Perceived HIV Stigmatization, Hiv/aids Cognition and Personality as Correlates of HIV Self-Disclosure among People Living with HIV in Ibadan, Nigeria
Adejumo, Adebayo O, Gender & Behaviour
The relationship between perceived HIV stigmatization, HIV/AIDS cognition, personality and HIV self-disclosure (HSD) was investigated. The influence of age and gender on these was also examined. PLWHA (N421) in Ibadan, Nigeria participated in the cross-sectional study. A positive relationship of extraversion (r=-.738, df=421, P<.05), HIV cognition (r=-.621, df=421, P<.05), neuroticism (r=-.212, df=421, P<.05) and agreeableness personality traits (r=-.155, df=421, P<.05) with HSD was observed. A 2x2x2x2 factorial analysis showed that old females, with low perceived stigmatisation, but with good HIV cognition (n=23, X =18.2, SD=3.8) were most likely to disclose their status. Perceived stigmatisation, HIV cognition, and personality jointly predicted HSD (R^sup 2^=.52; F (3,418) =.7.66 P <.05). Negative HIV cognition, perceived stigmatization, openness and conscientious personality traits are major barriers to HSD. Non disclosure remains an enormous barrier to the fight against HIV and AIDS. Policies and actions should therefore focus on these issues in HIV prevention, care and support.
Key words: HIV self- disclosure, Stigmatisation, personality, psychosocial factors, HIV self-disclosure, Nigeria.
In Nigeria, an estimated 4.6 percent of the population are living with HIV and AIDS (UNGASS, 2010). Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia, the size of Nigeria's population (around 149 million) meant that by the end of 2009, there were about 2.98 million people living with HIV. AIDS is not only claiming so many lives, about 192,000 in 2009, Nigeria's life expectancy has declined significantly. The average life expectancy was 54 years for women and 53 years for men in 1991 (UNGASS, 2010). However, in 2009 these figures had fallen to 48 for women and 46 for men (CIA, 2010). HIV transmission has been linked to HIV non disclosure (Galletly & Pinkerton, 2006; Rubin, 2007; and Ogundahunsi, Daniel, & Oladapo, 2007). Understanding the psychological factors related to HIV/ AIDS disclosure among people living with HIV/ AIDS (PLWHA) to others is a critical issue for HIV prevention and care efforts (Rubin, 2007).
HIV self disclosure is the tendency of an individual to be free to autonomously discuss his/her HIV status with a sexual partner, family, or units of a society. Unfortunately, the potential for rejection, abandonment, physical and emotional abuse and other adverse consequences create substantial barriers to disclosing HIV status (Rothenberg & Paskey, 1995). HIV disclosure is a complex issue since quite often disclosure of status is also linked to disclosure of other clandestine behaviours (such as same sex activity, injection drug use, or any HIV risk behaviour (Adejumo, 2004). The link between situational or dispositional factors and health behaviour is documented in literature (Elwood & Carter, 2003). It is therefore necessary to investigate the relationship between psychological factors and HIV self-disclosure from a sub-Saharan Africa perspective.
Data throughout the world suggests that failure to disclose HIV status is related to three major problems. First, substantial numbers of new HIV infections could occur among partners of HIV-positive persons who do not disclose their status (Mohammed & Kissinger, 2006; and Barnes, 2007). Second it could also hinder access to ante-retroviral therapy (Sullivan, 2005; Ogundahunsi, Daniel, & Oladapo, 2008). Third, failure to disclose could hinder social support required for mental health (Derlega et al, 1993; Pennebaker et al, 1993).
Numerous factors have been associated with HIV status disclosure. HIV-infected individuals are more likely to disclose to a partner whom they know is HIV-positive than to an HIVnegative or unknown sero-status partner (Niccolai et al, 2006; Marks and Crepaz, 2001). A short duration of relationship, polygamous marriage, working out of home, not knowing someone with HIV and lower income were negatively associated with disclosure in a study conducted in Tanzania (Antelman, 2001). …