Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
AIDS Behav. 2018 Dec;22(12):3933-3944. doi: 10.1007/s10461-018-2263-6.
HIV-status disclosure may improve psychosocial health and adherence to antiretroviral therapy (ART), but existing insights suffer from methodological limitations. We explored disclosure over time during pregnancy and postpartum among 1347 HIV-positive women in Cape Town. Among 995 women diagnosed HIV-positive before the pregnancy and entering antenatal care (median age 30 years), 95% had disclosed to ≥ 1 individual. In Mokken scale analysis, we observed two separate dimensions of disclosure: disclosure to a male partner, and disclosure to family/community members. Among 352 women diagnosed during the pregnancy and initiating ART (median age 27 years), 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis. Relationship status modified the impact of pregnancy intentions and poverty on disclosure to a male partner. These unique data provide important insights into dimensions of disclosure during pregnancy and postpartum, and suggest that women's social and economic circumstances are central determinants of disclosure.
HIV 状况披露可能会改善心理社会健康和抗逆转录病毒治疗（ART）的依从性，但现有研究存在方法学上的局限性。我们在开普敦的 1347 名 HIV 阳性妇女中，探讨了怀孕期间和产后期间的披露情况。在 995 名在怀孕前被诊断为 HIV 阳性并进入产前保健（中位年龄 30 岁）的女性中，95%的人向≥1 个人披露了病情。在莫肯量表分析中，我们观察到披露的两个独立维度：向男性伴侣披露，以及向家人/社区成员披露。在 352 名在怀孕期间被诊断并开始接受 ART（中位年龄 27 岁）的女性中，61%的人在诊断后 12 个月内向男性伴侣披露，71%的人向家人/社区成员披露。关系状况改变了怀孕意向和贫困对向男性伴侣披露的影响。这些独特的数据为怀孕期间和产后期间披露的维度提供了重要的见解，并表明女性的社会和经济状况是披露的核心决定因素。
