Determinants Of Condom Use And HIV Status Disclosure To Sexual Partners Among Adults Receiving Antiretroviral Therapy At Ashaiman ART Clinic, Analysis of Routine Data, 2010-2016 Drs. R. P. Frimpong-Mansoh , B. N. L Calys- Tagoe, E. F. Therson- Coffie, K. O. Antwi- Agyei

outline Introduction Methods Results Discussion Conclusion Recommendation November 22, 2018

Introduction HIV prevention is key to achieving the 2030 SDG goal 3 Consistent and correct condom use reduces the risk of heterosexual transmission of HIV by about 80 percent Disclosure may motivate sexual partners to seek testing, change behavior and ultimately decrease transmission of HIV Routine data collected at Ashaiman ART site is rarely analyzed To assess determinants of HIV Status disclosure and condom use among HIV clients registered at ART Clinic in Ashaiman Municipality from 2010-2016 November 22, 2018

Methods 1/2 Records of adult clients registered at the ART Clinic from 2010-2016 were reviewed Extracted data entered into Microsoft Excel and exported into Epi Info TM Version 7 for analysis Extracted data included Year of Registration, Age, Sex, Marital Status, Educational Level, referral information, Disclosure, Sexual activity. Cleaning of data was done to ensure consistency and completeness of the data set November 22, 2018

Methods: 2/2 Frequencies and proportions were done Logistic regression was done to assess the determinants of Condom Use and HIV status Disclosure using variables that were significant at the Univariate analysis Data analysis was part of academic work for residents of the Faculty of Public Health, Ghana College of Physicians and Surgeons Relevant administrative protocols were adhered to November 22, 2018

Map Of Ashaiman Municipality November 22, 2018

Results :1/7 Socio-demographic Characteristics Variable Number N=1099 Percentage(%) Age group 15-24 25-34 35-44 45-54 55 and above 98 519 315 115 52 8.9 47.2 28.7 10.5 4.7 Sex Female Male 898 201 81.7 18.3 Educational level No education Primary Secondary Tertiary 212 220 642 25 19.3 20.0 58.4 2.3 November 22, 2018

Results :2/7 Socio-demographic characteristics Number Percentage(%) Marital status Single Cohabiting Married Separated Divorced Widowed 206 122 570 28 81 18.7 11.1 51.9 2.5 7.3 Employment status Unemployed Employed 1019 80 92.7 Referral information Walk in VCT Site Diagnostic HIV testing PMTCT Programme TB Transfer in on ART Transfer in on OI 110 517 419 5 40 8 10.0 47.0 38.1 0.5 3.6 0.7 November 22, 2018

Results: 3/7 Number of clients registered per year, Ashaiman, 2010-2016 November 22, 2018

Results:4/7 Proportion of Sexually active Clients, Ashaiman, 2010-2016 November 22, 2018

Results: 5/7 HIV status disclosure and condom use among clients, Ashaiman, 2010-2016 November 22, 2018

Results: 6/7 Determinants of Condom Use among sexually active clients, Ashaiman, 2010-2016 Variable Number(%) Odds ratio P value Referral Info Diagnostic HIV testing PMTCT TB Trans in on ART Trans in on OI Walk in VCT 103(48.8%) 77(36.5%) 0(0) 11(5.2%) 1(0.5%) 19(9.0%)  Reference 0.5157 0.000 1.5857 0.2668 0.7620 0.0073 0.9424 0.9672 0.3615 0.4594   Disclosure to sexual Partner No Yes 163(77.25) 48(22.75) Reference 8.13 November 22, 2018

Results: 7/7 Determinants of HIV Status Disclosure Variable Number(%) Odds Ratio P value Referral Info Diagnostic HIV testing PMTCT TB Trans in on ART Trans in on OI Walk in VCT 121(44.0) 116(42.2) 1(0.4) 13(4.7) 2(0.7) 22(8.0) Reference 0.5867 2.7800 0.8184 1.0138 0.5992 0.0248 0.4993 0.6848 0.9908 0.1674 Condom Use No Yes 62(22.5) 213(77.5) 8.8203 0.0000 Marital Status Cohabiting Single Married Divorced Widowed Separated   26(9.5) 22(8.8) 218(79.3) 5(1.8) 0(0) 4(1.5) 0.6047 2.2865 0.5632 5.2991 0.2104 0.0065 0.3689 0.9665 0.1004 November 22, 2018

Discussion About 1/3 of clients used condoms HIV status disclosure was 45.5% Clients who used condoms were 8 times as likely to disclose their status to their clients compared to those who do not use condoms Married couples were twice as likely to disclose their status to partners compared to cohabiting Clients referred from PMTCT programme had 42% reduction in disclosing their status and 48%reduction in using condoms November 22, 2018

Conclusion Condom use  and HIV status disclosure to sexual partners are low Determinants of condom use are HIV status disclosure and clients referral from PMTCT programme Determinants of HIV status disclosure are being married and Condom Use November 22, 2018

Recommendation Counselors at ART clinics/Antenatal Clinics Health education especially at ANC on importance of Condom use and HIV status disclosure should be intensified National AIDS Control Programme Re-training of peer educators at ART clinic on how clients can create the safe environment for disclosing their status. Campaign against stigmatization of HIV clients should be intensified in order to allow PLHIVs disclose their status to their partners November 22, 2018

References References Ghana AIDS Commission. Summary Of The 2016 HIV Sentinel Survey Report. Society 2016; 6–8. Sarkar NN. Barriers to condom use. European Journal of Contraception and Reproductive Health Care 2008; 13: 114–122. Obiri-Yeboah D, Amoako-Sakyi D, Baidoo I, et al. The Fears of Disclosing HIV Status to Sexual Partners: A Mixed Methods Study in a Counseling Setting in Ghana. AIDS Behav 2016; 20: 126–136. Avornyo R, Amoah J. Disclosing Parental Human Immunodeficiency Virus (HIV) Status to Children in Ghana: Reasons for and against Disclosure and Effects of Decision. Adv Appl Sociol 2014; 4: 205–211. Ncube NM, Akunna J, Babatunde F, et al. Sexual risk behaviour among HIV- positive persons in Kumasi, Ghana. Ghana Med J 2012; 46: 27–33. Dave SS, Stephenson J, Mercey DE, et al. Sexual behaviour, condom use, and disclosure of HIV status in HIV infected heterosexual individuals attending an inner London HIV clinic. Sex Transm Infect 2006; 82: 117-9-20. November 22, 2018

THANK YOU November 22, 2018