Yale University

Factors affecting disclosure in South African HIV-positive pregnant women.

TitleFactors affecting disclosure in South African HIV-positive pregnant women.
Publication TypeJournal Article
Year of Publication2008
AuthorsMakin, Jennifer D., Brian W. C. Forsyth, Maretha J. Visser, Kathleen J. Sikkema, Sharon Neufeld, and Bridget Jeffery
JournalAIDS patient care and STDs
Date Published2008 Nov
KeywordsAIDS Serodiagnosis, Demography, Disclosure, Female, HIV Seropositivity, Humans, Longitudinal Studies, Pregnancy, Pregnancy Complications, Infectious, Psychology, Questionnaires, Risk Factors, Sexual Partners, Socioeconomic Factors, South Africa
AbstractTo provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal al clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20-4.47), prior discussion about testing (AOR 4.19; CI 2.34-7.49), having a partner with tertiary education (AOR 2.76; CI 1.29-5.88) and less experience of violence (AOR 0.48; CI 0.24-0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06-1.49), less financial dependence on partners (AOR 0.46; CI 0.25-0.85), and knowing someone with HIV (AOR 2.13; CI 1.20-3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84-0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72-0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help.
Alternate JournalAIDS Patient Care STDS

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