坦桑尼亚乞力马扎罗地区接受护理和治疗诊所服务的 HIV 阳性妇女向性伴侣透露 HIV 感染状况及其结果的相关因素。

Factors associated with HIV status disclosure to partners and its outcomes among HIV-positive women attending Care and Treatment Clinics at Kilimanjaro region, Tanzania.

机构信息

Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania.

Community Health Department, Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania.

出版信息

PLoS One. 2019 Mar 13;14(3):e0211921. doi: 10.1371/journal.pone.0211921. eCollection 2019.

DOI:10.1371/journal.pone.0211921

PMID:30865633

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6415788/

Abstract

BACKGROUND

Sub Saharan Africa continues to be the epicenter of HIV with 70% of people living with HIV globally. Women form nearly 60% of those living with HIV. Studies have shown disclosure of one's HIV status is important in HIV prevention, in increasing partners who are tested and getting into care early as well as in improving retention in PMTCT and ART programs. This study aimed to determine the prevalence, factors and outcomes of HIV status disclosure to partners among HIV-positive women attending HIV care-and-treatment clinics (CTCs) at Kilimanjaro region, northern Tanzania.

METHODS

A cross-sectional study was conducted from January to June 2014 in 3 out of the 7 districts of Kilimanjaro region. The study population was HIV-positive women aged 15-49, who were attending for routine HIV care at 19 selected clinics. Face-to-face interviews were conducted with consenting women to collect necessary information. Multivariate logistic regression analyses were used to determine the independent predictors of HIV status disclosure to partner.

RESULTS

A total of 672 HIV-positive women in Moshi municipal, Hai and Mwanga districts were enrolled. Of them, 609 HIV-positive women reported to have a regular partner. Prevalence of serostatus disclosure to partners was 66%. Of the 400 who had disclosed; 56% did so within the first month of knowing their HIV status. In a multiple logistic regression model, HIV serostatus disclosure was higher among women who: were married/cohabiting (AOR = 4.16, 95% CI: 2.39-7.25; p<0.001), currently on ART (AOR = 2.06, 95% CI: 1.11-3.82; p = 0.020), and who reported had ever communicated with partners on number of children (AOR = 1.85, 95% CI: 1.15-2.98; p = 0.010) and contraceptives use (AOR = 2.01, 95% CI: 1.27-3.20; p = 0.208). Most of the women (81%) who disclosed their HIV status to did not reported negative outcomes.

CONCLUSION

In this setting still a third of the HIV-positive women (34%) fail to disclose their HIV- serostatus to partners. Interventions to impart skills in communication and negotiation between partners may help in improving disclosure of HIV. Efforts to involve men in general sexual and reproductive health including couple counseling and testing will contribute in improving disclosure and communication on HIV among partners.

摘要

背景

撒哈拉以南非洲地区仍然是 HIV 的重灾区，全球 70%的 HIV 感染者生活在该地区。而女性则占 HIV 感染者总数的近 60%。研究表明，HIV 感染者向伴侣透露其 HIV 状况对于 HIV 预防、增加接受检测的伴侣数量、尽早接受治疗以及改善 PMTCT 和 ART 项目的保留率都非常重要。本研究旨在确定坦桑尼亚北部乞力马扎罗地区接受 HIV 护理和治疗诊所（CTCs）治疗的 HIV 阳性妇女向其伴侣透露 HIV 状况的流行率、影响因素和结果。

方法

本横断面研究于 2014 年 1 月至 6 月在乞力马扎罗地区的 7 个区中的 3 个区进行。研究对象为年龄在 15-49 岁之间、在 19 个选定诊所定期接受 HIV 护理的 HIV 阳性妇女。对同意参加的妇女进行面对面访谈，以收集必要信息。采用多变量逻辑回归分析确定向伴侣透露 HIV 状况的独立预测因素。

结果

共招募了来自莫希市、Hai 和 Mwanga 区的 672 名 HIV 阳性妇女。其中，609 名 HIV 阳性妇女报告有固定伴侣。向伴侣透露 HIV 状况的比例为 66%。在 400 名已经透露的妇女中，有 56%是在知道自己 HIV 状况后的第一个月内透露的。在多变量逻辑回归模型中，向伴侣透露 HIV 状况的妇女中：已婚/同居（AOR = 4.16，95%CI：2.39-7.25；p<0.001）、正在接受 ART 治疗（AOR = 2.06，95%CI：1.11-3.82；p = 0.020）以及与伴侣就生育子女数量（AOR = 1.85，95%CI：1.15-2.98；p = 0.010）和避孕措施使用（AOR = 2.01，95%CI：1.27-3.20；p = 0.020）进行过沟通的妇女比例更高。大多数（81%）向伴侣透露 HIV 状况的妇女没有报告负面结果。