Factors associated with HIV status non-disclosure among people entering care at IeDEA sites in Cameroon: a cross-sectional study

Abstract

Background: While non-disclosure of HIV status may protect people living with HIV (PLWH) against stigma, discrimination, and violence, disclosure may facilitate access to social support and improve treatment adherence. This study examined factors associated with non-disclosure among recently-diagnosed PLWH at IeDEA study sites in Cameroon. Methods: We conducted a cross-sectional study of adults ≥ 19 years newly enrolling in HIV care at three Cameroon hospitals from January 2016 to June 2023 with recent (< 1 year) diagnoses and no evidence of prior HIV care. We used logistic regression to identify factors associated with non-disclosure of HIV status at the time of enrolment. Results: Among 2880 participants, the overall prevalence of HIV status non-disclosure at enrolment was 34.4%, ranging from 48.0% among those enrolling on the day of diagnosis to 18.7% among those enrolling > 30 days after diagnosis. Men and single participants had higher odds of non-disclosure compared with women (aOR: 1.68; 95% CI 1.38, 2.04) and those who were married/living with a partner (aOR: 1.66; 95% CI 1.36, 2.02). Those with early-stage HIV disease (WHO Stage 1 or 2 or CD4 ≥ 200 cells/mm3) also had higher odds of non-disclosure (aOR: 1.48; 95% CI 1.20, 1.83) compared with participants with advanced-stage disease. Conclusion: Among those diagnosed with HIV within 1 year prior to enrolment, men, single/unmarried people, and those with early-stage HIV disease were less likely to disclose their status. Further research on barriers to status disclosure among these groups is needed to guide disclosure support and counselling interventions.