Table 2.
Factors associated with HIV status disclosure to male and female sexual partners of Nigerian men who have Sex with Men and Transgender Women
| Characteristics |
Disclosure to Some/All Male Sexual Partners Relative Risk (95% Confidence Interval) |
Disclosure to Some/All Female Sexual Partners Relative Risk (95% Confidence Interval) |
||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted | p | Adjusted | p | Unadjusted | p | Adjusted | p | |
| Age | ||||||||
| ≤ 21 years | Reference | Reference | Reference | Reference | ||||
| 22–30 years | 1.02 (0.71–1.47) | 0.910 | 0.88 (0.61–1.28) | 0.512 | 0.72 (0.22–2.31) | 0.582 | 0.45 (0.13–1.53) | 0.201 |
| > 30 years | 1.18 (0.75–1.83) | 0.474 | 0.74 (0.46–1.19) | 0.213 | 2.61 (0.85–8.02) | 0.095 | 0.87 (0.25–3.10) | 0.835 |
| Gender Identity | ||||||||
| Man | Reference | Reference | Reference | Reference | ||||
| Woman | 0.72 (0.45–1.14) | 0.161 | 0.67 (0.43–1.05) | 0.078 | 1.55 (0.61–3.94) | 0.360 | 1.58 (0.62–4.04) | 0.336 |
| Other/Unknown | 0.88 (0.57–1.35) | 0.561 | 0.89 (0.58–1.36) | 0.594 | 1.21 (0.46–3.16) | 0.696 | 1.59 (0.60–4.25) | 0.351 |
| Sexual Orientation | ||||||||
| Gay/Homosexuala | Reference | Reference | Reference | Reference | ||||
| Bisexual | 0.91 (0.70–1.20) | 0.512 | 1.01 (0.76–1.34) | 0.952 | 0.70 (0.24–2.00) | 0.500 | 0.62 (0.17–2.28) | 0.474 |
| Education Level | ||||||||
| Junior Secondary or lessa | Reference | Reference | Reference | Reference | ||||
| Senior Secondary | 0.60 (0.39–0.92) | 0.019 | 0.47 (0.30–0.73) | < 0.001 | 0.76 (0.25–2.29) | 0.624 | 1.24 (0.51–3.03) | 0.634 |
| Higher than Senior Secondary | 0.79 (0.51–1.20) | 0.262 | 0.63 (0.41–0.95) | 0.029 | 0.74 (0.24–2.26) | 0.594 | 1.40 (0.55–3.56) | 0.476 |
| Occupation | ||||||||
| Unemployed | Reference | Reference | Reference | Reference | ||||
| Student | 0.82 (0.47–1.42) | 0.474 | 0.78 (0.46–1.33) | 0.369 | 0.93 (0.06–14.03) | 0.956 | 1.62 (0.15–17.42) | 0.689 |
| Professional/Self-Employed | 1.16 (0.72–1.88) | 0.545 | 0.97 (0.59–1.59) | 0.902 | 3.45 (0.41–28.87) | 0.254 | 2.84 (0.48–16.70) | 0.247 |
| Entertainment/Hospitality | 0.72 (0.37–1.41) | 0.336 | 0.87 (0.44–1.72) | 0.685 | 6.94 (0.89–54.47) | 0.065 | 6.25 (1.06–36.84) | 0.043 |
| Driver/Laborer | 1.09 (0.41–2.93) | 0.863 | 0.92 (0.41–2.07) | 0.834 | 4.17 (0.30–57.50) | 0.287 | 6.66 (1.10–40.36) | 0.039 |
| Other/Unknown/Missing | 1.08 (0.73–1.60) | 0.693 | 1.24 (0.80–1.91) | 0.334 | 4.70 (0.66–33.27) | 0.121 | 4.06 (0.84–19.74) | 0.082 |
| Marital Status | ||||||||
| Single/Never Married | Reference | Reference | Reference | Reference | ||||
| Married/Cohabiting | 1.35 (0.88–2.05) | 0.166 | 1.16 (0.71–1.90) | 0.545 | 5.59 (3.18–9.84) | < 0.001 | 3.95 (1.97–7.91) | < 0.001 |
| Divorced/Widowed/Other | 1.70 (1.09–2.65) | 0.018 | 1.29 (0.86–1.94) | 0.210 | 2.31 (0.63–8.46)3 | 0.207 | 1.26 (0.31–5.08)3 | 0.748 |
| Site | ||||||||
| Abuja | Reference | Reference | Reference | Reference | ||||
| Lagos | 1.17 (0.90–1.52) | 0.242 | 1.58 (1.14–2.20) | 0.006 | 0.59 (0.27–1.28) | 0.181 | 1.03 (0.33–3.25) | 0.960 |
| CD4 Count | ||||||||
| < 500 cells/mm3 | Reference | Reference | Reference | Reference | ||||
| ≥ 500 cells/mm3 | 1.31 (0.99–1.72) | 0.055 | 1.10 (0.83–1.45) | 0.496 | 0.86 (0.40–1.85) | 0.691 | 0.85 (0.42–1.70) | 0.639 |
| Unknown/Missing | 0.82 (0.47–1.46) | 0.505 | 1.31 (0.71–2.41) | 0.381 | 1.95 (0.92–4.13) | 0.084 | 2.53 (0.99–6.44) | 0.051 |
| Viral Load | ||||||||
| > =50 copies/mL | Reference | Reference | Reference | Reference | ||||
| < 50 copies/mL | 1.87 (1.44–2.43) | < 0.001 | 1.67 (1.24–2.25) | < 0.001 | 1.28 (0.64–2.58) | 0.482 | 0.61 (0.26–1.41) | 0.247 |
| Unknown/Missing | 0.67 (0.33–1.36) | 0.268 | 0.57 (0.23–1.39) | 0.218 | 1.85 (0.81–4.23) | 0.145 | 0.77 (0.23–2.53) | 0.667 |
| Currently Prescribed ART | ||||||||
| No | Reference | Reference | Reference | Reference | ||||
| Yes | 1.67 (1.27–2.19) | < 0.001 | 1.32 (0.93–1.86) | 0.117 | 1.56 (0.99–2.44) | 0.053 | 2.27 (1.07–4.83) | 0.033 |
| Unknown/Missing | 0.76 (0.21–2.72) | 0.677 | 1.34 (0.29–6.13) | 0.706 | 0.58 (0.09–3.77) | 0.572 | 1.82 (0.48–6.87) | 0.377 |
| Disclosed to Healthcare Provider | ||||||||
| No | Reference | Reference | Reference | Reference | ||||
| Yes, any HCP | 1.98 (1.26–3.12) | 0.003 | 1.51 (0.93–2.46) | 0.097 | 3.06 (1.30–7.23) | 0.011 | 1.09 (0.42–2.82) | 0.857 |
| Disclosed to Male Sexual Partners | ||||||||
| No | Not Applicable | Not Applicable | Reference | Reference | ||||
| Some or all MSP | 2.18 (1.19–4.01) | 0.012 | 1.93 (1.02–3.67) | 0.043 | ||||
| Disclosed to Female Sexual Partners | ||||||||
| No | Reference | Reference | Not Applicable | Not Applicable | ||||
| Some or all FSP | 1.54 (1.04–2.26) | 0.030 | 1.45 (0.97–2.18) | 0.069 | ||||
| Not Applicable (No FSP) | 1.14 (0.81–1.62) | 0.447 | 1.21 (0.82–1.79) | 0.338 | ||||
Abbreviations: ART antiretroviral therapy, HCP healthcare provider, FSP female sexual partner, MSP male sexual partner
aTo enable convergence of the models, “other/unknown” was combined into the reference group for sexual orientation and education level
Modified Poisson regression models were used to calculate relative risk and 95% confidence intervals for factors associated with HIV status disclosure. All variables in unadjusted models were included in the adjusted model for disclosure to each sex. All 493 participants included in these analyses reported male sexual partners in the preceding 12 months and contributed data to the models for disclosure to male sexual partners. Only the 222 participants who reported female sexual partners in the preceding 12 months contributed data to the models for disclosure to female sexual partners. Statistically significant associations (p ≤ 0.05) are shown in bold