Table 3. Disclosure interventions, measures and outcomes.
| Study and year of publication |
Year of data collection |
Time since HIV diagnosis |
Intervention type | Disclosure recipient (outcome measure) |
Baseline disclosure rates |
Follow-up time | Follow-up disclosure rates |
Statistical significance (p- value) |
|---|---|---|---|---|---|---|---|---|
| Cognitive-behavioral support groups | ||||||||
| Futterman et al., 2010 [32] | 2006-07 | NR | 8-session cognitive-behavioral group intervention plus peer support (mother mentors) | Sexual partners | Intervention: 41/59 (69.5%), Control: 41/77 (53.2%) | 6 months | Intervention: 34/40 (87.2%) Control: 25/31 (83.3%) | NS (p=0.055) |
| Jones et al., 2013 [34] | 2010-12 | NR | 4-session cognitive-behavioral group intervention | Sexual partners (accurate disclosure to partner) | Intervention – Men: 86%Intervention – Women: 80%Control – Men: 72%Control – Women: 70% | 6-8 weeks (immediately post-intervention) | Intervention – Men: 83%Intervention – Women: 81%Control – Men: 80%Control – Women: 65% | NR |
| Kaaya et al., 2013 [35] | 2001-04 | NR | 6-session support group intervention | Anyone(disclosure to specific people measured but not reported) | NR | 8-10 weeks follow-up | Intervention: 56%Control: 46%(RR: 1.2, 95% CI: 0.91-1.6) | NS (p=0.19) |
| Mundell et al., 2011 [37] | 2005-06 | Mean: 14 weeks | 10-session support group intervention | Anyone | Intervention: 71%Control: 60% | 8 months | Intervention: 97%Control: 82% | NR |
| Sarnquist et al., 2014 [41] | 2011 | NR | 3-session group intervention plus provider training | Sexual partners | Intervention: 84.1%Control: 78.8% | 6-weeks post-partum3-months post-partum | Intervention: 98.2%Control: 86.2%Intervention: 98.4%Control: 87.5% | Sig (p=0.048)Sig (p=0.04) |
| Snyder et al., 2014 [42] | 2010 | <12 months | 3-session cognitive behavioral support group | Anyone/number of people (Mean number of people disclosed to) | Mean: 2 | 3 weeks | Mean:4Disclosed to a friend or family member during the course of the intervention: 6/65 | |
| Wouters et al., 2009 [39] | 2004-07 | Mean: 31 months (range: 6 months – 15 years) | Home-based CHW visits and support group intervention (support group results presented here) | Family members (parents, relatives living in household, relatives living elsewhere) | Parents: 77.1%Relatives in household: 74.6%Relatives living elsewhere: 58.3% | 18 months after ART initiation (exact time after disclosure interventions unspecified) | Support group at time 0, disclosure from time 0 – time 1: Path coefficient: 0.103, t-value: 1.016Support group at time 1, disclosure from time 1 – time 2: Path coefficient: 0.191, t-value: 3.665 | Sig (p<0.05)Sig (p<0.001) |
| Home-based or peer/community health workers | ||||||||
| MacNeil et al., 1999 [36] | 1996-97 | Up to 4 weeks | Individual counseling and family education | Friend, parents, spouse, sexual partner, and anyone | Disclosed to friendI: 3 (3.8%) C: 6 (7.8%) Total: 9 (5.8%)Disclosed to parentsI: 15 (19.5%) C: 8 (10.4%) Total: 23 (14.9%)Disclosed to spouseI: 10 (13.0%) C: 9 (11.7%) Total: 19 (12.3%)Disclosed to sexual partnerI: 3 (3.9%) C: 6 (7.8%) Total: 9 (5.8%)Disclosed to someoneI: 16 (20.8%) C: 13 (16.9%) Total: 29 (18.8%) | 6 months | Disclosed to friendI: 11 (14.3%) C: 7 (9.1%) Total: 18 (11.7%)Disclosed to parentsI: 38 (49.4%) C: 23 (29.9%) Total: 61 (39.6%)Disclosed to spouseI: 20 (26.0%) C: 18 (23.4%) Total: 38 (24.7%)Disclosed to sexual partnerI: 12 (15.6%) C: 17 (22.1%) Total: 29 (18.8%)Disclosed to someoneI: 72 (93.5%) C: 58 (75.3%) Total: 130 (84.4%) | NSSig (p<0.05)NSNSSig (p<0.05) |
| Ncama, 2007 [38] | NR | NR | Home-based CHW visits | Anyone/number of people (more than 10 people) | Disclosed to anyone: 99% | NA (cross-sectional study design) | Disclosed to more than 10 people:Intervention: 555Control: 30%(r=26.442, d.f.=11) | Sig (p=0.006) |
| Rochat et al., 2013 [29] | 2010 | ∼6-8 years | 6-session family structured intervention by counselor | School-aged children (index child) | 0% | 8 weeks | No disclosure: 0/24Full disclosure: 11/24Partial disclosure: 13/24 | NR |
| Rochat et al., 2014 [30] | 2010-12 | 5-10 years | 6-session family structured intervention by counselor | School-aged children (index child) | No disclosure: 255/281Full disclosure: 19/281Partial disclosure: 7/281 | Within 8 weeks | No disclosure: 0/281Full disclosure: 171/281Partial disclosure: 110/281 | NR |
| Wouters et al., 2009 [39] | 2004-07 | Mean: 31 months (range: 6 months – 15 years) | Home-based CHW visits and support group intervention (CHW results presented here) | Family members | Disclosed to:Parents: 77.1%Relatives in household: 74.6%Relatives living elsewhere: 58.3% | 18 months after ART initiation (exact time after disclosure interventions unspecified) | CHW at time 0, disclosure from time 0 – time 1: Path coefficient: 0.086, t-value: 1.663CHW at time 1, disclosure from time 1 – time 2: Path coefficient: 0.120, t-value: 2.332 | NSSig (p<0.05) |
| Zuyderduin et al., 2008 [40] | 2002 | NR | Peer support (buddies) | Anyone/number of people (categorical: number of people disclosed to) | Disclosed to:1-5 people:I: 53.8% ;C: 68.4%6-10 people:I: 15.4%; C: 10.5%11-30 people:I: 21.3%; C: 5.3%31 or more:I:7.7%; C: 15.8% | 6 months | Moved to a higher category (disclosed to more people):Intervention: 48.7%Control: 39.5% | NR |
| Partner notification | ||||||||
| Brown et al., 2011 [31] | 2008-09 | 0 days | Anonymous partner notification | Sexual partners | 0%2 | 30 days | Partner returned for HTC:Passive referral: 20/82 (24%)Contract referral: 45/88 (51%)Provider referral: 42/82 (51%) | Sig (p<0.001for both contract referral vs. passive and provider referral vs. passive) |
| Henley et al., 2013 [33] | 2009-10 | 0 days | Anonymous partner notification | Sexual partners | NR | NR (variable, but generally within several days) | Partner returned for HTC: 1 Patient referral: 146/316 (46%)Contract referral: 139/228 (61%)Provider referral: 570/956 (60%) | Sig (p=0.049 for contract referral vs. patient and p=0.007 for provider referral vs. patient) |
Sig: Significant; NR: Not reported; NA: Not applicable; I: Intervention; C: Control
1
Additional data provided by authors
2
All participants were newly diagnosed, so presumably none had disclosed prior to the intervention