HIV Status Disclosure Among Postpartum Women in Zambia with Varied Intimate Partner Violence Experiences

Abstract

HIV-positive pregnant and postpartum women’s status disclosure to male sexual partners is associated with improved HIV and maternal and child health outcomes. Yet, status disclosure remains a challenge for many women living with HIV in sub-Saharan Africa, particularly those who are fearful of violence. The objective of the present study is to advance the current understanding of the relationship between intimate partner violence against women and their HIV status disclosure behaviors. We specifically evaluate how the severity, frequency, and type of violence against postpartum HIV-positive women affect status disclosure within married/cohabiting couples. A cross-sectional survey was administered by trained local research assistants to 320 HIV-positive postpartum women attending a large public health center for pediatric immunizations in Lusaka, Zambia. Survey data captured women’s self-reports of various forms of intimate partner violence and whether they disclosed their HIV status to the current male partner. Multiple logistic regression models determined the odds of status disclosure by the severity, frequency, and type of violence women experienced. Our findings indicate a negative dose-response relationship between the severity and frequency of intimate partner violence and status disclosure to male partners. Physical violence has a more pronounced affect on status disclosure than sexual or emotional violence. Safe options for women living with HIV who experience intimate partner violence, particularly severe and frequent physical violence, are urgently needed. This includes HIV counselors’ ability to evaluate the pros and cons of status disclosure among women and support some women’s decisions not to disclose.

Acceptability of a trial of vaginal progesterone for the prevention of preterm birth among HIV-infected women in Lusaka, Zambia: A mixed methods study

“…Some participants described specific aspects of the study that would be appealing to other women, such as the welcoming nature of the clinic, where staff treated patients well and information is kept confidential; and the fact that transportation and food was provided. [19] . .…”

HIV positive status disclosure to a sexual partner: the influence of marital status and partner communication

“…Given the importance of HIV status disclosure in promoting voluntary testing, safer sexual practices, adherence to ART [1], compliance with interventions for vertical transmission in the postpartum period [20], this study speci cally examined the rate and the in uence of marital status and knowing a partner's status on serostatus disclosure to sexual partners. Also, the study assessed the reasons for nondisclosure.…”

“…Evidence shows that disclosure of HIV status promotes voluntary testing, safer sexual practices and improves adherence to antiretroviral therapy (ART) [1]. Also, HIV status disclosure has been linked to positive mental health outcomes given that social support from family and social networks has been shown to improve psychological well-being and may play a signi cant role in the facilitation of the development of effective coping strategies, in addition to obtaining nancial support from family members [2].…”

HIV positive status disclosure to a sexual partner: the influence of marital status and partner communication

“…Given the importance of HIV status disclosure in promoting voluntary testing, safer sexual practices, adherence to ART [1], compliance with interventions for vertical transmission in the postpartum period [17], this study specifically examined the rate and the influence of marital status and knowing a partner's status on serostatus disclosure to sexual partners. Also, the study assessed the reasons for non-disclosure.…”

“…Disclosure of HIV serostatus among women living with HIV/AIDS in sub-Saharan Africa (SSA) has substantial implications for health outcomes, particularly in reaching the goal of an AIDS-free generation. Evidence shows that disclosure of HIV status promotes voluntary testing, safer sexual practices and improves adherence to antiretroviral therapy (ART) [1]. Also, HIV status disclosure has been linked to positive mental health outcomes given that social support from family and social networks has been shown to improve psychological well-being and may play a significant role in the facilitation of the development of effective coping strategies, in addition to obtaining financial support from family members [2].…”