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Prevalence and correlates of non-disclosure of maternal HIV status to male partners: a national survey in Kenya.
BMC Public Health. 2018 05 30; 18(1):671.BP

Abstract

BACKGROUND

Prevention of mother-to-child HIV transmission (PMTCT) programs usually test pregnant women for HIV without involving their partners. Non-disclosure of maternal HIV status to male partners may deter utilization of PMTCT interventions since partners play a pivotal role in decision-making within the home including access to and utilization of health services.

METHODS

Mothers attending routine 6-week and 9-month infant immunizations were enrolled at 141 maternal and child health (MCH) clinics across Kenya from June-December 2013. The current analysis was restricted to mothers with known HIV status who had a current partner. Multivariate logistic regression models adjusted for marital status, relationship length and partner attendance at antenatal care (ANC) were used to determine correlates of HIV non-disclosure among HIV-uninfected and HIV-infected mothers, separately, and to evaluate the relationship of non-disclosure with uptake of PMTCT interventions. All analyses accounted for facility-level clustering, RESULTS: Overall, 2522 mothers (86% of total study population) met inclusion criteria, 420 (17%) were HIV-infected. Non-disclosure of HIV results to partners was higher among HIV-infected than HIV-uninfected women (13% versus 3% respectively, p < 0.001). HIV-uninfected mothers were more likely to not disclose their HIV status to male partners if they were unmarried (adjusted odds ratio [aOR] = 3.79, 95% CI: 1.56-9.19, p = 0.004), had low (≤KSH 5000) income (aOR = 1.85, 95% CI: 1.00-3.14, p = 0.050), experienced intimate partner violence (aOR = 3.65, 95% CI: 1.84-7.21, p < 0.001) and if their partner did not attend ANC (aOR = 4.12, 95% CI: 1.89-8.95, p < 0.001). Among HIV-infected women, non-disclosure to male partners was less likely if women had salaried employment (aOR = 0.42, 95%CI: 0.18-0.96, p = 0.039) and each increasing year of relationship length was associated with decreased likelihood of non-disclosure (aOR = 0.90, 95% CI: 0.82-0.98, p = 0.015 for each year increase). HIV-infected women who did not disclose their HIV status to partners were less likely to uptake CD4 testing (aOR = 0.32, 95% CI: 0.15-0.69, p = 0.004), to use antiretrovirals (ARVs) during labor (OR = 0.38, 95% CI 0.15-0.97, p = 0.042), or give their infants ARVs (OR = 0.08, 95% CI 0.02-0.31, p < 0.001).

CONCLUSION

HIV-infected women were less likely to disclose their status to partners than HIV-uninfected women. Non-disclosure was associated with lower use of PMTCT services. Facilitating maternal disclosure to male partners may enhance PMTCT uptake.

Authors+Show Affiliations

Kenyatta National Hospital, P.O. Box 2590-00202, Nairobi, Kenya. kinuthia@uw.edu.Kenya Medical Research Institute, Nairobi, Kenya.University of Washington, Seattle, WA, USA.University of Washington, Seattle, WA, USA.Division of Global HIV & TB, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya.Division of Global HIV & TB, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya.Division of Global HIV & TB, US Centers for Disease Control and Prevention (CDC), Nairobi, Kenya.University of Washington, Seattle, WA, USA.University of Washington, Seattle, WA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29848345

Citation

Kinuthia, John, et al. "Prevalence and Correlates of Non-disclosure of Maternal HIV Status to Male Partners: a National Survey in Kenya." BMC Public Health, vol. 18, no. 1, 2018, p. 671.
Kinuthia J, Singa B, McGrath CJ, et al. Prevalence and correlates of non-disclosure of maternal HIV status to male partners: a national survey in Kenya. BMC Public Health. 2018;18(1):671.
Kinuthia, J., Singa, B., McGrath, C. J., Odeny, B., Langat, A., Katana, A., Ng'ang'a, L., Pintye, J., & John-Stewart, G. (2018). Prevalence and correlates of non-disclosure of maternal HIV status to male partners: a national survey in Kenya. BMC Public Health, 18(1), 671. https://doi.org/10.1186/s12889-018-5567-6
Kinuthia J, et al. Prevalence and Correlates of Non-disclosure of Maternal HIV Status to Male Partners: a National Survey in Kenya. BMC Public Health. 2018 05 30;18(1):671. PubMed PMID: 29848345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and correlates of non-disclosure of maternal HIV status to male partners: a national survey in Kenya. AU - Kinuthia,John, AU - Singa,Benson, AU - McGrath,Christine J, AU - Odeny,Beryne, AU - Langat,Agnes, AU - Katana,Abraham, AU - Ng'ang'a,Lucy, AU - Pintye,Jillian, AU - John-Stewart,Grace, Y1 - 2018/05/30/ PY - 2018/01/28/received PY - 2018/05/15/accepted PY - 2018/6/1/entrez PY - 2018/6/1/pubmed PY - 2019/6/30/medline KW - Antiretrovirals KW - HIV KW - Male partner KW - Non-disclosure KW - PMTCT SP - 671 EP - 671 JF - BMC public health JO - BMC Public Health VL - 18 IS - 1 N2 - BACKGROUND: Prevention of mother-to-child HIV transmission (PMTCT) programs usually test pregnant women for HIV without involving their partners. Non-disclosure of maternal HIV status to male partners may deter utilization of PMTCT interventions since partners play a pivotal role in decision-making within the home including access to and utilization of health services. METHODS: Mothers attending routine 6-week and 9-month infant immunizations were enrolled at 141 maternal and child health (MCH) clinics across Kenya from June-December 2013. The current analysis was restricted to mothers with known HIV status who had a current partner. Multivariate logistic regression models adjusted for marital status, relationship length and partner attendance at antenatal care (ANC) were used to determine correlates of HIV non-disclosure among HIV-uninfected and HIV-infected mothers, separately, and to evaluate the relationship of non-disclosure with uptake of PMTCT interventions. All analyses accounted for facility-level clustering, RESULTS: Overall, 2522 mothers (86% of total study population) met inclusion criteria, 420 (17%) were HIV-infected. Non-disclosure of HIV results to partners was higher among HIV-infected than HIV-uninfected women (13% versus 3% respectively, p < 0.001). HIV-uninfected mothers were more likely to not disclose their HIV status to male partners if they were unmarried (adjusted odds ratio [aOR] = 3.79, 95% CI: 1.56-9.19, p = 0.004), had low (≤KSH 5000) income (aOR = 1.85, 95% CI: 1.00-3.14, p = 0.050), experienced intimate partner violence (aOR = 3.65, 95% CI: 1.84-7.21, p < 0.001) and if their partner did not attend ANC (aOR = 4.12, 95% CI: 1.89-8.95, p < 0.001). Among HIV-infected women, non-disclosure to male partners was less likely if women had salaried employment (aOR = 0.42, 95%CI: 0.18-0.96, p = 0.039) and each increasing year of relationship length was associated with decreased likelihood of non-disclosure (aOR = 0.90, 95% CI: 0.82-0.98, p = 0.015 for each year increase). HIV-infected women who did not disclose their HIV status to partners were less likely to uptake CD4 testing (aOR = 0.32, 95% CI: 0.15-0.69, p = 0.004), to use antiretrovirals (ARVs) during labor (OR = 0.38, 95% CI 0.15-0.97, p = 0.042), or give their infants ARVs (OR = 0.08, 95% CI 0.02-0.31, p < 0.001). CONCLUSION: HIV-infected women were less likely to disclose their status to partners than HIV-uninfected women. Non-disclosure was associated with lower use of PMTCT services. Facilitating maternal disclosure to male partners may enhance PMTCT uptake. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/29848345/Prevalence_and_correlates_of_non_disclosure_of_maternal_HIV_status_to_male_partners:_a_national_survey_in_Kenya_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5567-6 DB - PRIME DP - Unbound Medicine ER -