Departments of Epidemiology, and.
Global Health, University of Washington, Seattle, WA.
J Acquir Immune Defic Syndr. 2021 Apr 1;86(4):389-395. doi: 10.1097/QAI.0000000000002566.
HIV status disclosure by pregnant women living with HIV (PWLHIV) to their male partners is associated with improved maternal and infant outcomes. Understanding relationship factors associated with nondisclosure of HIV status by PWLHIV to their partners can inform the design of interventions to facilitate disclosure.
We conducted a cross-sectional study using enrollment data from 500 PWLHIV unaware of their male partners' HIV status and participating in a randomized clinical trial assessing secondary distribution of HIV self-testing kits in Kampala, Uganda. The primary outcome was women's HIV status nondisclosure to their partners. We conducted univariate and multivariate binomial regressions to assess the association between baseline sociodemographic, HIV history, and relationship characteristics with HIV status nondisclosure.
68.2% of the 500 PWLHIV had not disclosed their HIV status to their partner(s). Factors associated with higher likelihood of nondisclosure included relationship duration <1 year [adjusted prevalence ratio (aPR = 1.25); 95% confidence interval (CI): 1.02 to 1.54], being in a polygamous relationship (aPR = 1.21; 95% CI: 1.07 to 1.36), unmarried (aPR = 1.20; 95% CI: 1.07 to 1.35), uncertainty about whether their partner had ever tested for HIV (aPR = 1.55; 95% CI: 1.28 to 1.88), and a lack of social support from people aware of their status (aPR = 1.32; 95% CI: 1.18 to 1.49).
Relationship factors, including shorter-term, unmarried, and polygamous relationships and uncertainty about partner's HIV testing history, were associated with higher likelihood of pregnant women's nondisclosure of HIV status to their partner. Interventions that facilitate couples' HIV testing and disclosure, provide counseling to reduce relationship dissolution in serodiscordant couples, and offer peer support for women may increase disclosure.
Clinicaltrials.gov ID number: NCT03484533.
艾滋病毒感染者（PLHIV）向其男性伴侣透露艾滋病毒状况与改善母婴结局有关。了解 PLHIV 未向其伴侣透露艾滋病毒状况的相关关系因素，可以为促进透露状况的干预措施提供信息。
我们对参加乌干达坎帕拉评估二级分发艾滋病毒自检包的随机临床试验的 500 名不了解其男性伴侣艾滋病毒状况的 PLHIV 使用入组数据进行了一项横断面研究。主要结局是女性未向伴侣透露艾滋病毒状况。我们进行了单变量和多变量二项式回归，以评估基线社会人口统计学、艾滋病毒史和关系特征与艾滋病毒状况未透露之间的关系。
500 名 PLHIV 中有 68.2%未向其伴侣透露艾滋病毒状况。与更高可能性未透露相关的因素包括关系持续时间<1 年[调整后患病率比（aPR=1.25）；95%置信区间（CI）：1.02 至 1.54]、处于一夫多妻关系（aPR=1.21；95%CI：1.07 至 1.36）、未婚（aPR=1.20；95%CI：1.07 至 1.35）、不确定其伴侣是否曾经接受过艾滋病毒检测（aPR=1.55；95%CI：1.28 至 1.88）以及缺乏知晓其状况的人的社会支持（aPR=1.32；95%CI：1.18 至 1.49）。
关系因素，包括短期、未婚和一夫多妻关系以及对伴侣艾滋病毒检测史的不确定性，与孕妇向其伴侣隐瞒艾滋病毒状况的可能性较高有关。促进夫妻艾滋病毒检测和透露状况的干预措施，为减少血清不一致的夫妻关系破裂提供咨询，并为妇女提供同伴支持，可能会增加透露状况的可能性。
ClinicalTrials.gov 注册号：NCT03484533。
