Study area and design
An institution-based unmatched case-control study was conducted from December 1 up to February 30/2020 among 378 (94 cases and 284 controls) adult Human immune virus-infected Adult on Anti-Retroviral Therapy Follow-Up Care at North Shewa zone public Hospitals in Oromia Region, Ethiopia, 2020. According to a 2007 Central Statics Agency (CSA) report, the zone had a total population of 1431 305 (22). Currently, the zone has four government hospitals that have been provided antiretroviral treatment service for a total of 4025 adult HIV positive patients.
Sample Size Determination
The sample size was computed using Epi-info Stat Calc program by making assumptions of the 95% confidence level, four controls for each case, 80% power, and 4.16 OR of knowing sexual partner’s HIV status from a study conducted in Bale Hospital, Oromia region(12), gives a total of 344 samples. By adding a 10% non-respondent rate the total sample size was 378 (94 cases and 284 controls). The sample size was calculated using the double population proportion formula in Epi-info TM version 220.127.116.11.
Sampling Technique and procedures
First proportional allocation of sample size was made to each hospital based on the total number of HIV positive patients on follow-up care. Then data from the cases were collected by consecutive sampling methods whereas data from the controls were collected by using systematic random sampling techniques.
All adult Human immune virus-infected Adults on Anti-Retroviral Therapy Follow-Up Care at North Shewa zone public Hospitals in Oromia Region, Ethiopia, 2020.
All adult Human immune virus-infected Adult on Anti-Retroviral Therapy Follow-Up Care at and had a sexual partner during their HIV diagnosis at North Shewa zone public Hospitals in Oromia Region, Ethiopia, 2020
Inclusion and Exclusion Criteria
This study includes HIV positive patients age ≥18 years, had a sexual partner during HIV diagnosis and, had at least one month of ART follow up care. It excludes couple tested HIV positive patients.
Sexual partner: In this study, it is defined as someone's husband/wife if married and girl or boyfriend if single.
Current sexual partner: In this study, it is defined as a person’s sexual partner during an HIV diagnosis.
Lifetime sexual partner: is defined as the total number of sexual partner a person had in his/her lifetime
Delayed disclosure: it is defined as disclosure of HIV positive status to sexual partner/s after one month of HIV positive diagnosis.
Risky sexual practice: Sex without a condom with a sexual partner before disclosure of HIV positive status.
Data Collection Tools
The data collection tool was developed from reviewing a similar study conducted previously in Ethiopia (8, 11, and 12). The tool was prepared in English first and translated into Afaan Oromo and Amharic then back to the English language.
Data Collection technique and Procedure
After screened for eligibility, taken written informed consent, and given information about the purpose of the study data was gathered from the medical record and the patients by interviewing while they come for their medical appointments.
Data Collectors and supervisors
Eight BSc degree nurses, two assigned in each ART clinic from other work units were recruited and trained about tools and ways of the data collection procedure. Similarly, two MSc Nurses from other working units were recruited for supervision.
Data Quality Control
A pretest was conducted on 5% of the sample size at Sheno primary Hospital one week before the actual data collection. Then training of data collectors and supervisors on objectives, questionnaires, and ways of collecting the data was given for one day before the actual data collection time. To keep study participants’ confidentiality private room free from interruption for interviewing was prepared. Before entry, data were checked for completeness.
Data Processing and Analysis
The data were checked for completeness and entered into Epi Data Version 3.1 and exported into SPSS version 25 for analysis. Descriptive statistics such as frequency and percentage has been presented using graphs and tables. A binary logistic regression model was used to identify the potential predictor variables for HIV positive status non-disclosure. Those independent variables which had a p-value of less than 0.25 during binary logistic regression analysis were entered into multivariable logistic regression analysis. Then Adjusted Odds Ratio (AOR) with 95% CI and p-value < 0.05 were used to identify factors significantly associated with HIV positive status non-disclosure to sexual partner/s.
Ethical Approval Statement
Ethical clearance was obtained from the Ethical Review Committee of Salale University. Permission letter also was obtained from Oromia Health Bureau and the respective hospitals. Written informed consent was taken from each study participant and explained the importance and purpose of the study. Any potential identifiers were eliminated to ascertain confidentiality.