Disclosure of HIV test results by women to their partners following antenatal HIV testing: a population-based cross-sectional survey among slum dwellers in Kampala Uganda

Abstract

BackgroundDisclosure of HIV status by women to their partners is the backbone for prevention of HIV transmission among couples as well as promotion of the prevention of mother to child transmission of HIV interventions. The aim of this study was to determine the prevalence and factors associated with disclosure of HIV test results by women to their sexual partners following antenatal HIV testing in Kamwokya slum community, Kampala, Uganda.MethodsThis was a population based cross-sectional study carried out from October to November 2011. A total of 408 randomly selected women aged 18–45 years, who had delivered a child within 2 years prior to the study, and had tested for HIV during antenatal care were recruited from Kamwokya community. A standardised interviewer- administered questionnaire was used to collect data. Data was entered into Epidata 2.1b and analysed using SPSS software version 16.0 and StatsDirect version 2.8.0.ResultsOverall 83.8% (95% CI: 79.9- 87.1) of the women reported that they had disclosed their HIV status to their sexual partners. Disclosure was significantly higher among women whose partners had also tested for HIV (OR=24.86, 95% CI: 5.30 - 116.56). Other factors that were associated with disclosure were secondary education or above (OR=2.66, 95% CI: 1.34 - 5.30), having attended 3 or more antenatal care visits (OR=3.62, 95% CI: 1.70 - 7.72), being married/cohabiting (OR=8.76, 95% CI: 4.06 - 18.81) and whether or not they would opt not to disclose a family member’s HIV status (OR=1.61, 95% CI: 1.003 - 2.58). Overall, stigma was not significantly associated with disclosure.ConclusionsDisclosure of HIV test results to sexual partners in this group of women was relatively high. The results suggest that having a sexual partner who had also tested probably made it easier to disclose the woman’s HIV status. Other predictors of disclosure were secondary education and above and having attended more antenatal care visits. These findings suggest the need for promotion of sexual partner HIV testing, improvement of literacy levels of women, and encouragement of women to attend antenatal care, as key factors in promoting disclosure of HIV results.

Factors that promote HIV disclosure among women attending prevention of mother-to-child transmission in a state in South Nigeria

“…This study showed that there are factors in the relationship between couples that promote HIV disclosure among pants. This same occurrence was reported by Batte et al in his study among women attending antenatal clinic in Uganda, where he showed that knowledge of HIV status of partners promotes disclosure irrespective zof the level of status sero-discordance [16]. WHO reported this to be a good factor in couples' counseling for HIV disclosure [11,17].…”

“…HIV-positive women in the study who had knowledge of their partners HIV status were encouraged to disclose their HIV status. Knowing the status of partners seemed to give confidence to the women and enhanced disclosure despite the 58% sero-discordance rate among the partici- Makin et al in a study among HIV-positive women receiving PMTCT service in South Africa reported that women who are married and are educated are more likely to disclose their status to their partners [12,16,18]; this study did not show any significance in the relationship. A study by Burmen et al also reported insignificant relationship in the two variables in his study in adult HIV-infected individuals in Kenya [19]; further study with bigger sample size is required.…”

Husband’s willingness-to-pay for HIV and syphilis screening at antenatal care clinic under the Thai universal coverage scheme

“…This is similar to other studies. Batte et al conducted a survey in Uganda and reported 98.9% of pregnant partners to receive CHTC whereas only 42.4% were tested when coming separately [20]. Moreover, Thirumurthy et al in Kenya attributed HIV self-testing of partners through pregnant women; the result showed 91% of the pregnant women gave the selftests to their partner but only 51% were tested [22], suggesting that husbands tended to receive HIV testing when they were approached as a couple.…”

“…The second section obtained the history of HIV and/or syphilis screening tests and knowledge of HIV prevention using the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) score (0-3, low; 3-4, moderate; 5, high). Based on the evidence from literature, the age [16], income [13,16], educational level [16,[18][19][20], history of having a child [16], history of STI screen tests [16,18,21], and knowledge of HIV prevention [16] were considered potential factors affecting WTP and willingness to test for STIs. Other potential determinants such as the number of ANC visits [20] were excluded because they were beyond the scope of this survey.…”

How Do We Get Partners to Test for HIV?: Predictors of Uptake of Partner HIV Testing Following Individual Outpatient Provider Initiated HIV Testing in Rural Uganda

“…Prior studies have most often been focused on barriers to testing for serodiscordant couples, and barriers for women to get their partners to test in the setting of ANC or other maternal health services; thus, there is a need for more research on barriers to partner testing in the general adult population for both men and women (18). The few studies that have examined facilitators of HIV testing found HIV-related partner communication and being in a serious committed relationship (18, 28, 29) to be associated with uptake of partner HIV testing. Among men, one study found that female partner HIV testing was associated with better perceived relationship quality (30).…”