Factors associated with HIV-positive and HIV-negative pregnant women disclosing their HIV test result to their partner in Tabora, Tanzania
Background: HIV
testing during pregnancy is almost universally available and accepted now and recently,
Tanzania adopted targeted universal ART including discordant couples. Understanding factors associated with HIV
status disclosure among HIV-positive and HIV-negative women is essential to
effectively enroll discordant couples into HIV prevention and treatment
services.
Methods: EGPAF is studying the effect of SMS
appointment reminders and cash transport payments on clinic attendance and
facility-based delivery for HIV-positive and HIV-negative women, and HIV
testing of exposed infants. Multivariate regression analysis of baseline data (n=1149)
identified factors associated with HIV status disclosure to a partner. Inclusion criteria included pregnant women (>=18
years) attending antenatal care who had at least one prior pregnancy.
Results: The
mean age of participants was 27 years; 86% were married; 46% were HIV-negative,
29% were known HIV-positive, and 25% were newly identified HIV-positive. The prevalence of partner disclosure was 58%
overall (48% among HIV-negative; 66% among HIV-positive). In multivariate analysis, partner disclosure
was more likely among women with known positive status (adjusted odds ratio
[AOR]=10.5, 95% CI: 6.2,17.8) or newly diagnosed positive status (AOR=1.8, 95% CI:
1.2,2.8) compared to those testing HIV-negative. Women whose health care was usually decided
by others (AOR=1.8, 95% CI: 1.1,2.8) were more likely to disclose compared to
women who decided themselves. Disclosure
was positively associated with being married (AOR=4.0, 95% CI: 1.9,8.1) or
cohabiting (AOR=2.9, 95% CI: 1.4,5.9), and negatively associated with having a
partner with some education (AOR=0.69, 95% CI: 0.50,0.95). Compared to women who knew their partner was
negative, women with known positive partners were more likely to disclose HIV
status (AOR=3.4, 95% CI: 2.0,5.9) while those who did not know their partner''s
status were less likely to disclose HIV status (AOR=0.08, 95% CI: 0.05,0.15).
Conclusions: Disclosure
is more common among pregnant women who are HIV-positive, rely on others for
health care decisions and know their partner is HIV positive. The lower rates of disclosure among
HIV-negative women suggest that lack of open communication about HIV risk and
HIV status may limit identification of discordant couples; service providers
should strengthen and update communication-relevant key messages into post-test
counseling for those testing negative.
G. Mbita1, G. Antelman1, R. van de Ven1, P. Njau2, G. Woelk3
1Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania, United Republic of, 2Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania, United Republic of, 3Elizabeth Glaser Pediatric AIDS Foundation, Washington DC, United States