Non-Disclosure of a Pregnant Woman’s HIV Status to Her Partner is Associated with Non-Optimal Prevention of Mother-to-Child Transmission

Abstract

Our objective was to study relations between non-disclosure of HIV to partner, socio demographics and prevention of HIV mother-to-child transmission (PMTCT), among HIV-infected pregnant women enrolled in the French Perinatal Cohort (ANRS-EPF-CO1) from 2005 to 2009 (N = 2,952). Fifteen percent of the women did not disclose their HIV status to their partner. Non-disclosure was more frequent in women diagnosed with HIV infection late in pregnancy, originating from Sub-Saharan Africa or living alone, as well as when the partner was not tested for HIV. Non-disclosure was independently associated with non optimal PMTCT: late initiation of antiretroviral therapy, detectable viral load at delivery and lack of neonatal prophylaxis. Nonetheless, the rate of transmission did not differ according to disclosure status. Factors associated with non-disclosure reflect vulnerability and its association with non optimal PMTCT is a cause for concern although the impact on transmission was limited in this context of universal free access to care.

Non-disclosure to male partners and incomplete PMTCT regimens associated with higher risk of mother-to-child HIV transmission: a national survey in Kenya

“…Indeed, we also reported an association between non-disclosure and lower uptake of both maternal and infant ARVs for PMTCT (Kinuthia et al, 2015). These findings are consistent with studies reporting suboptimal uptake and adherence to PMTCT regimens in women who had not disclosed their HIV status (Ebuy, Yebyo, & Alemayehu, 2015; Jasseron et al, 2013; Kinuthia et al, 2011; Spangler, Onono, Bukusi, Cohen, & Turan, 2014) and add to the literature on disclosure and MTCT. Strategies to maintain confidentiality and facilitate disclosure to male partners are needed to maximize PMTCT effectiveness (Kinuthia et al, 2011; Schechter et al, 2014).…”

Pregnant Women and Disclosure to Sexual Partners After Testing HIV-1–Seropositive During Antenatal Care

“…Departments of 2 Medicine, 3 Global Health, 4 Epidemiology, and 5 Pediatrics, University of Washington, Seattle, Washington. 6 Departments of Medicine, Psychiatry, and Therapeutics, Kenyatta University, Nairobi, Kenya.…”

“…Disclosure to male partners antenatally has been associated with improved adherence to prevention of mother-to-child transmission (PMTCT) regimens, 2 better infant feeding practices, 3 safer sex practices, and increased male partner testing. 4 Conversely, women who have not disclosed their HIV-1 status to their partner have been observed to be more likely to have suboptimal adherence to PMTCT regimens, [5][6][7] higher rates of noncompletion of PMTCT regimens, 8 and fewer infants tested postnatally for HIV-1. 9 In addition to disclosure's implications for infants, there are important health implications of disclosure for male partners themselves, whether the members of the couple are both affected by HIV-1 or not.…”

Shame, Guilt, and Stress: Community Perceptions of Barriers to Engaging in Prevention of Mother to Child Transmission (PMTCT) Programs in Western Kenya

“…7,8 Literature about sub-Saharan Africa demonstrates a combination of health systems barriers to uptake of PMTCT, as well as widely perceived HIV-stigma and social or family influences. [9][10][11][12][13] While much of the HIV literature describes stigma and discrimination as a single concept, Nyblade et al specified four distinct domains of stigma: fear of casual contact; moral values of shame, blame and judgment; discrimination; and disclosure.…”