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. 2018 Dec;22(12):3933-3944.
doi: 10.1007/s10461-018-2263-6.

Patterns and Predictors of HIV-Status Disclosure Among Pregnant Women in South Africa: Dimensions of Disclosure and Influence of Social and Economic Circumstances

Kirsty Brittain  1   2 , Claude A Mellins  3 , Robert H Remien  3 , Tamsin Phillips  4   5 , Allison Zerbe  6 , Elaine J Abrams  6   7 , Landon Myer  4   5
Affiliations

Patterns and Predictors of HIV-Status Disclosure Among Pregnant Women in South Africa: Dimensions of Disclosure and Influence of Social and Economic Circumstances

Kirsty Brittain et al. AIDS Behav. 2018 Dec.

Abstract

HIV-status disclosure may improve psychosocial health and adherence to antiretroviral therapy (ART), but existing insights suffer from methodological limitations. We explored disclosure over time during pregnancy and postpartum among 1347 HIV-positive women in Cape Town. Among 995 women diagnosed HIV-positive before the pregnancy and entering antenatal care (median age 30 years), 95% had disclosed to ≥ 1 individual. In Mokken scale analysis, we observed two separate dimensions of disclosure: disclosure to a male partner, and disclosure to family/community members. Among 352 women diagnosed during the pregnancy and initiating ART (median age 27 years), 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis. Relationship status modified the impact of pregnancy intentions and poverty on disclosure to a male partner. These unique data provide important insights into dimensions of disclosure during pregnancy and postpartum, and suggest that women's social and economic circumstances are central determinants of disclosure.

Keywords: Disclosure; HIV; Mokken scale analysis; Pregnancy; South Africa.

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Conflict of interest statement

Conflict of interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Analytic populations and methods used1 1 ART: antiretroviral therapy.
Figure 2a
Figure 2a
Impact of pregnancy intention on occurrence of disclosure to a male partner among women diagnosed HIV-positive during pregnancy and married and/or cohabiting 2b Impact of pregnancy intention on occurrence of disclosure to a male partner among women diagnosed HIV-positive during pregnancy and neither married nor cohabiting
Figure 3a
Figure 3a
Impact of poverty on occurrence of disclosure to a male partner among women diagnosed HIV-positive during pregnancy and married and/or cohabiting 3b Impact of poverty on occurrence of disclosure to a male partner among women diagnosed HIV-positive during pregnancy and neither married nor cohabiting
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