Resumen
Background: Serostatus disclosure to couples in people living with HIV (PLWH) has been associated with positive results in emotional adjustment to HIV infection as well as in self-care behaviors such as adherence to antiretroviral treatment, retention in care and consequently reduction of transmission risk. However, there are high percentages of non-disclosure due to barriers perceived by individuals as well as for negative consequences that affect their psychological well-being and mental health. The aim of this study was identified psychosocial variables related to non-disclosure of HIV diagnosis to couples (barriers). Methods: Cross-sectional study carried out at an HIV clinic in Mexico City between November 2012 and May 2013. We included PLWH under antiretroviral treatment, with a couple at the moment of data collection. Sex, age, employee or not, couple''s type (stable, occasional and both), couple''s sex, time since HIV diagnosis, depressive and anxious symptoms were the variables included in analysis. A structured questionnaire and validated psychometric tests were used to measure variables. Data analysis included descriptive, unadjusted and adjusted analysis through logistic regression. Results: Two hundred and seven PLWH were included, 89.4% (n=185) were males, with mean age 35.57 years (SD=8.43) and mean time since HIV diagnosis of 61.57 months (SD=58.33); 33.8%
(n = 70) had not disclosed their diagnosis. In unadjusted analysis, variables associated with non-disclosure included being man (OR=3.6 95%CI 1.1-12.8, p=.034), having an occasional couple (OR=33.2 95%CI 5.5-199.4, p< .001), less time since diagnosis (less than 19 months OR=2.9 95%CI 1.2-7.4, p=.014; 19 to 40 months OR=3.8 95%CI 1.4-10.1, p=.004; 41 to 90 months OR=2.7 95%CI 1.1-7.0, p=.028; comparing with >90 months) moderate anxiety symptoms (OR=3.0 95%CI 1.3-7.0, p=.006) and severe depression symptoms (OR=3.8 95%CI 1.1-13.4, p=.022). In adjusted analysis, having occasional couples (aOR=44.7, 95%CI 8.9-223.0, p< .001) and severe depressive symptoms (aOR=32.2 95%CI 3.6-291.7, p=.002) were variables associated with non-disclosure, the model showed a good fit (R2=.448, p< .001).
Conclusions: Identifying related psychosocial variables for non-disclosure of HIV diagnosis to couples (barriers) could help to design psychological interventions aimed to promoting serostatus disclosure with beneficial results in psychological well-being and clinical outcomes in PLWH.