Daniels Joseph, De Vos Lindsey, Mogos Winta, Olivier Dawie, Shamu Simukai, Mudau Maanda, Klausner Jeffrey, Medina-Marino Andrew
Charles Drew University, 1731 E. 120th Street, Los Angeles, CA 90059, USA; and Corresponding author. Email:
Foundation for Professional Development, 173 Mary Road, Die Wilgers, Pretoria, 0184, South Africa.
Sex Health. 2019 Jun;16(3):274-281. doi: 10.1071/SH18177.
Background Sexually transmissible infections (STI) may increase the risk of mother-to-child transmission (MTCT) of HIV. However, diagnostic testing and targeted treatment of STI (STI-TT) during pregnancy is not standard care in South Africa.
A qualitative study was nested in a STI-TT intervention to investigate motivating and enabling factors associated with STI test results disclosure to sexual partners. A semi-structured interview protocol covered partner communication, HIV and STI disclosure, financial security and relationships dynamics. Interviews were conducted in participants' preferred language, audio-recorded, transcribed into English and analysed using a constant comparison approach. The study was conducted in two townships in Pretoria, South Africa.
Twenty-eight HIV-positive pregnant women were interviewed. Based on the interviews, two disclosure experiences for women were identified - those with vulnerable experiences and those with self-enabling experiences within their partnerships. Vulnerable women discussed intimate partner violence (IPV) and fear of relationship dissolution as factors influencing their test result disclosure. Self-enabled women discussed their ability to talk with their partners about STI and HIV infections and the influence of multiple concurrent partnerships in the acquisition of HIV/STIs. Both groups of women were concerned about men's health behaviours, and all cited the health and development of their unborn child as a key motivator for test result disclosure.
Improved counselling and support for pregnant women to disclose their STI test results to their partners may improve the impact of STI diagnostic testing during pregnancy by improving partner treatment uptake and thus reducing the risk of re-infection.
背景 性传播感染（STI）可能会增加人类免疫缺陷病毒（HIV）母婴传播（MTCT）的风险。然而，在南非，孕期对性传播感染进行诊断检测和针对性治疗（STI-TT）并非标准医疗服务。
一项定性研究嵌套于一项STI-TT干预措施中，以调查与向性伴侣披露性传播感染检测结果相关的促进因素和促成因素。一份半结构化访谈提纲涵盖了伴侣沟通、HIV和STI披露、经济保障以及关系动态。访谈以参与者偏好的语言进行，录音后转录为英文，并采用持续比较法进行分析。该研究在南非比勒陀利亚的两个城镇开展。
对28名HIV阳性孕妇进行了访谈。基于访谈，确定了女性的两种披露经历——在伴侣关系中有脆弱经历的和有自我促成经历的。脆弱的女性将亲密伴侣暴力（IPV）和对关系破裂的恐惧作为影响她们披露检测结果的因素。有自我促成能力的女性讨论了她们与伴侣谈论性传播感染和HIV感染的能力，以及多个并发伴侣关系在感染HIV/性传播感染方面的影响。两组女性都关注男性的健康行为，并且都将未出生孩子的健康和发育作为披露检测结果的关键动机。
加强对孕妇的咨询和支持，使其向伴侣披露性传播感染检测结果，可能会通过提高伴侣接受治疗的比例，从而降低再次感染的风险，来改善孕期性传播感染诊断检测的效果。
