Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study
Open Access
- 2 December 2013
- journal article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 13 (1), 1115
- https://doi.org/10.1186/1471-2458-13-1115
Abstract
Background Women’s ability to safely disclose their HIV-positive status to male partners is essential for uptake and continued use of prevention of mother-to-child transmission (PMTCT) services. However, little is known about the acceptability of potential approaches for facilitating partner disclosure. To lay the groundwork for developing an intervention, we conducted formative qualitative research to elicit feedback on three approaches for safe HIV disclosure for pregnant women and male partners in rural Kenya. Methods This qualitative acceptability research included in-depth interviews with HIV-infected pregnant women (n = 20) and male partners of HIV-infected women (n = 20) as well as two focus groups with service providers (n = 16). The participants were recruited at health care facilities in two communities in rural Nyanza Province, Kenya, during the period June to November 2011. Data were managed in NVivo 9 and analyzed using a framework approach, drawing on grounded theory. Results We found that facilitating HIV disclosure is acceptable in this context, but that individual participants have varying expectations depending on their personal situation. Many participants displayed a strong preference for couples HIV counseling and testing (CHCT) with mutual disclosure facilitated by a trained health worker. Home-based approaches and programs in which pregnant women are asked to bring their partners to the healthcare facility were equally favored. Participants felt that home-based CHCT would be acceptable for this rural setting, but special attention must be paid to how this service is introduced in the community, training of the health workers who will conduct the home visits, and confidentiality. Conclusion Pregnant couples should be given different options for assistance with HIV disclosure. Home-based CHCT could serve as an acceptable method to assist women and men with safe disclosure of HIV status. These findings can inform the design and implementation of programs geared at promoting HIV disclosure among pregnant women and partners, especially in the home-setting.This publication has 51 references indexed in Scilit:
- Association between Male Partner Involvement and the Uptake of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Mwanza District, Malawi: A Retrospective Cohort StudyPLOS ONE, 2013
- HIV-1 Prevention for HIV-1 Serodiscordant CouplesCurrent HIV/AIDS Reports, 2012
- Increased risk of HIV-1 transmission in pregnancy: a prospective study among African HIV-1-serodiscordant couplesAIDS, 2011
- Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern TanzaniaAIDS Care, 2011
- The forgotten half of the equationAIDS, 2011
- Disclosure of HIV status between spouses in rural MalawiAIDS Care, 2011
- HIV-Related Stigma, Social Norms, and HIV Testing in Soweto and Vulindlela, South Africa: National Institutes of Mental Health Project Accept (HPTN 043)JAIDS Journal of Acquired Immune Deficiency Syndromes, 2010
- HIV/AIDS Stigma and Refusal of HIV Testing Among Pregnant Women in Rural Kenya: Results from the MAMAS StudyAIDS and Behavior, 2010
- Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approachAIDS Care, 2010
- Factors Affecting Disclosure in South African HIV-Positive Pregnant WomenAIDS Patient Care and STDs, 2008