In southern Mozambique, one out of three people diagnosed with HIV do not disclose their status

May 3, 2018, Barcelona Institute for Global Health
Rapid HIV test. Credit: varnent / LGBT Free Media Collective

Almost 40 percent of people previously diagnosed with HIV do not disclose their HIV status during diagnosis campaigns, leading to unnecessary retesting. In addition to wasting valuable resources, this phenomenon can distort indicators of progress toward the UNAIDS targets. These are the conclusions of a study performed in Southern Mozambique and led by ISGlobal—an institution supported by the "la Caixa" Foundation—in collaboration with the Manhiça Health Research Centre (CISM).

In 2014, UNAIDS set the goal to reach the 90-90-90 target by 2020: diagnose 90 percent of people infected with HIV, treat 90 percent of seropositive people, and achieve viral suppression in 90 percent of treated persons. Progress has been made in several African regions, but awareness of HIV status remains one of the challenges. This goes beyond , requiring accepting the result, understanding the implications, and willingness to disclose the status to others, including health counsellors. Failure to do so can lead to unnecessary repeated testing or dropping out of care.

In this study, the research team sought to characterize the people living with HIV that do not disclose their serological status during a diagnosis campaign in Manhiça district with 174,000 inhabitants and a high HIV prevalence (40 percent of adults). Of 1179 people registered as HIV-positive, more than one-third (36 percent) did not disclose their previous positive diagnosis to counsellors. Most of them were young, had dropped out of care, and had no history of antiretroviral treatment.

The high percentage of people who know they are infected but decide not to disclose it can lead to an overestimation of new HIV cases, thereby distorting programme indicators, particularly in countries like Mozambique where HIV testing is anonymous. "These results suggest that we are maybe closer the first UNAIDS target (90 percent of diagnosed people) and that we have to concentrate efforts on scaling up treatment delivery and reaching HIV positive individuals that have dropped out of care," says Denise Naniche, ISGlobal researcher and coordinator of the study.

The reasons for not disclosing HIV status may include not believing the result, thinking that brief periods of treatment has provided a cure, or fear of stigma. Therefore, the authors emphasise the need to develop interventions that "ensure appropriate psychosocial support to encourage the population to disclose their status and optimize scarce resources."

Explore further: Controlling the HIV epidemic: A progress report on efforts in sub-Saharan Africa

More information: Laura Fuente-Soro et al, Monitoring progress towards the first UNAIDS target: understanding the impact of people living with HIV who re-test during HIV-testing campaigns in rural Mozambique, Journal of the International AIDS Society (2018). DOI: 10.1002/jia2.25095

Related Stories

Controlling the HIV epidemic: A progress report on efforts in sub-Saharan Africa

May 2, 2017
In a Research Article published in PLOS Medicine, Richard Hayes of the London School of Hygiene & Tropical Medicine, UK and colleagues report early findings from PopART—a clinical trial evaluating an intervention to achieve ...

Botswana study shows 96 percent rate of viral suppression for patients on HIV drugs

March 23, 2016
Botswana appears to have achieved very high rates of HIV diagnosis, treatment, and viral suppression—much better than most Western nations, including the United States—according to a new study from Harvard T.H. Chan School ...

Men at higher risk of dying of AIDS than women: UNAIDS

December 1, 2017
Men are less likely to test for HIV or access antiretroviral therapy and, therefore, are more likely to die of AIDS-related illnesses than women, UNAIDS said on Friday.

High percentage of HIV-diagnosed women not in care

October 20, 2017
(HealthDay)—A high percentage of women receiving a new HIV diagnosis have already received this diagnosis in the past but are not undergoing HIV medical care, according to a study published online Oct. 19 in Morbidity and ...

HIV in sub-Sahara Africa: Testing and treatment start at home improves therapy

March 6, 2018
Lesotho, in southern Africa, is one of the worst hit countries by the HIV/AIDS epidemic worldwide. Indeed, a quarter of the adult population is infected with HIV. Many people however do not know their HIV status and, hence, ...

In Ethiopia, HIV disclosure is low

January 2, 2013
In Ethiopia, where more than 1.2 million people are infected with HIV, disclosure of infection by patients is important in the fight against the disease. A new study led by a Brown sociology researcher investigates HIV-positive ...

Recommended for you

Long-acting injectable implant shows promise for HIV treatment and prevention

October 9, 2018
A persistent challenge in HIV/AIDS treatment and prevention is medication adherence – getting patients to take their medication as required to get the best results.

Scientists develop rapid test for diagnosing tuberculosis in people with HIV

October 8, 2018
An international team that includes Rutgers scientists has made significant progress in developing a urine diagnostic test that can quickly, easily and inexpensively identify tuberculosis infection in people also infected ...

Researchers uncover new role of TIP60 protein in controlling tumour formation

October 8, 2018
Scientists from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore (NUS) have discovered a new molecular pathway that controls colorectal cancer development, and their exciting ...

Combination therapy targets latent reservoir of HIV

October 3, 2018
With more than 35 million people worldwide living with the virus and nearly 2 million new cases each year, the human immunodeficiency virus (HIV) remains a major global epidemic. Existing antiretroviral drugs do not cure ...

Anti-integrin therapy effect on intestinal immune system in HIV-infected patients

October 3, 2018
In a study published today in Science Translational Medicine, Mount Sinai researchers describe for the first time a mechanism that may shrink collections of immune cells in the gastrointestinal (GI) tract, called lymphoid ...

No 'reservoir': Detectable HIV-1 in treated human liver cells found to be inert

October 1, 2018
In a proof-of-principle study, researchers at Johns Hopkins report that a certain liver immune cell called a macrophage contains only defective or inert HIV-1 copies, and aren't likely to restart infection on their own in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.