Demographic, clinical and behavioural determinants of HIV serostatus nondisclosure to sex partners among HIV-infected pregnant women in the Eastern Cape, South Africa

被引：34

作者：

Adeniyi, Oladele Vincent ^{[1
]}

Ajayi, Anthony Idowu ^{[2
]}

Selanto-Chairman, Nonkosi ^{[3
]}

Ter Goon, Daniel ^{[4
]}

Boon, Gerry ^{[5
]}

Fuentes, Yusimi Ordaz ^{[6
]}

Hofmeyr, George Justus ^{[7
]}

Avramovic, Gordana ^{[8
]}

Carty, Craig ^{[9
]}

Lambert, John ^{[10
]}

机构：

[1] Walter Sisulu Univ, Cecilia Makiwane Hosp, Dept Family Med & Rural Hlth, East London Hosp Complex, East London, South Africa

[2] Univ Ft Hare, Dept Sociol, East London, South Africa

[3] Buffalo City Metro Dept Hlth, East London, South Africa

[4] Univ Ft Hare, Fac Hlth Sci, East London, South Africa

[5] Walter Sisulu Univ, Frere Hosp, Dept Paediat, East London Hosp Complex, East London, South Africa

[6] Cecilia Makiwane Hosp, Dept Family Med, East London Hosp Complex, East London, South Africa

[7] Walter Sisulu Univ, Frere Hosp, Effect Care Res Unit, East London Hosp Complex, East London, South Africa

[8] Univ Coll Dublin, Mater Misericordiae Univ Hosp, Catherine McAuley Educ & Res Ctr, Dublin, Ireland

[9] Relevance Network, Johannesburg, South Africa

[10] Univ Coll Dublin, Mater Misericordiae Univ Hosp, Catherine McAuley Educ & Res Ctr, Dublin, Ireland

来源：

PLOS ONE | 2017年 / 12卷 / 08期

关键词：

TRANSMISSION RISK; DISCLOSURE; PEOPLE; HIV/AIDS; PREDICTORS; ABSENT;

D O I：

10.1371/journal.pone.0181730

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objectives Drawing from a baseline sample of a cohort study, the study examines the extent and correlates of serostatus non-disclosure to sex partners and family members, and reasons for non-disclosure among HIV-infected pregnant women in the Eastern Cape Province, South Africa. Methods This longitudinal cohort study recruited 1709 pregnant women living with HIV who attended three of the largest maternity centres in the Eastern Cape, South Africa, for delivery between September 2015 and May 2016. Relevant items on demographics, serostatus awareness, disclosure to sex partners and family members, and lifestyle behaviours were obtained using structured interviews. Age-stratified binary logistic regression models were used to determine the significant correlates of non-disclosure among the participants. Results A higher rate of HIV serostatus non-disclosure to sex partners (25.6%) in comparison to family members (20%) was reported by the participants. Younger age, not living with partners and alcohol use were significantly associated with non-disclosure of HIV serostatus to sex partners. Non-disclosure of HIV serostatus to sex partners was significantly (p<0.05) associated with poor adherence to the highly active anti-retroviral therapy (HAART), failure to keep clinic appointments and high viral load at the delivery of the baby. Perceived fear of intimate partner violence, fear of rejection, guilt of not disclosing at the onset of the relationship, sex partner's non-disclosure of HIV serostatus, and guilt of unfaithfulness were some of the reasons for non-disclosure of HIV serostatus to sex partners. Conclusions Non-disclosure of HIV serostatus is a public health concern with serious implications for both mother-to-child transmission, as well as horizontal transmission, in our setting. Strategic efforts toward ending the epidemic of HIV and AIDS in South Africa should address the sociocultural and behavioural determinants of non-disclosure.

引用

页数：15

共 39 条

[1] Disclosure, stigma of HIV positive child and access to early infant diagnosis in the rural communities of OR Tambo District, South Africa: a qualitative exploration of maternal perspective [J].