Effect of HIV-Related Stigma and HIV-Related Stress on HIV Disclosure Concerns: a Study of HIV-Positive Persons on Antiretroviral Therapy at Two Urban Hospitals in Ghana

Limited research has examined HIV disclosure concerns and the role that HIV-related stigma and HIV-related stress play in disclosure in HIV care in Ghana. We explored HIV status disclosure concerns among 235 people living with HIV (PLHIV) and attending two general hospitals in the Greater Accra Region of Ghana. Hierarchical multiple regression was used to analyse the data. Our results showed that PLHIV who experienced higher levels of perceived HIV-related stigma reported greater levels of HIV disclosure concerns, and therefore were more likely not to disclose their HIV-positive status. In addition, we found that PLHIV who reported experiencing higher levels of HIV-related emotional stress also reported greater levels of HIV disclosure concerns. HIV-related instrumental stress was negatively associated with HIV disclosure concerns, suggesting that PLHIV who reported having greater access to money, food, transport, healthcare system, treatment, and antiretroviral medication were less likely to experience HIV disclosure concerns. The current data demonstrate that interventions that help to reduce HIV-related stigma and HIV-related stress may increase HIV status disclosure, thereby improving the psychological health of PLHIV in Ghana.