Format

Send to

Choose Destination
PLoS One. 2017 Aug 24;12(8):e0181730. doi: 10.1371/journal.pone.0181730. eCollection 2017.

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

Author information

1
Department of Family Medicine and Rural Health, Walter Sisulu University, Cecilia Makiwane Hospital/East London Hospital Complex, East London, South Africa.
2
Department of Sociology, University of Fort Hare, East London, South Africa.
3
Buffalo City Metro Department of Health, East London, South Africa.
4
Faculty of Health Sciences, University of Fort Hare, East London, South Africa.
5
Department of Paediatrics, Walter Sisulu University, Frere Hospital/East London Hospital Complex, East London, South Africa.
6
Department of Family Medicine, Cecilia Makiwane Hospital/East London Hospital Complex, East London, South Africa.
7
Effective Care Research Unit, Walter Sisulu University, Frere hospital/East London Hospital Complex, East London, South Africa.
8
University College of Dublin/Mater Misericordiae University Hospital, Catherine McAuley Education & Research Centre, Dublin, Ireland.
9
The Relevance Network, Johannesburg, South Africa.
10
University College Dublin/Mater Misericordiae University Hospital, Catherine McAuley Education & Research Centre, Dublin, Ireland.

Abstract

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.

PMID:
28837563
PMCID:
PMC5570311
DOI:
10.1371/journal.pone.0181730
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center