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AIDS Behav. 2018 Dec;22(12):3945-3956. doi: 10.1007/s10461-018-2272-5.

HIV Disclosure Among Pregnant Women Initiating ART in Cape Town, South Africa: Qualitative Perspectives During the Pregnancy and Postpartum Periods.

Author information

1
Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708-0086, USA. melissa.watt@duke.edu.
2
Duke Global Health Institute, Duke University, Box 90519, Durham, NC, 27708-0086, USA.
3
Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
4
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
5
Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.

Abstract

For women enrolled in prevention of mother-to-child transmission (PMTCT) programs, non-disclosure of their HIV status can be a significant barrier to sustained HIV care engagement. To explore decision-making surrounding HIV disclosure among HIV-infected pregnant women, we conducted repeated in-depth interviews during pregnancy and postpartum with 20 women recruited from a PMTCT clinic in Cape Town, South Africa. Three domains were examined using thematic analysis: (1) disclosure experiences, (2) challenges associated with partner disclosure, and (3) implications of nondisclosure. All women had disclosed to someone by the time of the baby's birth, typically limiting their disclosure to trusted individuals. Only half of participants disclosed to the father of the child. Nondisclosure, particularly to partners, was a significant source of worry and stress. Women used pregnancy as an explanation for using medication and attending frequent clinic appointments, and recognized impending challenges in the postpartum period when this excuse would no longer apply. Results suggest that PMTCT programs have a key role to play in helping individuals to make decisions about HIV disclosure, and assisting patients to navigate the disclosure process, especially with partners.

KEYWORDS:

Disclosure; HIV; Option B+; PMTCT; Pregnancy; South Africa

PMID:
30196332
PMCID:
PMC6209531
[Available on 2019-12-01]
DOI:
10.1007/s10461-018-2272-5

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