Men's perception of hiv-positive status disclosure in rural South Africa

Background Disclosure of an HIV-positive status has significant implications for public health outcomes, social relationships, and individual psychological and emotional well-being. The response to the disclosure is critical for future treatment adherence, feelings of stigma, future disclosure, and overall health behaviours. There is paucity of data on the impact of the reaction of the person disclosed to on men’s willingness to disclose. We report on men’s perception of HIV-positive status disclosure in rural KwaZulu-Natal, South Africa. Methods Following informed consent and COVID-19 regulations, 12 telephonic in-depth interviews and 3 face-to-face group discussions (October-November 2020) were conducted with a purposive sample of men aged 23–65 years from rural KwaZulu-Natal. Themes were identified from the interview transcripts, manually coded, and analysed thematically. The study was approved by the University of KwaZulu-Natal, University of Johannesburg, and Africa Health Research Institute research ethics committee. Results Personal characteristics, gender, HIV knowledge and HIV identity were key factors for study participants to disclose their HIV-positive status to another person. Participants reported that if that person is popular, friendly, and talkative, they will be reluctant to disclose to them fearing that they might tell others. Some were wary of disclosing to female nurses from their community. It is also difficult for men to reveal their HIV-positive status to their partners fearing that they will be viewed as a cheater or someone with a promiscuous past. Knowing that the person disclosed to is also HIV positive makes it easier for the men in our study to disclose their HIV status. Conclusion Our findings show that men often weigh up the costs and benefits of disclosing their HIV-positive status depending on who they are disclosing to. Further research is needed to understand different ways in which men can disclose their HIV-positive status without fear of stigmatization.