HIV disclosure results in different experiences for women and men

Ongoing efforts to increase HIV testing in sub-Saharan Africa means that more and more people will learn their status and wrestle with decisions about disclosing an HIV diagnosis. While many people living with HIV fear the reaction from their intimate partners, disclosing an HIV diagnosis is critical to reducing transmission and staying in care.

In a new study, UCSF Bixby researchers examined people’s experiences with HIV disclosure as part of a broader testing initiative in East Africa. They found that men and women had very different experiences when considering whether to tell their partners about an HIV diagnosis:

  • Women reported the most severe consequences of HIV disclosure, including abandonment, blame and violence from their partners.
  • Men more often reported positive experiences with disclosure, including an increased ability to stay in care and sense of empowerment.
  • When keeping an HIV diagnosis hidden, men were able to enroll in HIV care without telling their partners. Some men sought care far away from their home communities in order to keep it a secret.
  • While many women also sought care away from home in order to keep their status secret, fewer had the freedom to do so. Many women also found it difficult to start and remain in care due to fears of their partners finding out.

These findings underscore the different experiences women and men have with disclosing an HIV diagnosis—and the importance of programs to support these unique needs. For instance, it is crucial to increase the ability of health care systems, providers and counselors help people living with HIV disclose their status to their partners. As the rapid scale-up of HIV testing worldwide continues, the need for gender-sensitive, culturally appropriate support programs are urgent.