Amsterdam 2015
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| Abstract #2279 - Time to talk? Disclosure and HIV | ||||
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Session: 29.3: Time to talk? Disclosure and HIV (Parallel) on Thursday @ 11.30-13.00 in C202 Chaired by Bouko Bakker, Philippe Adam Authors: Presenting Author: Dr Marie Suzan-Monti - INSERM UMR912 - SESSTIM, France |
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| Additional Authors: | ||||
| Aim: Previous analysis of data from the national representative ANRS-VESPA2 survey showed that most PLWH followed up in French hospitals had disclosed their HIV status to at least one family member, friend or colleague. The objective of the present analysis was to identify and describe the different profiles of PLWH according to their level of disclosure and to characterize groups by clustering individuals according to shared associated factors. | ||||
| Method / Issue: ANRS-VESPA2 is a cross-sectional survey conducted in 2011 on 3022 adult PLWH attending French hospitals and HIV-diagnosed >6 months. Socio-behavioural (face-to-face patient interviews) and medical (provided by medical staff) data were collected. Participants answered questions about HIV status disclosure to close family (parents, children, siblings), other relatives, friends, and colleagues. Hierarchical classification based on multiple correspondence analysis was implemented in order to identify clusters of participants with similar behavior in terms of disclosure. A multinomial logistic model allowed us to characterize the identified disclosure clusters by estimating their respective associated factors. Models were adjusted for the number of the categories of persons to which participants could potentially disclose to. | ||||
| Results / Comments: Three clusters were identified according to disclosure level: cluster 1 (n=869) was associated with the highest disclosure (4 categories of people/4 i.e. close family, other relatives, friends and colleagues), cluster 2 (n=861) with medium disclosure (2 categories/4 i.e. close family and friends), and cluster 3 (n=1292) with the lowest disclosure (1 category/4 i.e. friends). PLWH diagnosed HIV positive before 2003, those having experienced an AIDS-defining event, men who have sex with men (MSM) and intravenous drug users (IDU) were mainly classified into clusters 1 and 2. PLWH living in a couple, those with a primary school education level and migrants from Sub-Saharan Africa were mainly classified in cluster 3. After adjustment for age the number of the categories of persons to which participants could potentially disclose to, the following factors were significantly associated with belonging to cluster 1 vs cluster 3 (highest vs lowest level of disclosure): years since diagnosis (OR[95%CI] 1.015[1.0111.018]), experience of an AIDS-defining event (1.5[1.12.0]), and receiving HAART (2.0[1.03.8]). Compared with French heterosexual men, MSM (2.1[1.43.2]), IDU (4.5[2.68.2]) and French heterosexual women (2.3[1.43.8]) were more likely to belong to cluster 1 than cluster 3. The opposite was true for Sub-Saharan Africa migrants (0.6[0.41.0]). In addition, compared with PLWH living in a couple or living alone with no need of support, those living alone who needed moral support were significantly more likely to have a higher level of disclosure (1.5[1.22.0]). A similar pattern of associated factors was observed when comparing cluster 2 with cluster 3 (medium vs lowest disclosure level). | ||||
| Discussion: The present results suggest that for HIV-positive people living alone, disclosing their serostatus might be a way to obtain moral support, a key component to treatment adherence and positive prevention. This is particularly true for vulnerable social groups, such as migrants, where HIV disclosure is observed the least often. | ||||
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