Disclosure of HIV seropositivity to sexual partner and psychosocial factors in Ethiopia: Systematic review and meta-analysiss

Background: To control the transmission of HIV to the second or third person, HIV sero-disclosure to their sexual partner is indispensable. Psychosocial factors would have a great influence on the HIV disclosure status of HIV infected people to their sexual partners. This review aimed to estimate the national proportion of HIV disclosure practice to their sexual partner and identify psychosocial factors as the main contributors.
Methods: We retrieved PubMed, Scopus, African Journals Online, and Google Scholar databases. The Newcastle Ottawa quality assessment scale was used to assess the quality of studies. To ensure the absence of publication bias, we employed a funnel plot and Egger’s regression test for the subjective and objective assessment, respectively. Variation across studies was assessed using the I2 statistic. The pooled proportion was estimated by using weighted inverse variance random-effects model meta-analysis. We did subgroup and sensitivity analysis to explore the reason for heterogeneity and the impact of outlier finding on the overall estimation, respectively. Trend analysis was also performed to see the presence of time variation. 
Results: The proportion of HIV sero-disclosure practice to sexual partners was 76.03 % (Confidence Interval (CI):  68.78, 83.27). Being on ART (AOR=6.19; 95% CI: 2.92, 9.49), cohabiting with partner (AOR=4.48; 95% CI: 1.24, 7.72), getting counseling (AOR=3.94; 95% CI: 2.08, 5.80), had discussion prior to HIV testing (AOR= 4.40; 95% CI: 2.11, 6.69), knowing partner’s HIV status (AOR= 6.08; 95%CI: 3.05, 9.10),smooth relationship with partner (AOR=4.44; 95% CI:1.28, 7.61), and being member of anti-HIV association (AOR=3.70; 95% CI: 2.20, 5.20) were the supporting factors for HIV positive people to disclose HIV positive status to sexual partner.
Conclusions: In Ethiopia, still more than one-fourth of HIV-infected adults did not disclose their HIV positivity status to sexual partners. Psychosocial factors were the prominent supporting factors of HIV-positive status disclosure. Behavioral change to disclosure once seropositivity to sexual partner is highly needed to further decrease the transmission rate of HIV in Ethiopia which would be focus of health and education sectors in the country.

Author(s): Aklilu Endalamaw Sinshaw, Demeke Geremew, Habte Belete, Sintayehu Ambachew, Berihun Assefa, Tesfa Dejenie Habtewold, Rhonda Wilson

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