Non-disclosure of HIV-positive status to a partner and mother-to-child transmission of HIV: Evidence from a case–control study conducted in a rural county in Kenya

Nyandat, Joram; Rensburg, Gisela Van

doi:10.4102/sajhivmed.v18i1.691

Cited by 13 publications

(11 citation statements)

References 47 publications

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“…Besides, discussion of hitherto private social problems might have helped women address other social problems they were struggling with. For example, other research findings highlight how disclosure of HIV status and lack of partner's support may inhibit access to PMTCT services (32). Similarly, the findings from this study can provide insights into the use of digital technology in the provision of health services.…”

Section: Discussionmentioning

confidence: 69%

Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya

Okal¹,

Sarna²,

Lango³

et al. 2022

Front. Glob. Womens Health

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BackgroundThe prevention of mother-to-child transmission (PMTCT) is considered one of the most successful HIV prevention strategies in detecting and reducing HIV acquisition in utero or at birth. It is anticipated that with the increasing growth of digital technologies mobile phones can be utilized to enhance PMTCT services by improving provider-client interactions, expanding access to counseling services, and assisting in counteracting social and structural barriers to uptake of PMTCT services. Understanding the subjective experiences of women accessing PMTCT services in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of HIV-positive pregnant women attending maternal and neonatal clinic services in Kisumu, Kenya.MethodsData are reported from in-depth interviews with women, following a longitudinal study investigating the impact of a structured, counselor-delivered, mobile phone counseling intervention to promote retention in care and adherence to ARV prophylaxis/treatment, for HIV-positive pregnant women. Thematic content analysis was conducted.ResultsDiscussions indicated that mobile-phone counseling provided useful health-related information, enhanced agency, and assisted mothers access critical PMTCT services across the cascade of care. Similarly, mobile-phone counseling offered personalized one-to-one contact with trained health providers including facilitating discussion of personal issues that likely affect access to services. Findings also identified barriers to the uptake of services, including a lack of partner support, poor health, poverty, facility-related factors, and provider attitudes.DiscussionOverall, findings show that mobile-phone counseling is feasible, acceptable, and can enhance access to PMTCT services by overcoming some of the individual and facility-level barriers. Although mobile-phone counseling has not been routinized in most health facilities, future work is needed to assess whether mobile-phone counseling can be scaled-up to aid in the effective use of HIV and PMTCT services, as well as improving other related outcomes for mother and child dyad.

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Section: Discussionmentioning

confidence: 69%

Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya

Okal¹,

Sarna²,

Lango³

et al. 2022

Front. Glob. Womens Health

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“…The overall rate of disclosure is in line with study conducted in Uganda in that 83.8% had disclosed their sero-status to at least one person, 22 study of South Africa (80.0%) disclosed to one of their family 23 and Kenyan study (83%). 24 However it is higher than the rate (59%) found in a study conducted in South African HIV positive pregnant women. 2 Still much higher than in Tanzania (60%) of those pregnant women interviewed had disclosed to significant others.…”

Section: Discussionmentioning

confidence: 69%

Prevalence and factors affecting disclosure of HIV status among pregnant women attending antenatal care in Addis Ababa public health centres: a cross sectional survey

Dulla¹,

Meseret²,

Nega³

2019

OGIJ

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ANC, antenatal care; AOR, adjusted odds ratio; ART, antiretroviral therapy; B + , using a single tablet fixed dose combination of tenofovir, lamivudine and efavirenz; CART, combined antiretroviral treatment; CARV, combined antiretroviral therapy; CD4, cluster of differentiations 4; CI, confidence interval; COR, crude odds ratio; HCT, HIV counselling and testing; HIV, human immune deficiency virus; OR, odds ratio; PLWHIV, people living with HIV; PMTCT, prevention of mother to child transmission; SD, standard deviation; SPSS, statistical package for social sciences; WHO, World health organization Disclosure of HIV status to sexual partner is an important prevention goal emphasized by the WHO and centers for disease control and prevention in their protocols for HIV testing and counseling. Besides it offers a number of important benefits to the infected individual and the general public. 2-5 Some of potential benefits for the individual and public including increased opportunities for social support, improved access to necessary medical care (antiretroviral treatment), increased opportunities to discuss and implement HIV risk reduction with partners, and increased opportunities to plan for the future, motivating sexual partners to be tested, change bad behaviours, reduce vertical and sexual transmission risk. [7][8][9][10][11][12] Consequently, Women who disclose their HIV sero-status to their sexual partners may be more likely to participate in programmes for prevention of HIV transmission to their sexual partners as well as to their infants. 13 in addition, it enables couples to make informed reproductive health choices that may ultimately lower the number of unintended pregnancies among HIV positive women and help them take ARV drugs properly and give it to the new born as recommended by physicians. 14 Despite, all the mentioned benefits, HIV infected women may face a lot of potential risks following disclosure: including loss of economic support, blame, abandonment, physical and emotional abuse, discrimination and disruption of family relationships. 14,15 Fear of the above these risks identified as barriers to disclose their serostatus for immediate partners 16,17 that in turn lead to lost opportunities

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“…7 Qualitative studies show that PWLHIV fear being seen taking medications or attending PMTCT services 8,9 The detrimental consequences of non-disclosure during pregnancy are well documented: lack of disclosure contributes to 9.8 times higher odds of infant HIV acquisition, ART non-adherence for both the mother and infant, and 2.8 times higher likelihood of loss to follow up from ART care. [10][11][12] A case-control study found that mothers living with HIV who had uninfected infants were 14 times more likely to have disclosed their status to their male partners than mothers with HIV-infected infants. 13 Similarly, a national survey in Kenya found that non-disclosure during pregnancy was associated with 12.8 times higher odds of MTCT of HIV.…”

Section: Background and Significancementioning

confidence: 99%

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

Bulterys

Mugwanya

Stein

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: HIV status disclosure by pregnant women living with HIV (PWLHIV) to their male partners is associated with improved maternal and infant outcomes. Understanding relationship factors associated with non-disclosure of HIV status by PWLHIV to their partners can inform the design of interventions to facilitate status disclosure.Methods: We conducted a cross-sectional study using enrollment data from 500 PWLHIV participating in a randomized controlled trial assessing secondary distribution of HIV self-testing kits in Kampala, Uganda. HIV status non-disclosure was the primary outcome of interest. We conducted univariate and multivariate binomial regressions to assess the association between socio-demographic, HIV history, and relationship characteristics and non-disclosure of HIV status.Results: Overall, 68.2% of women in our sample had not disclosed their HIV status to their partners. Factors that increased the likelihood of non-disclosure included shorter relationship duration <1 year (adjusted prevalence ratio (aPR=1.25); 95% CI: 1.02-1.54), being in a polygamous relationship (aPR=1.21; 95% CI: 1.07-1.36), not married (aPR=1.20; 95% CI: 1.07-1.35), reporting uncertainty about whether their partner had ever HIV-tested (aPR=1.55; 95% CI: 1.28-1.88), and reporting lack of social support from people aware of their status (aPR=1.32; 95% CI: 1.18-1.49). Conclusion:Relationship factors, including shorter-term, unmarried, and polygamous relationships, and uncertainty about the partner's HIV testing history, were associated with increased likelihood of non-disclosure of HIV status by pregnant women to their partner. Interventions that facilitate couples' disclosure, provide counseling messaging to reduce relationship dissolution in serodiscordant couples, and provide opportunities for women to benefit from peer support may help improve disclosure.

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Non-disclosure of HIV-positive status to a partner and mother-to-child transmission of HIV: Evidence from a case–control study conducted in a rural county in Kenya

Cited by 13 publications

References 47 publications

Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya

Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya

Prevalence and factors affecting disclosure of HIV status among pregnant women attending antenatal care in Addis Ababa public health centres: a cross sectional survey

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

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