Individual and structural factors associated with HIV status disclosure to main partner in Cameroon: ANRS 12-116 EVAL survey, 2006-2007

Encouraging HIV-positive people to disclose their serostatus to their main partner is considered as a key component of secondary prevention. The purpose of this study was to identify individual and structural factors associated with HIV serostatus disclosure to one's steady partner in Cameroon, a country which has implemented a large program for access to antiretroviral therapy. We used data from the cross-sectional, nationally representative survey, ANRS 12-116 EVAL (Evaluation du programme camerounais d'accès aux traitements antirétroviraux--Impact sur la prise en charge et les conditions de vie de la population infectée par le VIH), conducted between 2006 and 2007 among HIV-infected outpatients attending health care facilities. Among the 1673 HIV-positive individuals reporting a steady partner at the time of the survey (61% women), 85.4% (n = 1429) had disclosed their serostatus to them; 77% of the respondents were receiving antiretroviral therapy. Multivariate analysis based on multilevel modeling approaches showed that the following individual factors were associated with disclosure: living with one's steady partner, living with children, reporting systematic condom use or sexual abstinence with one's steady partner, being a woman who is not the head of the household, and finally having HIV-infected people among friends or relatives and not living below the poverty line. Structural factors associated with disclosure were as follows: attending national health facilities in the country's capital cities Yaoundé or Douala and having access to psychosocial or economical support interventions. These results strengthen the argument for the introduction or development of psychosocial interventions at all levels of organization in Cameroonian hospitals as an important component of public health policies for those living with HIV.