HIV status disclosure patterns and male partner reactions among pregnant women with HIV on lifelong ART in Western Kenya

Abuogi, Lisa; Hampanda, Karen; Odwar, Tobias; Helová, Anna; Odeny, Thomas; Onono, Maricianah; Bukusi, Elizabeth A.; Turan, Janet M.

doi:10.1080/09540121.2019.1659915

Cited by 12 publications

(16 citation statements)

References 39 publications

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“…Other possible reasons are lower barriers to testing due improved partner disclosure of HIV status and diminished concerns of intimate partner violence 36 . We have previously observed that pregnant women in this study setting are more willing to disclose their HIV status to a current partner 37 compared to earlier studies 38 – 44 , which is consistent with other recently published studies from Kenya 45 – 47 , indicating a potential positive move forward towards more openness between partners. We have also reported on reduced concerns of intimate partner violence related to women’s participation in PMTCT care in the study area 37 .…”

Section: Discussionsupporting

confidence: 91%

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Nordberg

Mwangi

Kop

et al. 2021

Sci Rep

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Mother-to-child transmission of HIV remains a significant concern in Africa despite earlier progress. Early infant diagnosis (EID) of HIV is crucial to reduce mortality among infected infants through early treatment initiation. However, a large proportion of HIV-exposed infants are still not tested in Kenya. Our objective was to investigate whether weekly interactive text-messages improved prevention of mother-to-child transmission (PMTCT) of HIV care outcomes including EID HIV testing. This multicentre, parallel-group, randomised, open-label trial included six antenatal care clinics across western Kenya. Pregnant women living with HIV, aged 18 years or older, with mobile phone access, were randomised in a 1:1 ratio to weekly text messages that continued until 24 months postpartum, asking “How are you?” (“Mambo?”) to which they were asked to respond within 48 h, or a control group. Healthcare workers contacted participants reporting problems and non-responders by phone. Participants in both groups received routine PMTCT care. The prespecified secondary outcome reported in this paper is EID HIV testing by eight weeks of age (blinded outcome assessment). Final 24-months trial results will be published separately. We estimated risk ratios using Poisson regression with robust standard errors. Between June 2015–July 2016, we screened 735 pregnant women, of whom 600 were enrolled: 299 were allocated to the intervention and 301 to the control group. By eight weeks of age, the uptake of EID HIV testing out of recorded live births was 85.5% in the intervention and 84.7% in the control group (71.2% vs. 71.8% of participants randomised, including miscarriages, stillbirths, etc.). The intention-to-treat risk ratio was 0.99; 95% CI: 0.90–1.10; p = 0.89. The proportion of infants diagnosed with HIV was 0.8% in the intervention and 1.2% in the control group. No adverse events were reported. We found no evidence to support that the WelTel intervention improved EID HIV testing. A higher uptake of EID testing than expected in both groups may be a result of lower barriers to EID testing and improved PMTCT care in western Kenya, including the broader standard use of mobile phone communication between healthcare workers and patients. (ISRCTN No. 98818734. Funded by the European-Developing Countries Clinical Trial Partnership and others).

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Section: Discussionsupporting

confidence: 91%

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Nordberg

Mwangi

Kop

et al. 2021

Sci Rep

View full text Add to dashboard Cite

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“…The high proportion of partner disclosure is in line with recently published data from Kenya [39,41], including western Kenya [42], suggesting that more women are disclosing their HIV status to their partners compared to earlier Kenyan studies [11,36,[43][44][45][46][47]. In our study, younger women were more likely to have disclosed their HIV status to a partner compared to older women, indicating an increased openness and less stigma surrounding positive HIV status in younger couples in western Kenya, which could enable more male involvement in PMTCT care.…”

Section: Discussionsupporting

confidence: 86%

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

Nordberg

Gabriel

Were

et al. 2020

BMC Pregnancy Childbirth

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Background: Social concerns about unintentional HIV status disclosure and HIV-related stigma are barriers to pregnant women's access to prevention of mother-to-child transmission of HIV (PMTCT) care. There is limited quantitative evidence of women's social and emotional barriers to PMTCT care and HIV disclosure. We aimed to investigate how social concerns related to participation in PMTCT care are associated with HIV status disclosure to partners and relatives among pregnant women living with HIV in western Kenya. Methods: A cross-sectional study, including 437 pregnant women living with HIV, was carried out at enrolment in a multicentre mobile phone intervention trial (WelTel PMTCT) in western Kenya. Women diagnosed with HIV on the day of enrolment were excluded. To investigate social concerns and their association with HIV disclosure we used multivariableadjusted logistic regression, adjusted for sociodemographic and HIV-related characteristics, to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: The majority (80%) had disclosed their HIV status to a current partner and 46% to a relative. Older women (35-44 years) had lower odds of disclosure to a partner (OR = 0.15; 95% CI: 0.05-0.44) compared to women 18-24 years. The most common social concern was involuntary HIV status disclosure (reported by 21%). Concern about isolation or lack of support from family or friends was reported by 9%, and was associated with lower odds of disclosure to partners (OR = 0.33; 95% CI: 0.12-0.85) and relatives (OR = 0.37; 95% CI: 0.16-0.85). Concern about separation (reported by 5%; OR = 0.17; 95% CI: 0.05-0.57), and concern about conflict with a partner (reported by 5%; OR = 0.18; 95% CI: 0.05-0.67), was associated with lower odds of disclosure to a partner.

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“…The support from the sexual partner was described as understanding and without violence and bad behavior. In similar studies done in Tanzania and Kenya, participants reported 91.7% and 87.5% positive reflections, respectively [ 54 , 55 ]. Due to this increasing trend, it is advised that HIV care and counseling centers should encourage and counsel people living with HIV to disclose their status [ 18 , 56 ].…”

Section: Discussionmentioning

confidence: 84%

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

et al. 2022

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Background Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV. Methods A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The “HIV disclosure” questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively. Results One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63–61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92–11.62), being aware of sexual partners’ HIV status (COR = 6.20, 95% CI 1.79–21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48–23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners’ HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members. Conclusion This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners.

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HIV status disclosure patterns and male partner reactions among pregnant women with HIV on lifelong ART in Western Kenya

Cited by 12 publications

References 39 publications

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

The effect of weekly interactive text-messaging on early infant HIV testing in Kenya: a randomised controlled trial (WelTel PMTCT)

Social concerns related to HIV status disclosure and participation in the prevention of mother-to-child transmission of HIV care among pregnant women in Kenya

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

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