When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.

BACKGROUND: In Africa, women tested for HIV during antenatal care are counselled to share with their partner their HIV test result and to encourage partners to undertake HIV testing. We investigate, among women tested for HIV within a prevention of mother-to-child transmission of HIV (PMTCT) program...

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Main Authors: Hermann Brou, Gérard Djohan, Renaud Becquet, Gérard Allou, Didier K Ekouevi, Ida Viho, Valériane Leroy, Annabel Desgrées-du-Loû, ANRS 1201/1202/1253 Ditrame Plus Study Group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-12-01
Series:PLoS Medicine
Online Access:http://europepmc.org/articles/PMC2100145?pdf=render
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author Hermann Brou
Gérard Djohan
Renaud Becquet
Gérard Allou
Didier K Ekouevi
Ida Viho
Valériane Leroy
Annabel Desgrées-du-Loû
ANRS 1201/1202/1253 Ditrame Plus Study Group
author_facet Hermann Brou
Gérard Djohan
Renaud Becquet
Gérard Allou
Didier K Ekouevi
Ida Viho
Valériane Leroy
Annabel Desgrées-du-Loû
ANRS 1201/1202/1253 Ditrame Plus Study Group
author_sort Hermann Brou
collection DOAJ
description BACKGROUND: In Africa, women tested for HIV during antenatal care are counselled to share with their partner their HIV test result and to encourage partners to undertake HIV testing. We investigate, among women tested for HIV within a prevention of mother-to-child transmission of HIV (PMTCT) programme, the key moments for disclosure of their own HIV status to their partner and the impact on partner HIV testing. METHODS AND FINDINGS: Within the Ditrame Plus PMTCT project in Abidjan, 546 HIV-positive and 393 HIV-negative women were tested during pregnancy and followed-up for two years after delivery. Circumstances, frequency, and determinants of disclosure to the male partner were estimated according to HIV status. The determinants of partner HIV testing were identified according to women's HIV status. During the two-year follow-up, disclosure to the partner was reported by 96.7% of the HIV-negative women, compared to 46.2% of HIV-positive women (chi(2) = 265.2, degrees of freedom [df] = 1, p < 0.001). Among HIV-infected women, privileged circumstances for disclosure were just before delivery, during early weaning (at 4 mo to prevent HIV postnatal transmission), or upon resumption of sexual activity. Formula feeding by HIV-infected women increased the probability of disclosure (adjusted odds ratio 1.54, 95% confidence interval 1.04-2.27, Wald test = 4.649, df = 1, p = 0.031), whereas household factors such as having a co-spouse or living with family reduced the probability of disclosure. The proportion of male partners tested for HIV was 23.1% among HIV-positive women and 14.8% among HIV-negative women (chi(2) = 10.04, df = 1, p = 0.002). Partners of HIV-positive women who were informed of their wife's HIV status were more likely to undertake HIV testing than those not informed (37.7% versus 10.5%, chi(2) = 56.36, df = 1, p < 0.001). CONCLUSIONS: In PMTCT programmes, specific psychosocial counselling and support should be provided to women during the key moments of disclosure of HIV status to their partners (end of pregnancy, weaning, and resumption of sexual activity). This support could contribute to improving women's adherence to the advice given to prevent postnatal and sexual HIV transmission.
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spelling doaj.art-c132ddca285549ffa0565da247b581852022-12-21T17:31:35ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762007-12-01412e34210.1371/journal.pmed.0040342When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.Hermann BrouGérard DjohanRenaud BecquetGérard AllouDidier K EkoueviIda VihoValériane LeroyAnnabel Desgrées-du-LoûANRS 1201/1202/1253 Ditrame Plus Study GroupBACKGROUND: In Africa, women tested for HIV during antenatal care are counselled to share with their partner their HIV test result and to encourage partners to undertake HIV testing. We investigate, among women tested for HIV within a prevention of mother-to-child transmission of HIV (PMTCT) programme, the key moments for disclosure of their own HIV status to their partner and the impact on partner HIV testing. METHODS AND FINDINGS: Within the Ditrame Plus PMTCT project in Abidjan, 546 HIV-positive and 393 HIV-negative women were tested during pregnancy and followed-up for two years after delivery. Circumstances, frequency, and determinants of disclosure to the male partner were estimated according to HIV status. The determinants of partner HIV testing were identified according to women's HIV status. During the two-year follow-up, disclosure to the partner was reported by 96.7% of the HIV-negative women, compared to 46.2% of HIV-positive women (chi(2) = 265.2, degrees of freedom [df] = 1, p < 0.001). Among HIV-infected women, privileged circumstances for disclosure were just before delivery, during early weaning (at 4 mo to prevent HIV postnatal transmission), or upon resumption of sexual activity. Formula feeding by HIV-infected women increased the probability of disclosure (adjusted odds ratio 1.54, 95% confidence interval 1.04-2.27, Wald test = 4.649, df = 1, p = 0.031), whereas household factors such as having a co-spouse or living with family reduced the probability of disclosure. The proportion of male partners tested for HIV was 23.1% among HIV-positive women and 14.8% among HIV-negative women (chi(2) = 10.04, df = 1, p = 0.002). Partners of HIV-positive women who were informed of their wife's HIV status were more likely to undertake HIV testing than those not informed (37.7% versus 10.5%, chi(2) = 56.36, df = 1, p < 0.001). CONCLUSIONS: In PMTCT programmes, specific psychosocial counselling and support should be provided to women during the key moments of disclosure of HIV status to their partners (end of pregnancy, weaning, and resumption of sexual activity). This support could contribute to improving women's adherence to the advice given to prevent postnatal and sexual HIV transmission.http://europepmc.org/articles/PMC2100145?pdf=render
spellingShingle Hermann Brou
Gérard Djohan
Renaud Becquet
Gérard Allou
Didier K Ekouevi
Ida Viho
Valériane Leroy
Annabel Desgrées-du-Loû
ANRS 1201/1202/1253 Ditrame Plus Study Group
When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
PLoS Medicine
title When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
title_full When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
title_fullStr When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
title_full_unstemmed When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
title_short When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.
title_sort when do hiv infected women disclose their hiv status to their male partner and why a study in a pmtct programme abidjan
url http://europepmc.org/articles/PMC2100145?pdf=render
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