A cross-sectional study of the magnitude, barriers, and outcomes of HIV status disclosure among women participating in a perinatal HIV transmission study, “the Nevirapine Repeat Pregnancy study”

Abstract

BackgroundHIV status disclosure is a difficult emotional task for HIV-infected persons and may create the opportunity for both social support and rejection. In this study, we evaluated the proportions, patterns, barriers and outcomes of HIV- 1 status disclosure among a group of women in Uganda.MethodsAn exit interview was conducted one year post-partum for 85 HIV-infected women who participated in a study of HIV-1 transmission rates among NVP-experienced compared with NVP-naïve women in “The Nevirapine Repeat Pregnancy (NVP-RP) Study” at the Makerere University-Johns Hopkins University Research Collaboration, Kampala-Uganda, between June 2004 and June 2006.ResultsOf the 85 women interviewed, 99 % had disclosed their HIV status to at least one other person. Disclosure proportions ranged between 1 % to employer(s) and 69 % to a relative other than a parent. Only 38 % of the women had disclosed to their sex partners. Women with an HIV-infected baby were more likely than those with an uninfected baby to disclose to their sex partner, OR 4.9 (95 % CI, 2.0 –11.2), and women were less likely to disclose to a partner if they had previously disclosed to another relative than if they had not, OR 0.19 (95 % CI, 0.14–0.52). The most common reasons for non-disclosure included fear of separation from the partner and subsequent loss of financial support 34 %, and not living with the partner (not having opportunities to disclose) 26 %. While most women (67 %) reported getting social support following disclosure, 22 % reported negative outcomes (neglect, separation from their partners, and loss of financial support). Following disclosure of HIV status, 9 % of women reported that their partner (s) decided to have an HIV test.ConclusionResults from this study show high overall HIV disclosure proportions and how this disclosure of HIV status can foster social support. However, proportions of disclosure specifically to male sex partners were low, which suggests the need for interventions aimed at increasing male involvement in perinatal care, along with supportive counseling.

Study on HIV Status Disclosure and Treatment Adherence Amongst Support Group Members in Mushin Local Government Area (LGA), Lagos State

“…Encouragingly, the study also revealed a high overall disclosure rate (90%) when considering those who disclosed to at least one person, including a sexual partner or someone else. This aligns with findings from other studies by [13,14]. The high disclosure rates observed in the God is Good Support Group suggest a potential link between support group membership and increased disclosure.…”

Describing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda

“…Lack of disclosure of HIV positive status has been associated with increased LTFU [ 23 , 41 ] in women enrolled in PMTCT programs. We hypothesize that women who have not disclosed report to their partners that they visit monthly a health care facility for ANC, but not for HIV care; after delivering they may stop coming to the clinic since they cannot justify to their partners' monthly visits to a health care facility.…”

HIV serostatus disclosure to sexual partner: a survey among women in Tehran, Iran

“…Additionally, our study found out that the rate of disclosure to at least one person (including a sexual partner or anyone else) was high (94.1%). Other studies also found similar or higher rates of disclosure to at least one person [ 37 , 38 ]. Among those who disclosed to at least one person, nearly half of them (49.3%) only disclosed to their sexual partners and only 8.1% disclosed to two or more people apart from their sexual partners.…”