Stigmatization, Status Disclosure and Support among HIV Positive Women in the Kumasi Metropolis of Ghana; a Qualitative Study

Abstract

Background: HIV-related stigma and discrimination are impediments to mitigating the HIV epidemic, with women mostly affected. This qualitative study explored issues of stigmatization, disclosure of status and adherence to Antiretroviral therapy (ART) among HIV positive women. Methods: This study was conducted in three ART centers in the Kumasi metropolis of Ghana. 23 HIV positive women aged 18-49 years and on Antiretroviral (ARVs) for treatment or prophylaxis for >3 months and 14 health workers at the ART centers were recruited. Three focus group discussions with 23 HIV positive women and 14 in-depth interviews with health workers were conducted. Participants were interviewed about their opinions and experiences on issues of stigmatization, status disclosure, social support and adherence to ART.  Results: Thematic analysis revealed that experience of stigmatization by HIV positive women leads to a default of ART. Some women who had disclosed their status had support from their partners whereas others experienced intimate partner violence and loss of financial support. Stigmatization and fear of divorce, rejection or abandonment were significant reasons for not disclosing HIV status. Conclusion: HIV testing and counseling programs should provide guidance and strategies to best disclose status to help minimize abuse following disclosure.