“Telling my husband I have HIV is too heavy to come out of my mouth”: pregnant women's disclosure experiences and support needs following antenatal HIV testing in eastern Uganda

Abstract

IntroductionDisclosure of HIV serostatus by women to their sexual partners is critical for the success of the prevention of mother-to-child transmission of HIV (PMTCT) programme as an integrated service in antenatal care. We explored pregnant HIV-positive and HIV-negative women's partner disclosure experiences and support needs in eastern Uganda.MethodsThis was a qualitative study conducted at Mbale Regional Referral Hospital in eastern Uganda between January and May 2010. Data collection was through in-depth interviews with 15 HIV-positive and 15 HIV-negative pregnant women attending a follow up antenatal clinic (ANC) at Mbale Hospital, and six key informant interviews with health workers at the clinic. Data management was done using NVivo version 9, and a content thematic approach was used for analysis.ResultsAll HIV-negative women had disclosed their HIV status to their sexual partners but expressed need for support to convince their partners to also undergo HIV testing. Women reported that their partners often assumed that they were equally HIV-negative and generally perceived HIV testing in the ANC as a preserve for women. Most of the HIV-positive women had not disclosed their HIV status to sexual partners for fear of abandonment, violence and accusation of bringing HIV infection into the family. Most HIV-positive women deferred disclosure and requested health workers’ support in disclosure. Those who disclosed their positive status generally experienced positive responses from their partners.ConclusionsWithin the context of routine HIV testing as part of the PMTCT programme, most women who test HIV-positive find disclosure of their status to partners extremely difficult. Their fear of disclosure was influenced by the intersection of gender norms, economic dependency, women's roles as mothers and young age. Pregnant HIV-negative women and their unborn babies remained at risk of HIV infection owing to the resistance of their partners to go for HIV testing. These findings depict a glaring need to strengthen support for both HIV-positive and HIV-negative women to maximize opportunities for HIV prevention.

HIV serostatus disclosure and associated factors among HIV positive pregnant women attending antenatal care services in northwest Ethiopia

“…12,13 In contrary, it is extremely higher than reports from Uganda, Tanzania and Zimbabwe. 6,14,15 The difference could be due to variations in study population, study design, sampling size. In the other way, the improvement may be due to continuous efforts to strengthen the health system infrastructure, build staff capacity, increase public awareness, involve community health extension workers, and step up the number of sectoral collaborations to enhance maternity and child health programs.…”

“…Here serostatus disclosure plays an important role for involving the partner of women in prevention of mother to child transmission of HIV. 5,6 However, only few studies state that HIV serostatus nondisclosure has been a major public health challenge among pregnant women of the country. 4,7 Therefore, knowledge about HIV serostatus disclosure among pregnant women might help to promote prevention of mother to child transmission of HIV (PMTCT) and to monitor the performances of HIV control activities.…”

Disclosure, Knowledge of Partner Status, and Condom Use Among HIV-Positive Patients Attending Clinical Care in Tanzania, Kenya, and Namibia

“…12 Substantial gender differences in the rates, barriers, and outcomes of disclosure have been found in a number of studies, with women particularly reluctant to disclose HIV-positive results for fear of losing economic support, being abandoned by their partners, and/or being subjected to physical and emotional abuse. 12,[14][15][16] HIV disclosure is also often a prerequisite for knowing the HIV status of a sex partner. PLHIV who have not disclosed their HIV status to their partners are less likely to know their partner's HIV status 17 and between 20-45% of PLHIV in clinical care in sub-Saharan Africa do not know the HIV status of their partners.…”

Vítimas e culpadas: representações sociais sobre mulheres que vivem com HIV

“…Estudos mostram que as mulheres com HIV possuem profundo medo de abandono, violência e acusações ao divulgarem para os seus maridos que são HIV positivas [16][17] . Estudo realizado na Índia mostrou que a maioria dos cuidadores eram mulheres, as quais se dividiam em multitarefas: ser mulher, trabalhadora, mãe e cuidadora 18 .…”