Positive Status Disclosure and Sexual Risk Behaviour Change among People Living with HIV in Northern Region, Ghana

Abstract Objective: To investigate sexual behaviour changes adopted by PLHIV on Antiretroviral therapy (ART) in the Northern Region of Ghana. Methods: We employed a cross-sectional survey with a questionnaire to collect data from 900 clients from nine major ART centres within the region. Chi-square and logistics regression analyses were applied to the data. Results: The common safe sexual behaviours adopted by more than 50% of PLHIV on ART included: condom use, reduction in sexual partners, abstinence, reduction in unprotected sex with married/regular partners, and avoidance of new casual sex partners. Also, the fear of others getting to know patients’ HIV positive status (χ2=7.916, p =.005), fear of stigma (χ2=5.201, p =.023), fear of losing family support (χ2= 4.211, p =.040) and not ready to disclose yet (χ2= 4.475, p =.034) were statistically significant predictors of non-disclosure of HIV positive status among the participants. Moreover, change in sexual behaviour is influenced by; “to avoid spreading the disease to others”, [ R 2 =.043, F (1, 898) =40.237, p <.0005], “to avoid contracting other STIs [ R 2 =.010, F (1, 898) =8.937, p < .0005], live long [R 2 =.038, F (1, 898) =35.816, p < .0005 ] , hide HIV-positive status [ R 2 =.038, F (1, 898) =35.587, p < .0005], achieve good results from ART treatment [ R 2 =.005, F (1, 898) =4. 282, p <.05] and live a Godly life” [ R 2 =.023, F (1, 898) =20. 880, p < .0005]. Conclusion: Although a high self-disclosure rate of HIV positive status was identified, with more participants disclosing either to their spouses or parents, reasons for disclosure and non-disclosure differed from person to person. Future HIV prevention interventions should be tailored to facilitate open communication on disclosure status and positive sexual behaviour changes.