TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background
HIV status disclosure plays a critical role in reducing stigma, improving treatment adherence, and enhancing social support for people living with HIV (PLHIV). Despite its importance, disclosure remains a complex process influenced by individual, relational, and systemic factors. The Eastern Europe and Central Asia region, including Georgia, faces high levels of stigma, making HIV status disclosure particularly challenging. This study explores factors associated with HIV status disclosure among Georgian PLHIV to inform interventions and policies.

Aim
To examine the sociodemographic and healthcare-related factors associated with HIV status disclosure among PLHIV in Georgia.

Methods
This secondary data analysis utilized the PLHIV Stigma Index 2.0 survey conducted in Georgia in 2022, which included 765 participants recruited through peer-to-peer interviews in Tbilisi and three additional regions. Data on demographics, stigma, discrimination, and healthcare interactions were collected following standardized methodologies developed by UNAIDS. Statistical analysis included chi-square tests to explore univariate associations and multivariate logistic regression to adjust for potential confounders and identify significant predictors of disclosure.

Results
Of the 765 participants, 67.4% were male, most of them aged 30–49 years (61.3%). Lower education levels were reported by 64.2%, while 39.6% were unemployed. HIV status disclosure to at least someone from their social and healthcare environment was reported by 86.9% of participants, with 13.1% not disclosing to anyone. Multivariate analysis identified significant predictors of disclosure. Participants aged 30–39 were less likely to disclose than those aged 18–29 (aOR=0.39, 95% CI: 0.16–0.93). Disclosure was more likely among those in intimate relationships (aOR=3.93, 95% CI: 2.42–6.40) and those diagnosed with alcohol or substance use disorder (aOR=4.53, 95% CI: 1.04–19.75) or mental health disorders (aOR=6.86, 95% CI: 1.61–29.24).

Conclusions
This study highlights the significant influence of demographic, relational, and health-related factors on HIV status disclosure in Georgia. Age, relationship status, and co-occurring conditions were key predictors of disclosure. The findings underscore the need for targeted interventions to address stigma, promote safe disclosure, and improve healthcare engagement for PLHIV. Future research should focus on understanding the mechanisms through which these factors influence disclosure to enhance policy and practice in the region.