterns of HIV status disclosure and social support, and to characterize disclosure networks among a cohort of PLWHA in Kenya. We conducted a cross-sectional egocentric social network analysis of 174 PLWHA and their network members to examine whether characteristics of participants (egos), their networks, and network members (alters) were associated with HIV serostatus disclosure. Generalized linear mixed model (GLMM) examined alter characteristics, social support, trust levels, and an interaction between trust and intimate partners in predicting disclosure. The model was also stratified by trust to assess differences between low and high trust. Overall, 163 (93.7%) participants disclosed their HIV status to at least one person in their network. In the multivariable analyses stratified by trust, in ego-alter dyads where trust is high, the odds of disclosure are higher (aOR 35.34, 95% CI [10.05–124.32]) if the alter is a partner and a child (aOR 3.60, 95% CI [1.31–9.87]). In addition, disclosure was significantly more likely with alters perceived to provide health-related support (aOR 16.43, 95% CI [8.17–33.03]) or emotional support (aOR 3.20, 95% CI [1.75–5.86]). In Kenya, where disclosure decisions intersect with social dynamics, understanding the characteristics of disclosure networks can inform public health interventions that strengthen supportive relationships and reduce barriers to disclosure.