Partner Disclosure And Early CD4 Response Among HIV-Infected Adults Initiating Antiretroviral Treatment In Nairobi, Kenya

Abstract

Background: Disclosure of HIV sero-status can have significant positive implications for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response. Methods: We conducted a retrospective cohort study of recently diagnosed, ART-naïve HIV-infected adults (>18 yrs) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who had a partner/spouse and reported to either disclose or not disclose HIV status to a partner/spouse. CD4 counts were analyzed at baseline, 6 and 12 months after ART initiation. Results: Seventy six percent of adults reported they had disclosed their HIV-status to a partner/spouse. Those who disclosed were significantly younger and more likely to be married/cohabitating. At baseline, there was no statistically significant difference in median CD4 count between disclosure groups. At 6 months following ART, those who disclosed experienced significantly higher CD4 counts than those who did not, after adjusting for age, gender, baseline CD4 count, and married/cohabitating status (B = 19, 95% CI 0.3 to 38 p=0.046). Conclusion: Our results suggest that partner disclosure is associated with CD4 recovery following ART initiation.