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. 2017 Nov 29;18(1):691.
doi: 10.4102/sajhivmed.v18i1.691. eCollection 2017.

Non-disclosure of HIV-positive status to a partner and mother-to-child transmission of HIV: Evidence from a case-control study conducted in a rural county in Kenya

Joram Nyandat  1 , Gisela van Rensburg  1
Affiliations

Non-disclosure of HIV-positive status to a partner and mother-to-child transmission of HIV: Evidence from a case-control study conducted in a rural county in Kenya

Joram Nyandat et al. South Afr J HIV Med. .

Abstract

Background: Many factors contribute to an enhanced risk of infant HIV acquisition, two of which may include failure of a mother to disclose her HIV-positive status to her partner and exclusion of male partners in preventing mother-to-child transmission of HIV (PMTCT) interventions. To justify why HIV programmes need to integrate male partner involvement and partner disclosure, we need to establish an association between the two factors and infant HIV acquisition.

Objective: To determine whether failure to disclose an HIV-positive status to a male partner is associated with increased risk of infant HIV acquisition, and whether part of the association is explained by exclusion of male partner in PMTCT programmes.

Methods: Using a case-control study design, we identified a total of 180 mother-baby pairs with HIV-exposed infants. Thirty-six pairs with HIV-positive babies (cases) were compared to 144 pairs with HIV-negative babies (controls) on whether the mothers had disclosed their HIV status to their partner in order to determine whether a disclosure or lack of it contributed to increased risk of mother-to-child transmission of HIV (MTCT). Each case pair was matched to four control pairs from the same facility.

Results: Overall, 16.7% of mothers had not disclosed their HIV status to their partners, the proportion being significantly more among cases (52.8% vs. 7.6%, p < 0.001). Non-disclosure was significantly associated with infant HIV acquisition (aOR 9.8 (3.0-26.3); p < 0.001) and male partner involvement partially mediated the effect of non-disclosure on infant HIV acquisition (indirect coefficient = 0.17, p < 0.005).

Conclusions: Failure of an HIV-positive woman to disclose her status to her male partner and exclusion of male partners in PMTCT programmes are two social factors that may curtail success of interventions towards the goal of eliminating MTCT.

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Conflict of interest statement

The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Conceptual framework for relationship among variables affecting non-disclosure and mother-to-child transmission of HIV.
FIGURE 2
FIGURE 2
Framework for mediation analysis.
FIGURE 3
FIGURE 3
Summary of inclusion and exclusion of participants.
FIGURE 4
FIGURE 4
Regression coefficients for relationship between non-disclosure and HIV status at 6 weeks as mediated by male partner involvement.
See this image and copyright information in PMC

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