HIV Disclosure Among Sexually Infected People Living with HIV and AIDS in China: Prevalence, Influencing Factors, and Negative Outcomes

HIV disclosure is crucial for HIV prevention and control, but may also lead to discrimination, insult, and even violence against people living with HIV and AIDS (PLWHAs). In this study, we examined HIV disclosure, its influencing factors, and its association with intimate partner violence (IPV) among 1153 PLWHAs through the sexual route in Jinan, Shandong Province, China. Our results showed that 76.4% (881/1153) PLWHAs had disclosed someone about their HIV infection, the HIV disclosure rates among family members, friends, spouses, and current fixed partners of PLWHAs were 43.5% (501/1153), 47.9% (552/1153), 56.8% (129/227), and 43.2% (336/777), respectively. HIV disclosure was affected by socio-demographics, disease characteristics, and psycho-social factors and varied among family members, close friends, spouses, and current fixed sexual partners. Age ≤ 33 years ( aOR 1.79, 95% CI 1.27–2.53), heterosexual infection route ( aOR 1.52, 95% CI 1.06–2.17), HIV diagnosis time > 36 months ( aOR 1.84, 95% CI 1.30–2.59), with other chronic diseases ( aOR 1.87, 95% CI 1.34–2.61), lower self-stigma ( aOR 4.03–4.36, 95% CI 1.98–8.74), higher social support ( aOR 1.71–1.73, 95% CI 1.03–2.83), no depression ( aOR 1.54, 95% CI 1.12–2.11), and no suicidal ideation ( aOR 1.79, 95% CI 1.28–2.50) were all independently associated with increased likelihood of HIV disclosure. HIV disclosure was associated with an increased risk of IPV among current fixed sexual partners ( aOR 1.87, 95% CI 1.38–2.54) and spouses ( aOR 2.54, 95% CI 1.41–4.56). Our findings suggest that the HIV disclosure rate of PLWHAs is still low and is affected by multiple factors. There is an urgent need to design targeted and comprehensive interventions to improve HIV disclosure. IPV prevention should also be incorporated into the intervention system of HIV disclosure to ensure adequate and continuous support for PLWHAs.