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When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.

作者信息

Brou Hermann, Djohan Gérard, Becquet Renaud, Allou Gérard, Ekouevi Didier K, Viho Ida, Leroy Valériane, Desgrées-du-Loû Annabel

机构信息

Laboratoire Population Environnement Développement, Institut de recherche pour le développement, Nogent-sur-Marne, France.

出版信息

PLoS Med. 2007 Dec;4(12):e342. doi: 10.1371/journal.pmed.0040342.


DOI:10.1371/journal.pmed.0040342
PMID:18052603
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2100145/
Abstract

BACKGROUND: In Africa, women tested for HIV during antenatal care are counselled to share with their partner their HIV test result and to encourage partners to undertake HIV testing. We investigate, among women tested for HIV within a prevention of mother-to-child transmission of HIV (PMTCT) programme, the key moments for disclosure of their own HIV status to their partner and the impact on partner HIV testing. METHODS AND FINDINGS: Within the Ditrame Plus PMTCT project in Abidjan, 546 HIV-positive and 393 HIV-negative women were tested during pregnancy and followed-up for two years after delivery. Circumstances, frequency, and determinants of disclosure to the male partner were estimated according to HIV status. The determinants of partner HIV testing were identified according to women's HIV status. During the two-year follow-up, disclosure to the partner was reported by 96.7% of the HIV-negative women, compared to 46.2% of HIV-positive women (chi(2) = 265.2, degrees of freedom [df] = 1, p < 0.001). Among HIV-infected women, privileged circumstances for disclosure were just before delivery, during early weaning (at 4 mo to prevent HIV postnatal transmission), or upon resumption of sexual activity. Formula feeding by HIV-infected women increased the probability of disclosure (adjusted odds ratio 1.54, 95% confidence interval 1.04-2.27, Wald test = 4.649, df = 1, p = 0.031), whereas household factors such as having a co-spouse or living with family reduced the probability of disclosure. The proportion of male partners tested for HIV was 23.1% among HIV-positive women and 14.8% among HIV-negative women (chi(2) = 10.04, df = 1, p = 0.002). Partners of HIV-positive women who were informed of their wife's HIV status were more likely to undertake HIV testing than those not informed (37.7% versus 10.5%, chi(2) = 56.36, df = 1, p < 0.001). CONCLUSIONS: In PMTCT programmes, specific psychosocial counselling and support should be provided to women during the key moments of disclosure of HIV status to their partners (end of pregnancy, weaning, and resumption of sexual activity). This support could contribute to improving women's adherence to the advice given to prevent postnatal and sexual HIV transmission.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6372/2222936/4fa5f566ad6a/pmed.0040342.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6372/2222936/4fa5f566ad6a/pmed.0040342.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6372/2222936/4fa5f566ad6a/pmed.0040342.g001.jpg

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[1]
When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.

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本文引用的文献

[1]
Two-year morbidity-mortality and alternatives to prolonged breast-feeding among children born to HIV-infected mothers in Côte d'Ivoire.

PLoS Med. 2007-1

[2]
[Impact of HIV counseling and testing during antenal consultation for HIV- women in Abidjan (Côte d'Ivoire): a quantitative and qualitative study (Ditrame Plus 3 project, ANRS 1253)].

Sante. 2005

[3]
Infant feeding practices before implementing alternatives to prolonged breastfeeding to reduce HIV transmission through breastmilk in Abidjan, Cote d'Ivoire.

J Trop Pediatr. 2005-12

[4]
Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events.

AIDS. 2005-3-24

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AIDS. 2005-2-18

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Bull World Health Organ. 2004-4

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AIDS. 2004-3-5

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HIV infection of women in African countries.

Int Nurs Rev. 2003-12

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Contraceptive use, protected sexual intercourse and incidence of pregnancies among African HIV-infected women. DITRAME ANRS 049 Project, Abidjan 1995-2000.

Int J STD AIDS. 2002-7

[10]
Vulnerability of women in an African setting: lessons for mother-to-child HIV transmission prevention programmes.

AIDS. 2002-4-12

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