A small number of patients (11.6 percent) did not disclose their infection status at all. None of the patients had disclosed to all of their family members. Unmarried and illiterate patients had higher levels of nondisclosure. Reda said he was prompted to conduct the study after working in Ethiopian hospitals and seeing many patients refuse to use local medical centers, opting to be treated farther from home. "We suspected that this may be related to the fact that patients did not disclose their infection status to family members and did not want to risk being seen taking medications in nearby centers," Reda said.

This study's low disclosure rates confirmed his suspicions, highlighting a lack of awareness about the virus and a pervasive stigma surrounding those who are infected.

"This will create significant obstacles to the life-long treatment process and the prevention of the spread of the virus. It may also increase drug resistance. Concerted counseling efforts need to be instituted to create a supportive environment whereby patients could successfully disclose their infection without fear of discrimination," Reda said.