Partner HIV serostatus disclosure and determinants of serodiscordance among prevention of mother to child transmission clients in Nigeria

Onovo, Amobi; Nta, Iboro Ekpo; Onah, Aaron; Okolo, Chukwuemeka; Amro, Ahmad; Dakum, Patrick; Atobatele, Akinyemi; Gado, Pamela

doi:10.1186/s12889-015-2155-x

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…Among our cascade groups, newly-diagnosed and ANC women were less likely to know their partner's status, compared to postpartum and LTFU women, and this difference was statistically significant. Previous Nigerian studies reported a similar serodiscordance rate for North-Central Nigeria of 51.9% [ 23 ] and lower rate of 38.5% for South-East Nigeria [ 45 ]. Proportions of HIV-positive women with unknown male partner status of 62.4% and 85% have been reported from studies in North-Central and South-East Nigeria, respectively [ 24 , 45 ], which are much higher than for our study.…”

Section: Discussionmentioning

confidence: 71%

“…Since we could not establish time of HIV diagnosis for our cascade groups, it is not possible to determine how and if this played a role in the observed differences in serodiscordance, and knowledge of partner status. For serodiscordant couples, early partner testing, notification and treatment can avert seroconversion in the HIV-negative partner [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gender inequities often rooted in socio-cultural factors play a key role in low rates of HIV status disclosure to male partners among women living with HIV [ 17 ]. Reasons for male partner non-disclosure among these women include fear of abandonment with the resultant loss of emotional, material and financial support [ 17 – 22 ]; emotional abuse, including name-calling, accusations of infidelity and exposing the family to HIV [ 19 , 20 , 22 ], and sex deprivation [ 23 , 24 ]. Stigma as well as perceived or enacted discrimination - from male partners and/or the community at large-have also been reported [ 19 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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HIV status disclosure to male partners among rural Nigerian women along the prevention of mother-to-child transmission of HIV cascade: a mixed methods study

Odiachi¹,

Erekaha

Cornelius

et al. 2018

Reprod Health

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BackgroundHIV status disclosure to male partners is important for optimal outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Depending on timing of HIV diagnosis or pregnancy status, readiness to disclose and disclosure rates may differ among HIV-positive women. We sought to determine rates, patterns, and experiences of disclosure among Nigerian women along the PMTCT cascade.MethodsHIV-positive women in rural North-Central Nigeria were purposively recruited according to their PMTCT cascade status: pregnant-newly HIV-diagnosed, pregnant-in care, postpartum, and lost-to-follow-up (LTFU). Participants were surveyed to determine rates of disclosure to male partners and others; in-depth interviews evaluated disclosure patterns and experiences. Tests of association were applied to quantitative data. Qualitative data were manually analysed by theme and content using the constant comparative method in a Grounded Theory approach.ResultsWe interviewed 100 women; 69% were 21–30 years old, and 86% were married. There were 25, 26, 28 and 21 women in the newly-diagnosed, in-care, postpartum, and LTFU groups, respectively. Approximately 81% of all participants reported disclosing to anyone; however, family members were typically disclosed to first. Ultimately, more women had disclosed to male partners (85%) than to family members (55%). Rates of disclosure to anyone varied between groups: newly-diagnosed and LTFU women had the lowest (56%) and highest (100%) rates, respectively (p = 0.001). However, family (p = 0.402) and male partner (p = 0.218) disclosure rates were similar between cascade groups. Across all cascade groups, fear of divorce and intimate partner violence deterred women from disclosing to male partners. However, participants reported that with assistance from healthcare workers, disclosure and post-disclosure experiences were mostly positive.ConclusionIn our study cohort, although disclosure to male partners was overall higher, family members appeared more approachable for initial disclosure. Across cascade groups, male partners were ultimately disclosed to at rates > 75%, with no significant inter-group differences. Fear appears to be a major reason for non-disclosure or delayed disclosure by women to male partners. Augmentation of healthcare workers’ skills and involvement can mediate gender power differentials, minimize fear and shorten time to male partner disclosure among women living with HIV, regardless of their PMTCT cascade status.Trial registrationClinicaltrials.gov registration number NCT 01936753, September 3, 2013 (retrospectively registered).

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HIV status disclosure to male partners among rural Nigerian women along the prevention of mother-to-child transmission of HIV cascade: a mixed methods study

Odiachi¹,

Erekaha

Cornelius

et al. 2018

Reprod Health

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“…It was also observed in the present study, that more than one third of those not disclosed, indicated their willingness to disclose now and of those not willing to disclose now, close to three quarters were willing to disclose in the future. This observed willingness of the respondents, does not necessarily translate to disclosure, as reported in a Nigerian study [37], where there was no association between the study participants willingness to disclose and their partners getting tested in spite of the fact that, most of the participants who tested positive to HIV indicated their willingness to disclose.…”

Section: *Significantmentioning

confidence: 61%

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

Iwu¹,

Duru²,

Diwe³

et al. 2017

J AIDS Clin Res

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Background: The non-disclosure of HIV positive status has most often been accompanied by risky sexual behaviours which is a complex relationship that facilitates the transmission of sexually transmitted diseases such as HIV.Objective: To determine sexual behaviour, levels of sero-status disclose and willingness to disclose; and the socio-demographic determinants of disclosure and willingness to disclose among HIV positive male patients receiving care in hospitals in Imo State, Nigeria. Methods:A cross sectional analytical design using a simple random sampling technique to select 422 HIV male patients attending the adult HIV clinics of two major hospitals. Data was collected using a pretested, semi structured questionnaire. Descriptive statistics were presented using frequencies and summary indices. Chi square statistics were computed to determine significant relationships and binary logistic regression was used to determine predictors of disclosure and willingness to disclose. A p-value of ≤ 0.05 was considered significant. Results:A majority of the respondents were either traders or artisans (54.6%) with a mean age of 32.0 ± 2.0 years. The results revealed that more than one third of the respondents had two or more sexual partners (35.5%), less than one quarter correctly and consistently use condoms (23.3%) and close to one third had not disclosed their HIV positive status (31.7%); of which, less than two fifths are now willing to disclose (37.8%). It was further revealed that married HIV positive male patients who are traders or artisans above the age of 30 years with monthly income levels less than N40,000 ($110) and living in an urban or semi urban area with family members or other people, were significantly more likely to have disclosed their HIV positive status. Similarly, HIV positive male patients who had not disclosed their status, but are artisans aged above 30 years, were significantly more likely to be willing now to disclose their HIV positive status.

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“…There is ample data on the impact of expert mothers and similar peer support on PMTCT outcomes, disclosure rates, and experiences among WLHIV in general [2][3][4][5][6][7][21][22][23][24][25]. However, there is little data on disclosure among expert mothers functioning as mentors for other WLHIV.…”

Section: Plos Onementioning

confidence: 99%

A mixed-methods assessment of disclosure of HIV status among expert mothers living with HIV in rural Nigeria

Odiachi¹,

Sam-Agudu

Erekaha

et al. 2020

PLoS ONE

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Background Peer support provided by experienced and/or trained "expert" women living with HIV has been adopted by prevention of mother-to-child transmission of HIV (PMTCT) programs across sub-Saharan Africa. While there is ample data on HIV status disclosure among nonexpert women, there is little data on disclosure among such expert women, who support other women living with HIV. Objective This study compared HIV disclosure rates between expert and non-expert mothers living with HIV, and contextualized quantitative findings with qualitative data from expert women. Methods We compared survey data on HIV disclosure to male partners and family/friends from 37 expert and 100 non-expert mothers living with HIV in rural North-Central Nigeria. Four focus group discussions with expert mothers provided further context on disclosure to male partners, extended family and peers. Chi square and Fisher's exact tests were applied to quantitative data. Qualitative data were manually analyzed using a Grounded Theory approach. Results Two-thirds of the 137 participants were 21-30 years old; 89.8% were married, and 52.3% had secondary-level education. Disclosure to male partners was higher among expert (100.0%) versus non-expert mothers (85.0%), p = 0.035. Disclosure to anyone (93.1% vs 80.8%, p = 0.156), and knowledge of male partners' HIV status were similar (75.7% versus 66.7%, p = 0.324) between expert and non-expert mothers, respectively. With respect to male partners, HIV serodiscordance rates were also similar (46.4% vs 55.6%, p = 0.433).

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Partner HIV serostatus disclosure and determinants of serodiscordance among prevention of mother to child transmission clients in Nigeria

Cited by 13 publications

References 14 publications

HIV status disclosure to male partners among rural Nigerian women along the prevention of mother-to-child transmission of HIV cascade: a mixed methods study

HIV status disclosure to male partners among rural Nigerian women along the prevention of mother-to-child transmission of HIV cascade: a mixed methods study

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

A mixed-methods assessment of disclosure of HIV status among expert mothers living with HIV in rural Nigeria

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