Disclosure of HIV Status to Sexual Partners Among People With HIV in Singida Regional Referral Hospital of Tanzania: A Cross-Sectional Study.
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2024-09
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HIV status nondisclosure to sexual partners remains a major challenge in Tanzania's health system. This hospital-based, descriptive, cross-sectional study design recruited 380 people living with HIV (PLWH) to assess voluntary HIV status disclosure to sexual partners, the associated factors, and outcomes among PLWH in Tanzania. Approximately 78% ( n = 297) of the study participants reported disclosing their HIV status to their sexual partners. Adjusted multivariable logistic regression analysis revealed that HIV status disclosure to sexual partners was significantly associated with living with a sexual partner (adjusted odds ratio [AOR] = 3.91, 95% CI [1.43-10.72]), knowledge of HIV disclosure (AOR = 11.71, 95% CI [2.88-47.63]), known serostatus of the sexual partner (AOR = 40.20, 95% CI [15.31-105.56]), and HIV disclosure-related stigma (AOR = 0.92, 95% CI [0.85-0.99]). Addressing these significant factors will maximize the magnitude of voluntary disclosure to sexual partners.Type
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Alexander, Alex Gabagambi, Michael Relf, Hayden B Bosworth, Blandina T Mmbaga and Charles Muiruri (2024). Disclosure of HIV Status to Sexual Partners Among People With HIV in Singida Regional Referral Hospital of Tanzania: A Cross-Sectional Study. The Journal of the Association of Nurses in AIDS Care : JANAC, 35(5). pp. 397–408. 10.1097/jnc.0000000000000486 Retrieved from https://hdl.handle.net/10161/31459.
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Scholars@Duke
Michael Vernon Relf
Michael Relf, PhD, RN, ANEF, FAAN is the Mary T. Champagne Distinguished Professor of Nursing and Dean of the Duke University School of Nursing and a Research Professor in the Duke Global Health Institute. As Dean, Dr. Relf leads one of the nation's leading schools of nursing and a globally recognized institution for nursing education, research, clinical innovation, and community engagement. In this role, he has expanded need-based scholarships, increased pathways into nursing education, and championed access, belonging, and opportunity within the nursing profession. As a first-generation high school graduate who grew up in rural America, he is keenly aware of the power, privilege, and promise of higher education and nursing.
He is a nationally recognized nurse scientist, mentor, and educator, and influential academic leader whose work has advanced humanistic, stigma-free HIV care, health equity, global health, nursing workforce development, and nursing education.
He serves on the Board of Directors of the University of Global Health Equity in Rwanda. He has been a visiting professor at the University of Zululand (South Africa) and Queen’s University Belfast (Northern Ireland) and is a University Consulting Professor at Fudan University School of Nursing (China).
Areas of Expertise:
• HIV prevention, treatment, and care
• HIV-related stigma and discrimination
• Intimate partner violence and health outcomes
• Global health
• Nursing education
• Advanced practice nursing
• Nursing workforce development
• Community and population health
• Health equity and access to care
• Interprofessional and team-based care
• Academic health leadership
Dr. Relf's research focuses on the psychosocial aspects of HIV and the factors that influence health outcomes among people living with or at risk for HIV. Using mixed-methods approaches, he studies HIV-related stigma, intersectional stigma, everyday discrimination, intimate partner violence, and strategies that promote engagement in HIV primary care and treatment. His work has helped advance understanding of how social and structural factors affect health and wellbeing and has informed interventions designed to improve care, retention, and quality of life among individuals affected by HIV.
A central focus of his scholarship has been documenting and advancing the role of professional and advanced practice nurses in HIV prevention, treatment, and long-term care. His research has helped shape nursing practice, education, and competency development both nationally and internationally.
Dr. Relf's work examining the relationship between intimate partner violence and HIV risk behaviors among men who have sex with men received international media attention and was featured in major news outlets in North America and Europe. His research has contributed to broader conversations about violence, stigma, sexual health, and HIV prevention.
As a co-investigator on a President's Emergency Plan for AIDS Relief (PEPFAR)-funded initiative to strengthen nursing capacity in Southern Africa, Dr. Relf collaborated with nursing leaders in Botswana, Lesotho, Malawi, South Africa, Eswatini, and Zimbabwe to develop the Essential Nursing Competencies Related to HIV and AIDS. These competencies, endorsed by the International Council of Nurses, the Elizabeth Glaser Pediatric AIDS Foundation, and the Association of Nurses in AIDS Care, have since informed HIV nursing education and practice in multiple countries, including Canada and Thailand. He also led a national practice validation study to identify the competencies needed by nurse practitioners providing HIV specialty care.
His research has been supported by the National Institutes of Health (the National Institute of Nursing Research, the Fogarty International Center), the Health Resources and Services Administration, the President's Emergency Plan for AIDS Relief, the American Nurses Foundation, and Sigma Theta Tau International.
Leadership and Academic Administration
Dr. Relf has held several senior leadership positions at Duke University School of Nursing. From 2008 to 2014, he served as Assistant Dean for Undergraduate Education and Director of the Accelerated Bachelor of Science in Nursing Program. From 2014 to 2023, he served as Associate Dean for Global and Community Health Affairs, leading initiatives that expanded community partnerships, global engagement, and interdisciplinary collaboration. He was appointed Dean of the Duke University School of Nursing in 2025.
Prior to joining Duke, Dr. Relf served as Chair of the Department of Nursing at Georgetown University and as Associate Medical Administrator and Director of Nursing and Clinical Support Services at Whitman-Walker Clinic, a nationally recognized healthcare organization serving LGBTQ+ communities and individuals affected by HIV.
Honors and Distinctions
Dr. Relf is an Advanced HIV/AIDS Certified Registered Nurse (AACRN) and Certified Nurse Educator (CNE). He is a Fellow of the American Academy of Nursing and a Fellow of the Academy of Nursing Education of the National League for Nursing.
His contributions to nursing, HIV care, research, and mentorship have been recognized through numerous national awards, including:
• President's Award, Association of Nurses in AIDS Care (2024)
• Researcher Recognition Award, Association of Nurses in AIDS Care (2017)
• Distinguished Alumnus Award, South Dakota State University (2014)
• Spirit of Nursing Award for Mentoring (2006)
• Frank Lamendola Achievement Award for Nursing Leadership in HIV Care (2003)
Media and Speaking Topics
• Future of nursing
• Nursing workforce shortages
• HIV prevention and treatment
• HIV stigma and discrimination
• Global health
• Academic health leadership
• Nursing education innovation
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
Charles Muiruri
Dr. Muiruri is a health services researcher, Assistant Professor in the Duke Department of Population Health Sciences, Assistant Research Professor in the Global Health Institute, and Adjunct lecturer at the Kilimanjaro Christian Medical University College, Moshi Tanzania.
Broadly, his research seeks to improve the quality of healthcare and reduce disparities for persons with multiple chronic conditions both in and outside the United States. His current work focuses on prevention of nonAIDS comorbidities among people living with HIV. His current projects funded by NIAID, NHLBI and NIMHD focus on improving the quality of cardiovascular disease prevention and care among people living with HIV in North Carolina and Tanzania.
Areas of Expertise: Mixed methods, Qualitative methods, Applied Econometrics in Health services Research, Preference research, Implementation Science, Global Health, Health Policy
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