Correlates of HIV Status Nondisclosure by Pregnant Women Living With HIV to Their Male Partners in Uganda: A Cross-Sectional Study

Bulterys, Michelle A; Mugwanya, Kenneth; Stein, Gabrielle; Mujugira, Andrew; Nakyanzi, Agnes; Twohey-Jacobs, Lorraine; Ware, Norma C.; Heffron, Renee; Celum, Connie

doi:10.1097/qai.0000000000002566

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Most of the PLWHIV neglected were females with low-income status, 36 and they were faced with lots of challenges in raising their children and meeting their family needs. 37 …”

Section: Discussionmentioning

confidence: 99%

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Atwijukiire¹,

Nakidde²,

Otwine³

et al. 2022

HIV

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Purpose Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. The current study addressed this research gap, and explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Participants and Methods We conducted 12 in-depth interviews with the help of a translated interview guide, and they were audio recorded. Participants were purposively enrolled in the study, which employed a phenomenological qualitative design. The study was conducted at three public health facilities in Mbarara City. The data was analyzed using thematic content analysis. Approval for this research was obtained from the Mbarara University Research Ethics Committee (MUST-REC) and administrative clearance from the city clerk of Mbarara City. Results The mean age of the participants was 38 years old, ranging from 20 to 67 years. An equal number of males (six) and females participated in this study. Most of them had at least secondary level education, and only three had primary education. Half of the participants disclosed their serostatus to partners immediately after testing HIV positive. Key emerging themes as experienced benefits of HIV serostatus disclosure included: 1) social support and care; 2) decisions regarding health, fertility, and child bearing; 3) sharing information on HIV prevention and protection measures; 4) positive living; and 5) ease of HIV serostatus disclosure. The challenges associated with serostatus disclosure were summarized as one theme: misunderstandings in the families of the discordant couples. Conclusion Socially, psychologically and financially HIV positive individuals have benefited from their negative partners. Healthwise, they have been supported, and cared for after disclosing their positive status, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

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“…Most of the PLWHIV neglected were females with low-income status, 36 and they were faced with lots of challenges in raising their children and meeting their family needs. 37 …”

Section: Discussionmentioning

confidence: 99%

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Atwijukiire¹,

Nakidde²,

Otwine³

et al. 2022

HIV

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“…Yet HIV disclosure during pregnancy may reduce MTCT. 40 Policy decisions should carefully consider the reproductive rights of women living with HIV 41 as well as the population health benefits of interventions.…”

Section: Discussionmentioning

confidence: 99%

Financial Incentives, Not Behavioral Nudges, Led to Optimized HIV Testing among Pregnant Women in a High-Burden Urban Population in Ecuador

Ortiz

Grunauer

Gutierrez³

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Behavioral economic principles are increasingly being used in the fight against HIV, including improving voluntary testing in sub-Saharan Africa and South America. However, behavioral nudges have not been widely tested as a strategy to optimize HIV testing in pregnant women. Here, we assessed whether behavioral nudges or financial incentives were effective in optimizing HIV testing among pregnant women in a high-HIV burden setting. A randomized clinical trial was conducted between May 21 and Oct 5, 2018, to allocate pregnant women in Ecuador into three study arms: information only, soft commitment (i.e., a behavioral nudge), and financial incentives. All participants received an informational flyer, including the address of a testing location. Participants in the soft-commitment arm signed and kept a form on which they committed to get tested for HIV. Those in the financial incentive arm received a $10 incentive when tested for HIV. A stepwise logistic regression analysis estimated the effect of the study arms on HIV testing rate. Participants in the financial-incentive arm had higher odds of getting an HIV test (adjusted odds ratio 17.06, P < 0.001) as compared with information-only participants. Soft-commitment had the opposite effect (adjusted odds ratio 0.14, P = 0.014). Financial incentives might be useful in improving HIV testing among pregnant women, especially among those who might be at higher risk but who have not completed an HIV test.

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“…Also, the desired impact of the reported testing uptake is contingent on behavioural outcomes such as partner disclosure and enrolling in and adhering to PMTCT services (Flash et al, 2015). However, many women testing positive for HIV do not enter into PMTCT services (Okonkwo et al, 2022) and fail to disclose their new status to their partners (Bulterys et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

From Policy to Practice: A Process Evaluation of Implementing Opt-Out HIV Testing in Antenatal Clinics Across Ghana

PhD,

MPhil,

Owusu

et al. 2024

Preprint

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In 2008, Ghana adopted the WHO/UNAIDS guideline for 'opt-out' HIV testing in antenatal clinics (ANCs). Although initial concerns were expressed about healthcare providers’ (HCPs’) ability to adhere to the intervention’s delivery, mainstream research has predominantly emphasised effectiveness questions to report variable testing uptake. This process evaluation aims to uncover the contextual factors that moderate adherence to the intervention in 12 of Ghana’s antenatal clinics (ANCs). We employed Carroll's (2007) modified framework of implementation fidelity to investigate factors that moderated the implementation of the provider-initiated opt-out HIV testing policy. Moderating factors explored were complexity, context, facilitating strategies, and participant responsiveness. We conducted 28 individual interviews and 11 focus group discussions, together with unstructured non-participant observations of the ANC environment and HIV testing activities. Key informants included 4 national-level officers, 4 regional-level officers, and 12 ANC managers. HCP interviews explored the complexity and facilitation of the HIV testing process and experiences with the opt-out intervention. Pregnant women's interviews explored their experiences with the opt-out intervention. The data was analysed using the constructs of Carroll’s implementation framework. We found weak antenatal clinic infrastructure, the complex nature of the opt-out intervention, a lack of facilitation, varied participant responses and power imbalance as moderators of the opt-out intervention implementation. These moderating factors collectively hinder the adoption of a right-based approach to HIV testing.

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Correlates of HIV Status Nondisclosure by Pregnant Women Living With HIV to Their Male Partners in Uganda: A Cross-Sectional Study

Cited by 6 publications

References 27 publications

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Financial Incentives, Not Behavioral Nudges, Led to Optimized HIV Testing among Pregnant Women in a High-Burden Urban Population in Ecuador

From Policy to Practice: A Process Evaluation of Implementing Opt-Out HIV Testing in Antenatal Clinics Across Ghana

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