Prevalence and factors associated with hepatitis B serostatus disclosure among adults receiving care at Hawassa University Comprehensive Specialized Hospital, southern Ethiopia: a cross-sectional study

Abstract

BACKGROUND: Hepatitis B virus (HBV) infection is a globally prevalent disease and remains a significant public health burden. In Ethiopia, where HBV is endemic, it is a major contributor to chronic liver disease and liver-related mortality. Timely disclosure of serostatus is crucial for preventing intra-family transmission, facilitating contact tracing and vaccination, promoting adherence to follow-up and antiviral therapy, and improving the physical and psychosocial well-being of affected individuals. Therefore, this study aimed to assess the prevalence of HBV serostatus disclosure and identify factors associated with disclosure among adults receiving care at the Gastroenterology clinic of Hawassa University Comprehensive Specialized Hospital. METHODS: An institution-based analytical cross-sectional study was conducted from July 20 to September 30, 2025, to enroll all eligible participants. Data were collected via interviewer-administered, semi-structured questionnaires supplemented by a data abstraction sheet, and analyzed using STATA version 16.1. Poisson regression with robust variance estimation identified factors associated with HBV serostatus disclosure; results were presented as adjusted prevalence ratios (aPR) with 95% confidence intervals (CI), and statistical significance was set at P < 0.05. RESULTS: Of the 245 participants, 171 (69.8%) were male, and the median age was 34 years (interquartile range: 26-45 years). Overall, 46.5% of participants (95% CI: 40.3-52.8%) disclosed their HBV serostatus to at least one contact. Factors independently associated with HBV serostatus disclosure included being female (aPR = 1.46; 95% CI: 1.07-2.00), being ever married (aPR = 1.80; 95% CI: 1.21-2.68), living with chronic HBV for more than five years (aPR = 1.25; 95% CI: 1.11-1.96), having no comorbidities (aPR = 3.24; 95% CI: 1.43-5.39), having normal liver status (aPR = 1.31; 95% CI: 1.00-1.72), and having a higher HBV knowledge score (aPR = 1.07; 95% CI: 1.03-1.12). CONCLUSIONS: The findings indicated that HBV serostatus disclosure was low when compared to other African settings. Disclosure was driven by female gender, being ever married, longer duration of HBV diagnosis, absence of comorbidities, normal liver status and higher HBV knowledge. While the study provided valuable insights into the dynamics of disclosure, its cross-sectional design meant that definitive causal relationships could not be established. CLINICAL TRIAL NUMBER: Not applicable.