Madiba Sphiwe, Putsoane Mamorapeli
Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
AIDS Res Treat. 2020 Feb 12;2020:6126210. doi: 10.1155/2020/6126210. eCollection 2020.
The routine antenatal screening through the prevention of mother to child transmission of HIV (PMTCT) services results in pregnancy being often the point at which an HIV diagnosis is made. Disclosure to partners presents particular complexities during pregnancy. However, research on the pattern and experiences of disclosure in pregnancy is limited in Lesotho, despite the high prevalence of HIV among pregnant women. The aim of this study was to explore and describe the disclosure experiences of adolescent girls and young women (AGYW) after receiving a positive HIV test result during pregnancy. . Descriptive phenomenology using semistructured in-depth interview was used to collect data from AGYM sampled purposively from PMTCT sites located in urban areas of Maseru, Lesotho. Data analysis was inductive and followed the thematic approach. . There were 15 AGYW involved in this study with the mean age of 20 years. Fourteen reported being pregnant with their first child and perceived HIV testing in antenatal care as compulsory. Ten AGYM disclosed their HIV status in the immediate posttesting period to protect their partners from HIV infection. The narratives revealed that the AGYM hoped that after disclosing, the partner would be tested for HIV. Furthermore, the AGYM disclosed because they wanted freedom to take their medication. Their experience of disclosure was relief, as they did not have to hide their HIV status. The AGYM reported being supported to adhere to medication and clinic attendance by their partners who also provided emotional support to them to deal with being HIV positive and pregnant. . The AGYM recounted an overall positive experience of disclosure to their partners who agreed to test for HIV and adopted safe sex practices. This has positive implications for the PMTCT programme and the involvement of men in reproductive health. Therefore, there is need to integrate disclosure and partner testing interventions in the cascade of services in PMTCT programmes.
通过预防母婴传播艾滋病毒（PMTCT）服务进行的常规产前筛查，使得怀孕常常成为做出艾滋病毒诊断的时间点。在孕期向伴侣披露病情会带来特别复杂的情况。然而，尽管莱索托孕妇中艾滋病毒感染率很高，但关于孕期披露病情的模式和经历的研究却很有限。本研究的目的是探索并描述青少年女孩和年轻女性（AGYW）在孕期艾滋病毒检测呈阳性后向伴侣披露病情的经历。采用半结构化深度访谈的描述性现象学方法，从莱索托马塞卢市区的PMTCT站点有目的地抽取AGYW样本以收集数据。数据分析采用归纳法并遵循主题分析法。本研究中有15名AGYW参与，平均年龄为20岁。14人报告怀有她们的第一个孩子，并认为产前护理中的艾滋病毒检测是强制性的。10名AGYW在检测后立即披露了她们的艾滋病毒感染状况，以保护伴侣免受艾滋病毒感染。这些叙述表明，AGYW希望披露病情后，伴侣能接受艾滋病毒检测。此外，AGYW披露病情是因为她们希望能自由服药。她们披露病情后的感受是解脱，因为她们不必再隐瞒自己的艾滋病毒感染状况。AGYW报告称，她们的伴侣支持她们坚持服药并按时就诊，还在她们应对艾滋病毒呈阳性且怀孕的情况时给予情感支持。AGYW讲述了向伴侣披露病情的总体积极经历，她们的伴侣同意接受艾滋病毒检测并采取了安全性行为。这对预防母婴传播项目以及男性参与生殖健康具有积极意义。因此，有必要将披露病情和伴侣检测干预措施纳入预防母婴传播项目的一系列服务中。
