Partner Disclosure and Early CD4 Response among HIV-Infected Adults Initiating Antiretroviral Treatment in Nairobi Kenya.
T Tony Trinh, Nelly Yatich, Richard Ngomoa, Christine J McGrath, Barbra A Richardson, Samah R Sakr, Agnes Langat, Grace C John-Stewart, Michael H Chung
Author Information
T Tony Trinh: Department of Global Health, University of Washington, Seattle, Washington, United States of America.
Nelly Yatich: Coptic Hospital, Nairobi, Kenya.
Richard Ngomoa: Coptic Hospital, Nairobi, Kenya.
Christine J McGrath: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Barbra A Richardson: Department of Biostatistics, University of Washington, Seattle, Washington, United States of America.
Samah R Sakr: Coptic Hospital, Nairobi, Kenya.
Agnes Langat: US Center for Disease Control and Prevention, Nairobi, Kenya.
Grace C John-Stewart: Department of Global Health, University of Washington, Seattle, Washington, United States of America.
Michael H Chung: Department of Global Health, University of Washington, Seattle, Washington, United States of America.
BACKGROUND: Disclosure of HIV serostatus can have significant benefits for people living with HIV/AIDS. However, there is limited data on whether partner disclosure influences ART treatment response. METHODS: We conducted a retrospective cohort study of newly diagnosed, ART-naïve HIV-infected adults (>18 years) who enrolled at the Coptic Hope Center in Nairobi, Kenya between January 1st 2009 and July 1st 2011 and initiated ART within 3 months. Analysis was restricted to adults who reported to have either disclosed or not disclosed their HIV status to their partner. Analysis of CD4 response at 6 and 12 months post-ART was stratified by age group. RESULTS: Among 615 adults newly initiating ART with partner disclosure data and 12 month follow-up, mean age was 38 years and 52% were male; 76% reported that they had disclosed their HIV-status to their partner. Those who disclosed were significantly younger and more likely to be married/cohabitating than non-disclosers. At baseline, median CD4 counts were similar between disclosure groups. Among younger adults (< 38 years) those who disclosed had higher CD4 recovery than those who did not at 6 months post- ART (mean difference = 31, 95% CI 3 to 58 p = 0.03) but not at 12 months (mean difference = 17, 95% CI -19 to 52, p = 0.4). Among older adults (≥ 38years) there was no observed difference in CD4 recovery at 6 or 12 months between disclosure groups. CONCLUSION: Among younger adults, disclosure of HIV status to partners may be associated with CD4 recovery following ART.
