The Experiences of HIV Status Disclosure among Pregnant and Postpartum Women: A Systematic Review of Qualitative Evidence

Abstract Background The infection of HIV continues to be an important public health problem in Ethiopia. Disclosing own HIV positive result is crucial, and considered as a good indicator of behavior change towards HIV/AIDs. A systematic review and meta-analysis was conducted to pool the prevalence of positive HIV status disclosure to sexual partners and determine the influence of selected factors. Methods This systematic review and meta-analysis was conducted in Ethiopia among HIV positive people receiving health care at health facilities. In this review, primary studies were searched in Medline via PubMed, Google scholar and Google up to November, 2018. Data on disclosure of HIV positive result, knowledge of partner’s HIV status and prior discussion on HIV were extracted, and effect sizes like proportion and odds ratios were pooled. Heterogeneity and publication bias were assessed by chi-square and I2, and Egger test, respectively. Results A total of 12 studies with 4528 participants were included in to this review to estimate the prevalence of disclosure of HIV positive result to sexual partner, and 10 and 7 studies were included to determine the associations of the outcome variable with knowledge of sexual partner’s HIV status and with prior discussion on HIV, respectively. The pooled prevalence of HIV status disclosure to sexual partner was 73% (95% CI: 64, 82%). Having the knowledge of sexual partner’s HIV status [OR: 95%CI; 17.63 (7.88, 39.45)], and previous discussion on HIV [OR: 95% CI; 9.24 (5.56, 15.37)] increased the disclosure of own HIV positive result to sexual partner. The sub-group analysis indicated a prevalence of 74% in Oromia, 86% in Southern Nations Nationalities and Peoples (SNNPR), 87% in Amhara, 73% in Addis Ababa, and 54% in Tigray. Conclusions Disclosure of HIV status to sexual partner is lower than expected. Knowledge of partner’s HIV status and previous discussion on HIV were strong predictors of HIV positive status disclosure. Strategies helpful for encouraging open HIV discussion need to be strengthened to increase HIV positive result disclosure. Furthermore, since the heterogeneity of studies is high, large nationally representative study is suggested.

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Barriers to and Facilitators of HIV Serostatus Disclosure to Sexual Partners among Postpartum Women Living with HIV in South Africa

10.21203/rs.3.rs-24611/v3 ◽

2020 ◽

Author(s):

Oladele Vincent Adeniyi ◽

Charlotte Nwogwugwu ◽

Anthony Idowu Ajayi ◽

John Lambert

Keyword(s):

Sexual Partners ◽

Postpartum Women ◽

Study Cohort ◽

Hiv Status ◽

Sampling Weights ◽

Serostatus Disclosure ◽

Hiv Serostatus ◽

Women With Hiv ◽

Hiv Status Disclosure ◽

Status Disclosure

Abstract Background: Disclosure of HIV serostatus to sexual partner facilitates partner's support and testing, and correlates with better treatment outcomes. Studies examining changes in the rate of serostatus from delivery and postpartum periods are scarce. Our study fills this gap by using a follow-up survey of postpartum women with HIV to examine if disclosure prevalence has improved compared to the proportion recorded at childbirth. We further assessed the reasons for non-disclosure and correlates of serostatus disclosure to sexual partners. Methods: We conducted telephonic interviews with a final sample of 485 postpartum women with HIV drawn from the East London Prospective Cohort study database between January and May 2018. Disclosure of HIV status to partner was based on self-reporting. We fitted adjusted and unadjusted logistic regression models and also conducted descriptive statistical analyses. Sampling weights were used to correct for sampling errors. Results: Overall, 81.8% of women in the study cohort had disclosed their status to their partners, representing a 7.4 percentage point increase since child delivery. After adjusting for important covariates, women were more likely to disclose their status if they were married [adjusted odds ratio (AOR): 3.10; 95% confidence interval (CI):1.39-6.91] but were less likely to disclose if they use alcohol [AOR: 0.61; 95% CI:0.37-0.99] or reported sub-optimal adherence [AOR: 0.59; 95% CI:0.36-0.96]. Fear of rejection, stigma or being judged, new or casual relationships, and having a violent partner were the main reasons for not disclosing HIV status to sexual partners. Conclusion: We found a relatively higher rate of HIV status disclosure in the cohort compared to the rate recorded at childbirth, suggesting the likelihood of positive effect of post-delivery counselling. Also, complicated relationship dynamics and fear of social exclusion still constitute barriers to HIV status disclosure to sexual partners despite patients' counselling.

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Disclosure of HIV Status to Children in Sub-Saharan Africa: A Systematic Review

Medicina ◽

10.3390/medicina55080433 ◽

2019 ◽

Vol 55 (8) ◽

pp. 433 ◽

Cited By ~ 4

Author(s):

Doat ◽

Negarandeh ◽

Hasanpour

Keyword(s):

Systematic Review ◽

Democratic Republic Of Congo ◽

Psychological Impact ◽

Hiv Disclosure ◽

Sub Saharan Africa ◽

Hiv Status ◽

Sub Saharan ◽

Information Materials ◽

Hiv Status Disclosure ◽

Status Disclosure

Background and objectives: This study aimed to assess the level of HIV disclosure to children in sub-Saharan Africa as it relates to prevalence of disclosure, barriers, merits and demerits, timing of disclosure, and factors that promote parents and caregivers’ decisions to disclose the information. Materials and Methods: A systematic literature search was performed using the following online databases: PubMed, Google Scholar, Web of Science, Scopus, and Embase, to obtain relevant articles on HIV disclosure to children in sub-Saharan Africa. The following search terms were used: “HIV” AND “Disclosure” AND “Sub-Saharan Africa” AND “Children”. Results: A total of 18 articles were included in this systematic review. The studies on HIV status disclosure to children in sub-Saharan Africa included a total of 1343 HIV-positive children and 1879 caregiver/child or healthcare worker-child dyads, from the following countries: Ethiopia, South Africa, Ghana, Kenya, Cote d’Ivoire, Burundi, Cameroon, Democratic Republic of Congo, Uganda, Burkina Faso, and Zambia. The prevalence of HIV disclosure ranged from as low as 9% to 72%. Age was a major factor associated with disclosure. Conclusions: HIV status disclosure to children is quite low in sub-Saharan Africa. This is a result of multiple factors such as parents’/caregivers’ fear of the child disclosing status to others, a lack of knowledge on how the disclosure should be made, and the assertion that the children are young and cannot withstand the psychological impact of diagnosis.

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HIV Status Disclosure Among Postpartum Women in Zambia with Varied Intimate Partner Violence Experiences

AIDS and Behavior ◽

10.1007/s10461-017-1909-0 ◽

2017 ◽

Vol 22 (5) ◽

pp. 1652-1661 ◽

Cited By ~ 7

Author(s):

Karen M. Hampanda ◽

Christine Tagliaferri Rael

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Postpartum Women ◽

Hiv Status ◽

Hiv Status Disclosure ◽

Status Disclosure

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HIV status disclosure among postpartum women in rural Tanzania: predictors, experiences and uptake of a nurse-facilitated disclosure intervention

AIDS Care ◽

10.1080/09540121.2018.1428724 ◽

2018 ◽

Vol 30 (4) ◽

pp. 417-425 ◽

Cited By ~ 2

Author(s):

E. Geubbels ◽

A. Williams ◽

A. Ramaiya ◽

D. Tancredi ◽

S. Young ◽

...

Keyword(s):

Postpartum Women ◽

Hiv Status ◽

Rural Tanzania ◽

Hiv Status Disclosure ◽

Status Disclosure

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Impact of HIV-Status Disclosure on Adherence to Antiretroviral Therapy Among HIV-Infected Children in Resource-Limited Settings: A Systematic Review

AIDS and Behavior ◽

10.1007/s10461-016-1481-z ◽

2016 ◽

Vol 21 (1) ◽

pp. 59-69 ◽

Cited By ~ 19

Author(s):

Justin Nichols ◽

Alexis Steinmetz ◽

Elijah Paintsil

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Hiv Status ◽

Resource Limited Settings ◽

Resource Limited ◽

Hiv Status Disclosure ◽

Status Disclosure

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Barriers to and facilitators of HIV serostatus disclosure to sexual partners among postpartum women living with HIV in South Africa

BMC Public Health ◽

10.1186/s12889-021-10955-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Oladele Vincent Adeniyi ◽

Charlotte Nwogwugwu ◽

Anthony Idowu Ajayi ◽

John Lambert

Keyword(s):

Sexual Partners ◽

Postpartum Women ◽

Study Cohort ◽

Hiv Status ◽

Sampling Weights ◽

Serostatus Disclosure ◽

Hiv Serostatus ◽

Women With Hiv ◽

Hiv Status Disclosure ◽

Status Disclosure

Abstract Background Disclosure of HIV serostatus to a sexual partner can facilitate partner’s support and testing and better treatment outcomes. Studies examining changes in disclosure rates of serostatus from delivery and postpartum periods are scarce. Our study fills this gap by using a follow-up survey of postpartum women with HIV to examine if disclosure prevalence has improved compared to the proportion recorded at childbirth. We further assessed the reasons for non-disclosure and correlates of serostatus disclosure to sexual partners. Methods We conducted a cross-sectional analytical study (exit interview) with a final sample of 485 postpartum women with HIV drawn from the East London Prospective Cohort study database between January and May 2018. Disclosure of HIV status to partner was based on self-reporting. We fitted adjusted and unadjusted logistic regression models and also conducted descriptive statistical analyses. Sampling weights were used to correct for sampling errors. Results Overall, 81.8% of women in the study cohort had disclosed their status to their partners, representing a 7.4 percentage point increase since child delivery. After adjusting for important covariates, women were more likely to disclose their status if they were married [adjusted odds ratio (AOR): 3.10; 95% confidence interval (CI):1.39–6.91] but were less likely to disclose if they used alcohol [AOR: 0.61; 95% CI:0.37–0.99] or had reported adherence to ART [AOR: 0.59; 95% CI:0.36–0.96]. Fear of rejection, stigma or being judged, new or casual relationships, and having a violent partner were the main reasons for not disclosing HIV status to sexual partners. Conclusion We found a relatively higher rate of HIV status disclosure in the cohort compared to the rate recorded at childbirth, suggesting an improvement over time. Also, complicated relationship dynamics and fear of social exclusion still constitute barriers to HIV status disclosure to sexual partners despite patients’ counselling.

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